补中益气汤加减治疗气血亏虚型腰椎间盘突出症疗效及对患者疼痛程度的影响研究  

Effects of modified Buzhong Yiqi decoction on score of pain degree in LDH of qi-blood deficiency syndrome

作　　者：李忠泽 李嘉玮 白春晓[1] 覃昌龙 张超 董若愚 陈劲松 陈江[1] LI Zhongze;LI Jiawei;BAI Chunxiao;QIN Changlong;ZHANG Chao;DONG Ruoyu;CHEN Jinsong;CHEN Jiang(The First Ward,Department of Orthopedics,Dongzhimen Hospital of Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院骨伤科一区,北京100700

出　　处：《陕西中医》2024年第10期1340-1344,共5页Shaanxi Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助面上项目(82374492);北京中医药大学校级课题新教师启动基金资助项目(2023-BUCMXJSY015);北京中医药大学研究生自主科研课题(ZJKT2023081)。

摘　　要：目的:探讨补中益气汤加减治疗气血亏虚型腰椎间盘突出症疗效及对患者疼痛程度评分、Oswestry功能障碍指数问卷表(ODI)评分及血清人谷胱甘肽过氧化酶4(GPX4)、长链脂酰辅酶A合成酶4(ACSL4)水平的影响。方法:选取80例气血亏虚型腰椎间盘突出症患者,采用随机数字表法将患者分为补中益气组和对照组,每组40例,对照组采用常规西药治疗,补中益气组在对照组基础上采用补中益气汤加减治疗,两组均持续治疗8周。比较两组临床疗效、治疗前后中医证候评分、疼痛程度、ODI评分和血清GPX4、ACSL4水平变化以及两组治疗期间的不良反应发生情况。结果:补中益气组治疗总有效率为97.50%,对照组治疗总有效率为80.00%,差异有统计学意义(P<0.05)。治疗后,补中益气组的中医证候积分均较对照组低,Oswestry功能障碍指数(ODI)和视觉模拟评分(VAS)均较对照组低,两组GPX4水平较治疗前升高,ACSL4水平较治疗前降低,补中益气组血清GPX4水平较对照组高,ACSL4水平较对照组低,差异均有统计学意义(P<0.05)。补中益气组患者不良反应发生率为2.50%,对照组为5.00%,差异无统计学意义(P>0.05)。结论:补中益气汤加减治疗气血亏虚型腰椎间盘突出症具有较好效果,可以显著降低患者疼痛程度、改善腰椎功能障碍,降低患者体内炎症水平,并能在一定程度上延缓椎间盘内铁死亡进程。Objective:To explore the effects of modified Buzhong Yiqi decoction on score of pain degree and Oswestry disability index(ODI),levels of serum human glutathione peroxidase 4(GPX4)and long-chain acyl-CoA synthetase 4(ACSL4)in lumbar disc herniation(LDH)of qi-blood deficiency syndrome.Methods:A total of 80 patients with lumbar disc herniation(qi-blood deficiency syndrome)were enrolled.According to random number table method,they were divided into Buzhong Yiqi group(n=40)and control group(n=40).The control group was treated with routine western medicine,while Buzhong Yiqi group was treated with modified Buzhong Yiqi decoction on basis of control group for 8 weeks.The clinical curative effect,changes in scores of TCM syndromes,pain degree and ODI,levels of serum GPX4 and ACSL4 before and after treatment,and the occurrence of adverse reactions during treatment were compared between the two groups.Results:The difference in response rate of treatment between Buzhong Yiqi group and control group was statistically significant(P<0.05).After treatment,scores of TCM syndromes,Oswestry dysfunction index(ODI)and visual analogue scale(VAS)were lower in Buzhong Yiqi group than control group(P<0.05).After treatment,GPX4 level was increased,while ACSL4 level was decreased in both groups.The level of serum GPX4 in Buzhong Yiqi group was higher than that in control group,while ACSL4 level was lower than that in control group(P<0.05).There was no significant difference in the incidence of adverse reactions between Buzhong Yiqi group and control group(P>0.05).Conclusion:The curative effect of modified Buzhong Yiqi decoction is good in patients with LDH of qi-blood deficiency syndrome,which can significantly relieve pain,improve lumbar dysfunction,reduce inflammation level and delay ferroptosis process in intervertebral disc to some extent.

关 键 词：腰椎间盘突出症 气血亏虚型 补中益气汤 疼痛程度 血清人谷胱甘肽过氧化酶4 长链脂酰辅酶A合成酶4 铁死亡 

分 类 号：R681.53[医药卫生—骨科学]