长蛇灸联合加味独活寄生汤对腰椎间盘突出症肝肾亏虚证患者炎症因子及腰椎功能的影响  

Effects of long-snake moxibustion combined with modified Duhuo Jisheng Decoction on inflammatory factors and lumbar function in patients with liver-kidney deficiency pattern of lumbar disc herniation

作　　者：吕明芳[1,2] 朱小燕 万康敏 王艳 LYU Mingfang;ZHU Xiaoyan;WAN Kangmin;WANG Yan(Nanchang Hongdu Hospital of Traditional Chinese Medicine,Nanchang 330013,China;Traditional Chinese Medicine Weight Management Center,Nanchang 330038,China)

机构地区：[1]南昌市洪都中医院,南昌330013 [2]江西省中医体重管理中心

出　　处：《北京中医药大学学报》2024年第8期1171-1176,共6页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(No.82160932);江西省卫生健康委员会科技计划项目(No.20204087,No.202140179)。

摘　　要：目的探讨长蛇灸联合加味独活寄生汤治疗腰椎间盘突出症肝肾亏虚证的临床疗效。方法将2021年3月—2023年4月就诊于南昌市洪都中医院且符合纳入标准的腰椎间盘突出症肝肾亏虚证患者按随机数字法分为对照组和试验组,每组68例。对照组采用西医常规治疗,试验组在对照组的基础上给予长蛇灸联合加味独活寄生汤治疗,连续4周。观察2组患者临床疗效、日本骨科协会(JOA)评分、中医证候积分,检测血清前列腺素E2(PGE2)、转化生长因子-β1(TGF-β1)、白细胞介素-1β(IL-1β)、基质金属蛋白酶-2(MMP-2)、缺氧诱导因子-1α(HIF-1α)水平。结果与对照组临床疗效(79.41%)比较,试验组临床疗效(94.12%)升高(P<0.05)。与治疗前比较,2组患者治疗后中医证候积分降低,JOA评分升高,血清PGE2、TGF-β1、MMP-2、HIF-1α、IL-1β均降低(均P<0.05)。治疗后,与对照组比较,试验组患者中医证候积分降低,JOA评分升高,血清PGE2、TGF-β1、MMP-2、HIF-1α、IL-1β均降低(均P<0.05)。结论长蛇灸联合加味独活寄生汤可明显减轻腰椎间盘突出症肝肾亏虚证患者的炎症反应,抑制疼痛介质的分泌,改善腰椎功能,从而提高临床疗效。Objective This study aimed to investigate the clinical effect of long-snake moxibustion combined with modified Duhuo Jisheng Decoction in the treatment of the liver-kidney deficiency pattern of lumbar disc herniation.Methods All patients with liver-kidney deficiency pattern of lumbar disc herniation admitted to Nanchang Hongdu Hospital of Traditional Chinese Medicine from March 2021 to April 2023 were assigned the control group and the experimental group by random number table method,with 68 cases in each group.The control group was treated with conventional Western medicine,and the experimental group was treated with long-snake moxibustion combined with modified Duhuo Jisheng Decoction based on the control group for four consecutive weeks.Observe the clinical efficacy,the Japanese Orthopedic Association(JOA)score,and traditional Chinese medicine syndrome score of two groups of patients.Detect the serum levels of prostaglandin E2(PGE2),transforming growth factor-β1(TGF-β1),interleukin-1β(IL-1β),matrix metalloproteinase-2(MMP-2),and hypoxia-inducible factor-1α(HIF-1α)in two groups of patients.Results Compared with the control group(79.41%),the clinical efficaly of experimental group(94.12%)was increased(P<0.05).Compared with before treatment,TCM syndrome score of 2 groups was decreased,JOA score was increased,serum PGE2,TGF-β1,MMP-2,HIF-1α,and IL-1βwere decreased after treatment(P<0.05).After treatment,compared with control group,TCM syndrome score of experimental group was decreased,JOA score was increased,serum PGE2,TGF-β1,MMP-2,HIF-1α,and IL-1βwere decreased(P<0.05).Conclusion Long-snake moxibustion combined with modified Duhuo Jisheng Decoction can significantly reduce the inflammatory response of patients with liver-kidney deficiency pattern of lumbar disc herniation,inhibit the secretion of pain mediators,improve lumbar function,and thus improve clinical efficacy.

关 键 词：长蛇灸 加味独活寄生汤 腰椎间盘突出症 肝肾亏虚证 

分 类 号：R245.8[医药卫生—针灸推拿学]