益气温阳通痹方联合西药治疗肾虚血瘀型腰椎间盘突出症临床研究  

Clinical Study on Yiqi Wenyang Tongbi Prescription Combined with Western Medicine for Lumbar Disc Herniation of Kidney Deficiency and Blood Stasis Type

作　　者：王啸川 高梓博 陈凯 黄澄宇 林小栋 李永津[3] WANG Xiaochuan;GAO Zibo;CHEN Kai;HUANG Chengyu;LIN Xiaodong;LI Yongjin(The Second Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou Guangdong 510405,China;The Eighth Clinical Medical School of Guangzhou University of Chinese Medicine,Foshan Guangdong 528051,China;Spinal Department of Guangdong Provincial Hospital of Chinese Medicine,Guangzhou Guangdong 510120,China)

机构地区：[1]广州中医药大学第二临床医学院,广东广州510405 [2]广州中医药大学第八临床医学院,广东佛山528051 [3]广东省中医院脊柱科,广东广州510120

出　　处：《新中医》2025年第2期68-74,共7页New Chinese Medicine

基　　金：国家自然科学基金面上项目(82274554);广东省自然科学基金项目(2021A15150111474);广州市科技计划项目(202201020324);广东省中医院-拔尖人才资助专项(BJ2022YL07)。

摘　　要：目的:观察益气温阳通痹方联合西药治疗肾虚血瘀型腰椎间盘突出症的临床疗效。方法:选取2023年3月—2024年3月在广东省中医院脊柱科门诊就诊的60例肾虚血瘀型腰椎间盘突出症患者,采用随机数字表法分为对照组和试验组各30例。2组均服用依托考昔片、甲钴胺片治疗,试验组加服益气温阳通痹方治疗。2组均治疗4周。治疗前后评定2组患者的中医证候评分、腰部疼痛视觉模拟评分法(VAS)评分、下腰痛日本骨科协会(JOA)评分和Oswestry功能障碍指数(ODI)评分。评价2组的临床疗效,观察不良反应发生情况。结果:治疗4周后,2组总有效率、临床疗效分别比较,差异均无统计学意义(P>0.05)。2组腰部疼痛,腰膝酸软,面色不华、手足不温,下肢乏力、麻木及活动受限评分及总分均呈降低趋势;2组内各时间点的5项中医证候评分及总分比较,差异均有统计学意义(P<0.05)。治疗2周,2组5项中医证候评分及总分均较治疗前下降,差异均有统计学意义(P<0.05)。治疗4周,2组5项中医证候评分及总分均较治疗前、治疗2周下降,差异均有统计学意义(P<0.05);试验组5项中医证候评分及总分均低于对照组(P<0.05)。治疗后,2组VAS评分及ODI评分均呈降低趋势,JOA评分均呈升高趋势。2组内各时间点VAS评分、JOA评分及ODI评分分别比较,差异均有统计学意义(P<0.05)。治疗2周,2组VAS评分、ODI评分均较治疗前下降,JOA评分均较治疗前升高,差异均有统计学意义(P<0.05);2组VAS评分、JOA评分及ODI评分比较,差异均无统计学意义(P>0.05)。治疗4周,2组VAS评分、ODI评分均较治疗前、治疗2周下降,JOA评分均较治疗前、治疗2周升高,差异均有统计学意义(P<0.05);试验组VAS评分、ODI评分均低于对照组,JOA评分高于对照组,差异均有统计学意义(P<0.05)。2组治疗期间均未发生不良反应。结论:益气温阳通痹方联合依托考昔片及甲钴胺片治疗方�Objective:To observe the clinical effect of the therapy of Yiqi Wenyang Tongbi Prescription combined with western medicine on lumbar disc herniation(LDH)of kidney deficiency and blood stasis type.Methods:A total of 60 LDH patients of kidney deficiency and blood stasis type who were treated at the Clinic of Spine Department of Guangdong Provincial Hospital of Chinese Medicine from March 2023 to March 2024 were enrolled and divided into the control group and the trial group according to the random number table method,with 30 patients in each group.Both groups were treated with Etoricoxib Tablets and Mecobalamin Tablets.The trial group was additionally treated with Yiqi Wenyang Tongbi Prescription.Both groups were treated for four weeks.The traditional Chinese medicine syndrome scores,and the scores of Visual Analogue Scale(VAS)of lumbar pain,Japanese Orthopaedic Association(JOA)of low back pain,and Oswestry Disability Index(ODI)in both groups before and after treatment were evaluated;the clinical effects in the two groups were evaluated,and the incidence of adverse reactions was observed.Results:After four weeks of treatment,there were no significant difference being found in the comparison of the total effective rate and the clinical efficacy between the two groups(P>0.05).After treatment,the scores of low back pain,soreness and weakness of waist and knees,pale complexion and cold extremities,weakness and numbness of lower limbs,and limited mobility,and the total scores in both groups showed a decreasing trend;there were significant difference being found in the comparison of the data at each time point in both groups(P<0.05).After two weeks of treatment,the above scores in both groups were respectively dwindled when compared with those before treatment,differences being significant(P<0.05).After four weeks of treatment,the above scores in both groups were down-regulated when compared with those before treatment and after two weeks of treatment,differences being significant(P<0.05);the above scores in the trial gr

关 键 词：腰椎间盘突出症 肾虚血瘀证 益气温阳通痹方 腰椎功能 

分 类 号：R274.9[医药卫生—中西医结合]