恒古骨伤愈合剂口服联合经皮定向离子导入治疗对腰椎间盘突出症患者疼痛、腰椎功能、血清学指标的影响  

Effects of Oral Use Combined with Percutaneous Iontophoresis of Osteoking on Pain,Lumbar Function and Serological Indicators of Patients with Lumbar Disc Herniation

作　　者：罗鑫磊 刘晶晶[1] 王晓曦 范建云 纳强 劳常滔 LUO Xin-Lei;LIU Jing-Jing;WANG Xiao-Xi;FAN Jian-Yun;NA Qiang;LAO Chang-Tao(Honghe Hospital Affiliated to Kunming Medical University,Honghe 651400 Yunnan,China;Dept.of Orthopedics,the Sixth Affiliated Hospital of Kunming Medical University,Yuxi 653100 Yunnan,China)

机构地区：[1]昆明医科大学附属红河医院,云南红河651400 [2]昆明医科大学第六附属医院骨科,云南玉溪653100

出　　处：《广州中医药大学学报》2024年第6期1444-1449,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：云南省教育厅科学研究基金资助项目(编号:2023Y0956);云南省“兴滇英才支持计划”项目(编号:YNWR-MY-2020-033)。

摘　　要：【目的】分析恒古骨伤愈合剂(主要成分为陈皮、红花、三七、杜仲、人参、洋金花、黄芪、钻地风、鳖甲等)口服联合经皮定向离子导入(简称透药)治疗对腰椎间盘突出症(LDH)患者疼痛、腰椎功能、血清学指标的影响。【方法】将92例LDH患者随机分为对照组31例、口服组31例和联合组30例。对照组给予塞来昔布口服治疗,口服组给予恒古骨伤愈合剂口服治疗,联合组给予恒古骨伤愈合剂口服联合透药治疗,疗程为6周。观察3组患者治疗前后疼痛视觉模拟量表(VAS)评分、腰椎功能日本骨科协会(JOA)评分及血清肿瘤坏死因子α(tumor necrosis factorα,TNF-α)、基质金属蛋白酶3(matrix metalloproteinase 3,MMP-3)水平的变化情况。【结果】(1)研究过程中,对照组和口服组各失访2例,联合组无失访病例,最终对照组和口服组各29例、联合组30例患者纳入统计分析。(2)治疗后,3组患者的疼痛VAS评分和腰椎功能JOA评分均较治疗前明显下降(P<0.05);组间比较,联合组对疼痛VAS评分和腰椎功能JOA评分的下降幅度均明显优于对照组和口服组(P<0.05),而对照组与口服组比较,差异均无统计学意义(P>0.05)。(3)治疗后,3组患者的血清TNF-α水平均较治疗前明显下降(P<0.05);但治疗后3组间比较,差异无统计学意义(P>0.05)。(4)治疗后,口服组与联合组患者的血清MMP-3水平均较治疗前明显下降(P<0.05),而对照组患者的血清MMP-3水平较治疗前无明显下降(P>0.05);组间比较,口服组、联合组对血清MMP-3水平的下降幅度均明显优于对照组(P<0.05),而口服组与联合组比较,差异无统计学意义(P>0.05)。【结论】恒古骨伤愈合剂能够有效减轻LDH患者疼痛症状,改善患者腰椎活动功能,同时可有效降低血清TNF-α、MMP-3水平,其中以恒古骨伤愈合剂口服联合透药治疗的效果最佳。Objective To investigate the effects of oral use combined with percutaneous iontophoresis of Osteoking(mainly composed of Citri Reticulatae Pericarpium,Carthami Flos,Notoginseng Radix et Rhizoma,Eucommiae Cortex,Ginseng Radix et Rhizoma,Daturae Flos,Astragali Radix,Radix et Caulis Schizophragma Integrifolia,and Trionycis Carapax)on the pain,lumbar function and serological indicators of the patients with lumbar disc herniation(LDH).Methods Ninety-two patients with LDH were randomly divided into control group(31 cases),oral use group(31 cases)and combination group(30 cases).The control group was given oral administration of Celecoxib,the oral use group was given oral administration of Osteoking,and the combination group was given oral administration combined with percutaneous iontophoresis of Osteoking.The course of treatment for the 3 groups covered 6 weeks.The changes of pain visual analogue scale(VAS)score,lumbar function Japanese Orthopedic Association(JOA)score,serum tumor necrosis factor alpha(TNF-α)and matrix metalloproteinase 3(MMP-3)levels in the three groups were observed before and after treatment.Results(1)During the trial,there were 2 patients from both control group and oral use group lost to follow-up,but none of the combination group was lost to follow-up.Eventually,29 patients in the control group,29 patients in the oral group and 30 patients in the combination group were included in the statistical analysis.(2)After treatment,the pain VAS score and lumbar function JOA score in the three groups were significantly lower than those before treatment(P<0.05).The intergroup comparison showed that the decrease of pain VAS score and lumbar function JOA score in the combination group was significantly superior to that in the control group and the oral use group(P<0.05),while there was no significant difference between the control group and the oral use group(P>0.05).(3)After treatment,the serum TNF-αlevel in the three groups was significantly lower than that before treatment(P<0.05),while no significant

关 键 词：恒古骨伤愈合剂 经皮定向离子导入(透药) 腰椎间盘突出症 塞来昔布 肿瘤坏死因子α(TNF-α) 基质金属蛋白酶3(MMP-3) 

分 类 号：R681.57[医药卫生—骨科学] R274.9[医药卫生—外科学]