活血通督汤联合理筋手法对肾虚血瘀型退行性腰椎管狭窄症患者腰椎后伸角和血液流变学的影响  

Effect of Huoxue Tongdu Decoction combined with tendon-soothing maneuver on lumbar posterior angle and hemorheology in patients with degenerative lumbar spinal stenosis of kidney blood type

作　　者：黄华 王生余 曾令辉 雷智坚 黎习之 钟远鸣[2] HUANG Hua;WANG Shengyu;ZENG Linghui;LEI Zhijian;LI Xizhi;ZHONG Yuanming(Second Department of Orthopedics,Nanning Hospital of Traditional Chinese Medicine,Nanning,Guangxi 530004;Department of Orthopedics,the First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning,Guangxi 530004)

机构地区：[1]广西壮族自治区南宁市中医医院骨二科,广西南宁530004 [2]广西中医药大学第一附属医院骨科,广西南宁530004

出　　处：《河北中医》2024年第6期907-910,914,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：广西壮族自治区中医药管理局自筹经费科研课题(编号:GXZYZ20210238)。

摘　　要：目的观察活血通督汤联合理筋手法对肾虚血瘀型退行性腰椎管狭窄症(DLSS)患者腰椎后伸角和血液流变学的影响。方法将210例肾虚血瘀型DLSS患者按照随机数字表法分为2组,均予常规西医治疗。对照组105例加理筋手法治疗,治疗组105例在对照组治疗基础上联合活血通督汤治疗,2组均治疗8周。比较2组疗效;比较2组治疗前后中医证候评分;比较2组治疗前后血液流变学指标血浆黏度、红细胞比容(PCV)、纤维蛋白原(FIB)变化;比较2组治疗前后腰椎后伸角、日本骨科协会(JOA)评分变化;比较2组不良反应情况。结果治疗组总有效率94.29%(99/105),对照组总有效率79.05%(83/105),治疗组疗效优于对照组(P<0.05)。2组治疗后各项中医证候评分及总评分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后血浆黏度、PCV、FIB均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后腰椎后伸角、JOA评分均较本组治疗前升高(P<0.05),且治疗组升高更明显(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论活血通督汤联合理筋手法治疗肾虚血瘀型DLSS疗效确切,可有效改善患者血液流变学,增大腰椎后伸角,改善腰椎功能。Objective To observe the effect of Huoxue Tongdu Decoction combined with tendon-soothing maneuver on lumbar posterior angle and hemorheology in patients with degenerative lumbar spinal stenosis(DLSS)of kidney blood type.Methods A total of 210 DLSS patients of kidney blood type were randomly assigned into the treatment group(n=105)and the control group(n=105).All patients were managed by routine Western medicine and tendon-soothing maneuver,and those in the treatment group were additionally treated with Huoxue Tongdu Decoction.The aim was to compare traditional Chinese medicine(TCM)syndrome score,hemorheology indexes(plasma viscosity,packed cell volume[PCV],fibrinogen[FIB]),lumbar posterior angle,Japanese Orthopaedic Association(JOA),adverse reactions.The curative effect was assessed.Results The overall effective rate in the treatment group was better than that in the control group(94.29%[99/105]vs 79.05%[83/105],[P<0.05],respectively).After treatment,the patients in the two groups presented significantly lower TCM syndrome score and plasma viscosity,PCV,FIB,significantly higher the lumbar posterior angle and JOA scores than those before treatment(all P<0.05),and the improvements were more pronounced in the treatment group than in the control group(all P<0.05).The incidence of adverse reactions between groups was comparable(P>0.05).Conclusion For DLSS patients of kidney blood type,Huoxue Tongdu Decoction combined with tendon-soothing maneuver has definite curative effect,which can effectively improve hemorheology,increase lumbar posterior angle,and improve lumbar function.

关 键 词：脊柱 腰椎 椎管 椎管狭窄 中药疗法 正骨手法 

分 类 号：R681.533.2[医药卫生—骨科学] R289.6[医药卫生—外科学]