通络祛痛膏治疗寒湿型腰椎间盘突出症疗效的回顾性队列研究  

Retrospective cohort study on the curative effect of Tongluo Qutong ointment on cold-dampness type lumbar disc herniation

作　　者：侯志慧 江小萌 幸超峰 孙小航 张凯 周明武 陈佳 HOU Zhi-hui;JIANG Xiao-meng;XING Chao-feng;SUN Xiao-hang;ZHANG Kai;ZHOU Ming-wu;CHEN Jia(Department of Orthopedics,No.988 Hospital of PLA Joint Logistics Support Force,Zhengzhou 450008,China)

机构地区：[1]联勤保障部队第九八八医院全军创伤骨科中心,郑州450008

出　　处：《中国新药杂志》2024年第13期1350-1355,共6页Chinese Journal of New Drugs

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20220913;LHGJ20220907;LHGJ20220908;LHGJ20220912)。

摘　　要：目的:研究通络祛痛膏治疗腰椎间盘突出症的临床疗效,并分析通络祛痛膏的疗效优势人群和使用禁忌。方法:选取我院符合寒湿型腰椎间盘突出症诊断标准及纳入标准的240例患者,随机分为对照组和治疗组,每组120例,再根据年龄、体重指数(body mass index,BMI)、病程将治疗组分成若干亚组。对照组采用针刺和康复训练治疗,针刺后采用“五点支撑法”进行康复训练,均为每周6次,2周为1个疗程。治疗组在对照组基础上,在康复训练后于相应穴位和疼痛部位给予通络祛痛膏贴敷,每次2~3片,每次贴敷时间8 h,qd,2周为1个疗程。结果:治疗前两组日本骨科协会评估治疗评分(Japanese Orthopaedic Association Scores,JOA)无显著差异;治疗后两组JOA评分均提高,治疗组明显高于对照组,两组比较有显著性差异(P<0.05)。治疗前两组McGill疼痛评分无显著性差异,治疗后两组McGill疼痛评分均降低,治疗组明显低于对照组,两组比较有显著性差异(P<0.05)。治疗组临床总有效率高于对照组,两组比较有显著性差异(P<0.05)。所有亚组均可改善腰椎间盘突出症疼痛,其中年龄>60岁、BMI<26.9、病程<3年为通络祛痛膏的疗效优势人群。结论:通络祛痛膏可显著提高寒湿型腰椎间盘突出症患者的腰椎功能,建议在临床中选择有相应特征的患者使用。Objective:To study the clinical effect of Tongluo Qutong ointment in the treatment of lumbar disc herniation,and analyze the therapeutic advantages of Tongluo Qutong ointment and its contraindications.Methods:A total of 240 patients with cold-dampness type lumbar disc herniation in our hospital were selected and randomly divided into control group and treatment group,with 120 cases in each group.The treatment group was divided into several subgroups according to age,BMI and course of disease.The control group was treated with acupuncture and rehabilitation training,after acupuncture,“five-point support method”was used for rehabilitation training.All of them were treated 6 times a week and 1 course 2 weeks.On the basis of the control group,after rehabilitation training,Tongluo Qutong ointment was applied at the corresponding points and pain sites,2~3 tablets each time,for 8 hours each time,once a day,2 weeks for a course of treatment.Results:Before treatment,there was no significant difference in the Japanese Orthopaedic Association evaluates treatment(JOA)score between the two groups.After treatment,JOA score in both groups increased,and that in the treatment group was significantly higher than the control group with significant difference(P<0.05).Before treatment,there was no significant difference in McGill pain scores between the two groups.After treatment,the McGill pain score in both groups decreased,and the treatment group was significantly lower than the control group,with significant difference(P<0.05).The total clinical effective rate of the treatment group was higher than that of the control group(P<0.05).The pain of lumbar disc herniation was improved in all subgroups.Among them,age>60 years old,BMI<26.9,and the disease course<3 years were the curative advantage of Tongluo Qutong Ointment.Conclusion:Tongluo Qutong ointment can significantly improve the lumbar function of patients with cold-dampness type lumbar disc herniation,and it is recommended to select patients with corresponding characteristi

关 键 词：通络祛痛膏 寒湿型 腰椎间盘突出症 腰痛 队列研究 

分 类 号：R971[医药卫生—药品]