通督活血汤对腰椎间盘突出症急性期患者腰椎功能及血清炎症因子水平的影响  

Effect of Tongdu Huoxue Decoction on Lumbar Spine Function and Serum Inflammatory Factor Levels in Patients with Acute Lumbar Disc Herniation

作　　者：熊雨墨 李梓宸 李瑛 肖强兵 王丽华 胡昊 丰瑞兵 乔杰 胡彦 XIONG Yumo;LI Zichen;LI Ying;XIAO Qiangbing;WANG Lihua;HU Hao;FENG Ruibing;QIAO Jie;HU Yan(Bone Injury Diagnosis and Treatment Center of Hubei Research Institute of Traditional Chinese Medicine,Hubei Provincial Hospital of Traditional Chinese Medicine(TCM)/Affiliated Hospital of Hubei University of Chinese Medicine,Wuhan 430074,China;School of Acupuncture and Moxibustion and Orthopaedics,Hubei University of Chinese Medicine,Wuhan 430074,China;Department of TCM,Jianghan University,Wuhan 430074,China;Honghu City Hospital of TCM/Honghu Hospital of TCM Affiliated to Hubei University of Chinese Medicine,Jingzhou 433200,China)

机构地区：[1]湖北省中医院/湖北中医药大学附属医院,湖北省中医药研究院骨伤诊疗中心,武汉430074 [2]湖北中医药大学针灸骨伤学院,武汉430074 [3]江汉大学中医系,武汉430074 [4]洪湖市中医医院/湖北中医药大学附属洪湖中医医院,湖北荆州433200

出　　处：《中国实验方剂学杂志》2024年第13期135-141,共7页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：湖北省中医药管理局2023—2024年度中医药面上项目(ZY2023M005);湖北省中医药管理局2023—2024年度中医药青年人才项目(ZY2023Q004,ZY2023Q006)。

摘　　要：目的:观察通督活血汤治疗腰椎间盘突出症(LDH)急性期的临床疗效。方法:将2020年1月至2023年6月湖北省中医院和洪湖市中医医院骨科门诊收治的316例LDH急性期患者随机分为2组。对照组156例(脱落2例)予美洛昔康片治疗,观察组153例(脱落5例)予以通督活血汤治疗,2组均治疗3个月。比较2组临床疗效、治疗前后及McGill疼痛积分量表(SF-MPQ)、Oswestry功能障碍指数(ODI)评分、日本骨科协会下腰痛评价量表评分(JOA)、采用酶联免疫吸附测定法(ELISA)检测患者治疗前后血清白细胞介素-1β(IL-1β)、IL-6、肿瘤坏死因子-α(TNF-α)水平,采用NDI-092型肌电图诱发电位仪检测2组患者治疗前后的胫神经、腓总神经运动传导速度及临床疗效疗效,并比较2组患者的临床安全性。结果:治疗后观察组总有效率95.4%(146/153),对照组总有效率76.3%(119/156),观察组总有效率高于对照组(χ^(2)=23.18,P<0.05)。与本组治疗前比较,2组患者的SF-MPQ、ODI评分,IL-1β、IL-6、TNF-α水平均明显降低(P<0.05),与对照组治疗后比较,观察组下降更为明显(P<0.05)。2组患者的JOA得分、胫神经、腓总神经运动性传导速度均明显升高(P<0.05),与对照组治疗后比较,观察组升高更明显(P<0.05)。结论:通督活血方能够缓解LDH急性期腰腿痛、改善腰椎功能、抑制炎性反应,具有较好的安全性,值得临床推广。Objective:To observe the clinical efficacy of Tongdu Huoxue decoction in the treatment of acute lumbar disc herniation(LDH).Method:A total of 316 patients with acute LDH admitted to the orthopedic outpatient department of Hubei Provincial Hospital of Traditional Chinese Medicine and Honghu City Hospital of Traditional Chinese Medicine from January 2020 to June 2023 were randomly divided into two groups.156 cases in the control group(two cases with stopped follow-up)were treated with meloxicam tablets,while 153 cases in the observation group(five cases with stopped follow-up)were treated with Tongdu Huoxue decoction.Both groups were treated for three months.The clinical efficacy,McGill Pain Score Scale(SF-MPQ),Oswestry Dysfunction Index(ODI)score,and the Japanese Orthopaedic Association(JOA)scores of the two groups before and after treatment were compared.The serum levels of interleukin-1β(IL-1β),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)of the patients before and after treatment were determined by using enzyme-linked immunosorbent assay(ELISA).The NDI-092 type electromyographyevoked potential instrument was adopted to measure the motor conduction velocity and clinical efficacy of the tibial and common peroneal nerves in patients of the two groups before and after treatment,and the clinical safety of the two groups of patients was compared.Result:After treatment,the total effective rate in the observation group was 95.4%(146/153),significantly higher than that in the control group of 76.3%(119/156)(χ^(2)=23.18,P<0.05).After treatment,both groups showed significant reductions in SF-MPQ and ODI scores,as well as the levels of IL-1β,IL-6,and TNF-α(P<0.05),with the observation group showing a more significant reduction(P<0.05).Both groups showed a significant increase in JOA scores and motor conduction velocities of the tibial and common peroneal nerves after treatment(P<0.05),with the observation group showing a more significant increase(P<0.05).Conclusion:Tongdu Huoxue decoction can alleviate lumb

关 键 词：椎间盘突出 中医药疗法 腰椎功能 炎症因子 

分 类 号：R242[医药卫生—中医临床基础] R2-031[医药卫生—中医学] R289R274R68