补肝健腰汤联合悬吊核心肌群训练治疗肝肾亏虚型慢性非特异性下腰痛临床研究  

Clinical Study on Bugan Jianyao Decoction Combined with Suspension Core Muscle Training for Chronic Nonspecific Low Back Pain of Liver-Kidney Deficiency Type

作　　者：赵村辉 李道通 廖继东 范亚朋 刘佳 张雅琪 ZHAO Cunhui;LI Daotong;LIAO Jidong;FAN Yapeng;LIU Jia;ZHANG Yaqi(Luoyang Orthopedic-Traumatological Hospital of Henan Province/Henan Provincial Orthopedic Hospital,Luoyang Henan 471100,China)

机构地区：[1]河南省洛阳正骨医院/河南省骨科医院,河南洛阳471100

出　　处：《新中医》2025年第6期51-56,共6页New Chinese Medicine

基　　金：河南省中医药科学研究专项项目(2021ZYA061)。

摘　　要：目的:观察补肝健腰汤联合悬吊核心肌群训练治疗肝肾亏虚型慢性非特异性下腰痛(NLBP)的临床疗效。方法:选取2021年1月—2024年1月在河南省洛阳正骨医院/河南省骨科医院治疗的200例肝肾亏虚型慢性NLBP患者,按随机数字表法分为联合组与训练组各100例。训练组给予悬吊核心肌群训练治疗,联合组在训练组基础上给予补肝健腰汤治疗。2组均治疗4周。比较2组临床疗效、中医证候积分、不同体位下(最大后伸位、最大前屈位)核心肌群平均频率(MNF)、氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)、过氧化氢酶(CAT)]、Oswestry功能障碍指数(ODI)评分及疼痛视觉模拟评分法(VAS)评分。结果:治疗4周后,联合组总有效率94.00%(94/100),高于训练组78.00%(78/100)(P<0.05)。2组主症、次症积分及中医证候总积分均较治疗前降低(P<0.05),联合组主症、次症积分及中医证候总积分均低于训练组(P<0.05)。2组最大前屈位和最大后伸位时竖脊肌、多裂肌、腹直肌MNF值均较治疗前升高(P<0.05),联合组最大前屈位和最大后伸位时竖脊肌、多裂肌、腹直肌MNF值均高于训练组(P<0.05)。2组血清SOD、CAT水平均较治疗前升高(P<0.05),联合组血清SOD、CAT水平均高于训练组(P<0.05)。2组血清MDA水平均较治疗前降低(P<0.05),联合组血清MDA水平低于训练组(P<0.05)。2组ODI、VAS评分均较治疗前降低(P<0.05),联合组ODI、VAS评分均低于训练组(P<0.05)。结论:补肝健腰汤联合悬吊核心肌群训练治疗肝肾亏虚型慢性NLBP疗效显著,可有效减轻临床症状,改善核心肌群功能,作用机制可能与缓解氧化应激损伤有关。Objective:To observe the clinical effect of Bugan Jianyao Decoction combined with suspension core muscle training on chronic nonspecific low back pain(NLBP)of liver-kidney deficiency type.Methods:A total of 200 cases of patients with chronic NLBP of liver-kidney deficiency type,treated at Luoyang Orthopedic-Traumatological Hospital of Henan Province/Henan Provincial Orthopedic Hospital from January 2021 to January 2024,were selected and divided into the combination group and the training group,with 100 cases in each group.The training group was treated with suspension core muscle training,and the combination group was additionally treated with Bugan Jianyao Decoction based on the treatment of the training group.Both groups were treated for four weeks.The clinical effects,traditional Chinese medicine(TCM)syndrome scores,mean frequency(MNF)of core muscles in different positions(maximum extension,maximum flexion),oxidative stress indexes[superoxide dismutase(SOD),malondialdehyde(MDA),catalase(CAT)],Oswestry Disability Index(ODI)scores,and Visual Analogue Scale(VAS)scores of pain were compared between the two groups.Results:After four weeks of treatment,the total effective rate was 94.00%(94/100)in the combination group,higher than that of 78.00%(78/100)in the training group(P<0.05).The main and secondary symptom scores,and the total TCM syndrome scores in the two groups were decreased when compared with those before treatment(P<0.05),with the combination group showing lower scores than the training group(P<0.05).The MNF values of the erector spinae,multifidus muscle,and rectus abdominis in both maximum flexion and extension positions in the two groups were increased when compared with those before treatment(P<0.05),with the combination group showing higher MNF values than the training group(P<0.05).The levels of SOD and CAT in serum in the two groups were increased when compared with those before treatment(P<0.05),with the combination group showing higher levels than the training group(P<0.05).Serum MDA levels in th

关 键 词：慢性非特异性下腰痛 肝肾亏虚证 补肝健腰汤 悬吊核心肌群训练 氧化应激 

分 类 号：R274.9[医药卫生—中西医结合]