补阳还五汤加味联合颈腰椎整脊手法对腰椎间盘突出症患者血液流变学、氧化应激及表面肌电图的影响  

Effects of modified Buyang Huanwu Decoction combined with cervical and lumbar spine manipulation on hemorheology,oxidative stress and surface electromyography in patients with lumbar disc herniation

作　　者：刘泉江 刘赵 邱俊麟 LIU Quanjiang;LIU Zhao;QIU Junlin(Second Department of Orthopedics,Neijiang Hospital of Traditional Chinese Medicine,Neijiang,Sichuan 641000)

机构地区：[1]四川省内江市中医医院关节骨二科,四川内江641000

出　　处：《河北中医》2025年第3期396-400,共5页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的观察补阳还五汤加味联合颈腰椎整脊手法对腰椎间盘突出症患者血液流变学、氧化应激及表面肌电图的影响。方法选取2022年2月至2023年2月内江市中医医院中医骨伤科收治的腰椎间盘突出症患者92例,按照随机数字表法分为2组,每组46例。对照组予颈腰椎整脊手法治疗,治疗组在对照组基础上加补阳还五汤加味治疗。比较2组治疗后临床疗效及治疗前后腰功能[Oswestry功能障碍指数(ODI)、日本骨科协会(JOA)腰椎功能评分]、疼痛情况[疼痛视觉模拟评分(VAS)]、血液流变学[全血黏度(高切)、血浆黏度、血小板聚集率(PAR)、纤维蛋白原]、氧化应激[总抗氧化能力(T-AOC)、活性氧(ROS)、丙二醛(MDA)]及表面肌电图(患侧腰部竖脊肌、多裂肌的平均振幅值及平均频率斜率)变化情况。结果治疗组总有效率93.48%(43/46),对照组总有效率78.26%(36/46),治疗组总有效率明显高于对照组(P<0.05)。治疗后,2组ODI评分、疼痛VAS均较本组治疗前降低(P<0.05),JOA腰椎功能评分均较本组治疗前升高(P<0.05),且治疗后治疗组ODI、疼痛VAS均低于对照组(P<0.05),JOA腰椎功能评分高于对照组(P<0.05)。治疗后,2组全血黏度(高切)、血浆黏度、PAR、纤维蛋白原均较本组治疗前降低(P<0.05),且治疗后治疗组均低于对照组(P<0.05)。治疗后,2组T-AOC水平均较本组治疗前升高(P<0.05),ROS、MDA水平均较本组治疗前降低(P<0.05),且治疗后治疗组T-AOC水平高于对照组(P<0.05),ROS、MDA水平低于对照组(P<0.05)。治疗后,2组患侧腰部竖脊肌和多裂肌平均振幅值及平均频率斜率均较本组治疗前升高(P<0.05),且治疗后治疗组均高于对照组(P<0.05)。结论补阳还五汤加味联合颈腰椎整脊手法治疗腰椎间盘突出症具有较好的临床疗效,可改善腰功能,减轻疼痛,并能改善血液流变学、氧化应激和表面肌电图等指标。Objective To investigate the effects of modified Buyang Huanwu Decoction combined with cervical and lumbar spine manipulation on hemorheology,oxidative stress and surface electromyography(sEMG)in patients with lumbar disc herniation(LDH).Methods A total of 92 LDH patients admitted to Department of Orthopedics of Traditional Chinese Medicine,Neijiang Hospital of Traditional Chinese Medicine from February 2022 to February 2023 were randomised 1∶1 to receive cervical and lumbar spine manipulation(control group)or modified Buyang Huanwu Decoction+cervical and lumbar spine manipulation(treatment group).The aim was to compare waist function(Oswestry Disability Index[ODI],Japanese Orthopaedic Association[JOA]score),visual analogue scale(VAS)for pain,hemorheology(whole blood high shear viscosity,plasma viscosity,platelet aggregation rate[PAR],fibrinogen),oxidative stress indexes(total antioxidant capacity[T-AOC],reactive oxygen species[ROS],malondialdehyde[MDA]),sEMG(average amplitudes and frequency slope of lumbar erector spinae and multifidus muscle of the diseased side).The curative effect was assessed.Results The overall effective rate in the treatment group was significantly higher than that in the control group(93.48%[43/46]vs 78.26%[36/46],P<0.05).After treatment,significantly decreased ODI and VAS scores,and increased JOA scores were found in the both groups(all P<0.05),and the treatment group was superior to the control group for the scores of ODI,VAS and JOA(all P<0.05).The whole blood high shear viscosity,plasma viscosity,PAR,fibrinogen in the both groups were significantly decreased(P<0.05),which were significantly decreased in the treatment group than in the control group(P<0.05).Significantly increased T-AOC levels,and decreased ROS and MDA levels were found in the both groups(all P<0.05),and the different was significant between groups for the above indexes(all P<0.05).The average amplitudes and frequency slope of lumbar erector spinae and multifidus muscle of the diseased side in the both groups were si

关 键 词：椎间盘移位 腰椎 补阳还五汤加味 捏脊疗法 血液流变学 氧化应激 肌电描记术 

分 类 号：R681.533.105.31[医药卫生—骨科学]