身痛逐瘀汤协同常规治疗对破裂型腰椎间盘突出症患者髓核重吸收的影响  

Effects of Shentong Zhuyu Decoction combined with conventional treatment on nucleus pulposus reabsorption in patients with ruptured lumbar disc herniation

作　　者：程俊 熊辉[2] 伍智亮 徐无忌[1] 杨雷 李汪洋 CHENG Jun;XIONG Hui;WU Zhiliang;XU Wuji;YANG Lei;LI Wangyang(The Second Hospital of Hunan University of Chinese Medicine,Changsha,Hunan 410005,China;Hunan University of Chinese Medicine,Changsha,Hunan 410208,China)

机构地区：[1]湖南中医药大学第二附属医院,湖南长沙410005 [2]湖南中医药大学,湖南长沙410208

出　　处：《湖南中医药大学学报》2024年第11期2043-2048,共6页Journal of Hunan University of Chinese Medicine

基　　金：湖南省中医药管理局一般项目(B2024087)。

摘　　要：目的研究身痛逐瘀汤协同常规治疗对破裂型腰椎间盘突出症血瘀证患者髓核重吸收的影响。方法将2022年12月至2023年12月湖南中医药大学第二附属医院66例破裂型腰椎间盘突出症血瘀证患者按随机数字表法分为对照组和治疗组,各33例。对照组给予常规治疗,治疗组在对照组基础上予以身痛逐瘀汤治疗,两组均治疗2周。比较两组患者的突出髓核体积及重吸收率,腰椎功能日本骨科学会(Japanese Orthopaedic Association,JOA)评分,免疫炎症因子[白细胞介素(interleukin,IL)-1β、IL-6和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)]表达,中医证候积分,临床疗效及不良反应事件。结果与治疗前相比,治疗后两组患者的突出髓核体积、血清IL-1β、IL-6、TNF-α水平及中医证候积分均降低(P<0.05),且治疗组均低于对照组(P<0.05);而突出髓核重吸收率、JOA评分及临床疗效均升高(P<0.05),且治疗组均高于对照组(P<0.05)。结论身痛逐瘀汤联合常规治疗可促进破裂型腰椎间盘突出血瘀证患者的髓核重吸收,并提高腰椎功能和中医证候积分,降低免疫炎症反应,提高患者生活质量。Objective To investigate the effects of Shentong Zhuyu Decoction(STZYD)combined with conventional treatment on nucleus pulposus reabsorption in patients with ruptured lumbar disc herniation(LDH)of blood stasis pattern.Methods A total of 66 patients with ruptured LDH of blood stasis pattern who presented the Second Hospital of Hunan University of Chinese Medicine from December 2022 to December 2023 were divided into control group and treatment group according to the random number table method,with 33 patients in each group.The control group received conventional treatment,while the treatment group was treated with STZYD in addition to the treatment of the control group.Both groups were treated for two weeks.Comparisons were made between the two groups in terms of herniated nucleus pulposus volume and reabsorption rate,Japanese Orthopaedic Association(JOA)score,expression levels of immune inflammatory factors such as interleukin-1β(IL-1β),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α),Chinese medicine(CM)pattern scores,clinical efficacy,and adverse events.Results Compared with before treatment,both groups showed significant reductions in the herniated nucleus pulposus volume,serum levels of IL-1β,IL-6,and TNF-α,as well as CM pattern scores after treatment(P<0.05),with the treatment group demonstrating lower values than the control group(P<0.05).Additionally,there were significant increases in the herniated nucleus pulposus reabsorption rate,JOA scores,and clinical efficacy after treatment(P<0.05),with the treatment group showing higher values than the control group(P<0.05).Conclusion STZYD combined with conventional treatment can promote the reabsorption of herniated nucleus pulposus in patients with ruptured LDH of blood stasis pattern,improve the lumbar function and CM pattern scores,reduce immune inflammatory responses,and enhance patients'quality of life.

关 键 词：腰椎间盘突出症 身痛逐瘀汤 重吸收 破裂型 血瘀 

分 类 号：R274[医药卫生—中医骨伤科学]