通络祛痛膏与腰椎牵引法联合治疗寒湿痹阻证腰椎间盘突出症的临床效果观察  

Observation on clinical effect of Tongluo Qutong ointment combined with lumbar traction in the treatment of lumbar disc herniation with cold-dampness obstruction syndrome

作　　者：王富 WANG Fu(Department of Orthopedics,Jinan Integrated Traditional Chinese and Western Medicine Hospital,Jinan 271100,China)

机构地区：[1]济南市中西医结合医院骨科,271100

出　　处：《中国实用医药》2024年第15期24-27,共4页China Practical Medicine

摘　　要：目的探究在寒湿痹阻证腰椎间盘突出症治疗中使用通络祛痛膏联合腰椎牵引法的临床效果。方法抽取96例寒湿痹阻证腰椎间盘突出症患者,抽签分为对照组与研究组,各48例。对照组患者给予腰椎牵引法治疗,研究组患者给予腰椎牵引法与通络祛痛膏联合治疗。对比两组患者的中医证候积分、腰椎功能、腰椎关节活动度、生活质量、腰椎疼痛程度、血清细胞因子与血管内皮生长因子(VEGF)。结果中医证候积分方面,研究组患者腰背刺痛积分为(1.65±0.36)分,坐骨神经痛积分为(0.55±0.58)分,下肢麻木积分为(1.57±0.30)分,均低于对照组的(2.34±0.44)、(1.42±0.43)、(2.11±0.45)分(t=8.409、8.348、6.918,P<0.05);研究组患者日本骨科协会(JOA)评分为(21.01±3.23)分,比对照组的(19.34±2.18)分更高,而Oswestry功能障碍指数(ODI)评分为(16.24±2.30)分,低于对照组的(18.59±2.08)分(t=2.969、5.250,P<0.05);研究组患者腰椎前屈度为(40.17±3.04)°,腰椎后伸度为(19.17±3.07)°,均高于对照组的(33.11±4.15)°、(16.05±3.05)°(t=9.508、4.995,P<0.05);研究组患者躯体功能评分为(88.71±5.59)分,社会功能评分为(91.05±9.84)分,心理功能评分为(93.52±9.34)分,均高于对照组的(73.26±5.53)、(86.07±9.41)、(86.32±9.30)分(t=13.613、2.534、3.785,P<0.05);研究组患者VEGF为(104.11±23.51)ng/L,白细胞介素-1β(IL-1β)为(83.75±13.31)ng/L,白细胞介素-6(IL-6)为(64.24±12.18)ng/L,肿瘤坏死因子-α(TNF-α)为(52.14±10.04)ng/L,均低于对照组的(134.65±30.42)、(97.30±13.42)、(74.01±13.23)、(68.53±10.08)ng/L(t=5.503、4.967、3.764、7.982,P<0.05);研究组患者视觉模拟评分法(VAS)评分为(2.04±0.48)分,低于对照组的(3.51±0.46)分(t=15.319,P<0.05)。结论联合使用腰椎牵引法与通络祛痛膏可改善寒湿痹阻证腰椎间盘突出症患者的临床症状,提升腰椎功能与关节活动度,减轻疼痛,从而提升生活质量,促进患者康复。Objective To explore the clinical effect of Tongluo Qutong ointment combined with lumbar traction in the treatment of lumbar disc herniation with cold-dampness obstruction syndrome.Methods 96 cases of lumbar disc herniation patients with cold-dampness obstruction syndrome were selected and divided into a control group and a study group,each with 48 cases.The control group was treated with lumbar traction,while the study group was treated with lumbar traction and Tongluo Qutong ointment.The scores of traditional Chinese medicine syndromes,lumbar function,lumbar mobility,quality of life,degree of lumbar pain,serum cytokines and vascular endothelial growth factor(VEGF)were compared between the two groups.Results In terms of traditional Chinese medicine syndrome scores,the scores for low back pain,sciatica and lower limb numbness of the study group were(1.65±0.36),(0.55±0.58),and(1.57±0.30)points,which were lower than(2.34±0.44),(1.42±0.43)and(2.11±0.45)points of the control group(t=8.409,8.348,6.918;P<0.05).The Japanese Orthopaedic Association(JOA)score of the study group was(21.01±3.23)points,which was higher than(19.34±2.18)points of the control group,while the Oswestry Disability Index(ODI)score was(16.24±2.30)points,which was lower than(18.59±2.08)points of the control group(t=2.969,5.250;P<0.05).The lumbar anterior flexion and lumbar posterior extension in the study group were(40.17±3.04)and(19.17±3.07)°,which were higher than(33.11±4.15)°and(16.05±3.05)°in the control group(t=9.508,4.995;P<0.05).In the study group,the scores of physical function, social function and psychological function were (88.71±5.59), (91.05±9.84) and (93.52± 9.34) points, which were higher than (73.26±5.53), (86.07±9.41), (86.32±9.30) points in the control group (t=13.613, 2.534, 3.785;P<0.05). The study group had VEGF of (104.11±23.51) ng/L, interleukin-1β (IL-1β) of (83.75±13.31) ng/L, interleukin-6 (IL-6) of (64.24±12.18) ng/L, and tumor necrosis factor-α (TNF-α) of (52.14±10.04) ng/L, which were lower

关 键 词：腰椎间盘突出症 寒湿痹阻证 通络祛痛膏 腰椎牵引 

分 类 号：R274.9[医药卫生—中西医结合]