血府逐瘀汤联合温针灸治疗腰椎间盘突出症疼痛的临床研究  

Clinical Study of Xuefu Zhuyu Decoction(血府逐瘀汤)Combined with Warming Acupuncture and Moxibustion on Pain of Lumbar Disc Herniation

作　　者：于涛[1,2] 邢春旭 郑维 王海 李晓宁 YU Tao;XING Chunxu;ZHENG Wei;WANG Hai;LI Xiaoning(Heilongjiang University of Chinese Medicine,Harbin 150000,Heilongjiang,China;The Second Affiliated Hospital of Mudanjiang Medical University,Mudanjiang 157010,Heilongjiang,China;The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150000,Heilongjiang,China)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150000 [2]牡丹江医科大学附属第二医院,黑龙江牡丹江157010 [3]黑龙江中医药大学附属第二医院,黑龙江哈尔滨150000

出　　处：《中华中医药学刊》2025年第4期213-217,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：黑龙江省卫生健康委员会科研项目(2020-397)。

摘　　要：目的探究血府逐瘀汤联合温针灸治疗腰椎间盘突出症疼痛的疗效及对疼痛介质和炎症因子的影响。方法选取2022年2月—2023年8月牡丹江医学院附属第二医院收治的腰椎间盘突出症疼痛患者86例。采用随机数字表法分为研究组和对照组,各43例。对照组予以温针灸治疗,研究组在对照组基础上联合血府逐瘀汤治疗。治疗14 d后,比较两组患者的中医证候、疗效、疼痛程度、血清疼痛介质及炎症因子、日常活动能力,记录治疗期间的不良反应。结果两组治疗后主证评分、次证评分均降低(P<0.05),研究组治疗后主症评分、次症评分低于对照组(P<0.05)。研究组治疗总有效率高于对照组(P<0.05)。两组治疗后腰痛、放射痛、偏移性疼痛、神经痛评分均降低(P<0.05);研究组治疗后腰痛、放射痛、偏移性疼痛、神经痛低于对照组(P<0.05)。两组治疗后5-羟色胺(5-hydroxytryptamine,5-HT)、前列腺素E2(Prostaglandin E2,PGE2)、肿瘤坏死因子-α(Tumor necrosis factor-alpha,TNF-α)均降低(P<0.05);研究组治疗后5-HT、PGE2、TNF-α低于对照组(P<0.05)。两组治疗后日常活动能力(Daily activity ability,ADL)评分均升高(P<0.05),Oswestry功能障碍指数(Oswestry disability index,ODI)评分均降低(P<0.05);研究组治疗后ADL评分高于对照组(P<0.05),ODI评分低于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论血府逐瘀汤联合温针灸治疗腰椎间盘突出症,有助于缓解患者的疼痛程度,抑制疼痛及炎症因子表达,提高患者的日常活动能力。Objective To explore the therapeutic effect of Xuefu Zhuyu Decoction(血府逐瘀汤)combined with warm acupuncture and moxibustion on the pain of lumbar disc herniation and its influence on pain mediators and inflammatory factors.Methods Eighty-six patients with lumbar disc herniation pain admitted to the Second Affiliated Hospital of Heilongjiang University o Chinese Medicine from February 2022 to August 2023 were selected and divided into a study group and a control group using a random number table method,with 43 cases in each group.The control group was treated with warm acupuncture and moxibustion,while the study group was treated with Xuefu Zhuyu Decoction on the basis of the control group.After 14 days of treatment,the traditional Chinese medicine symptoms,efficacy,degree of pain,serum pain mediators and inflammatory factors,and daily activity ability of the two groups of patients were compared,and adverse reactions during the treatment period were recorded.Results After treatment,the main symptom scores and secondary symptom scores decreased in both groups(P<0.05).The main symptom scores and secondary symptom scores in the study group were lower than those in the control group after treatment(P<0.05).The total effective rate in the study group was higher than that in the control group(P<0.05).Both groups showed a decrease in scores of back pain,radiating pain,referred pain and neuropathic pain after treatment(P<0.05).The study group had lower scores of back pain,radiating pain,referred pain and neuropathic pain than the control group after treatment(P<0.05).The levels of serotonin(5-HT),prostaglandin E2(PGE2)and tumor necrosis factor-alpha(TNF-α)decreased in both groups after treatment(P<0.05).The study group had lower levels of 5-HT,PGE2 and TNF-αthan the control group after treatment(P<0.05).The activities of daily living(ADL)scores increased(P<0.05),and the Oswestry Disability Index(ODI)scores decreased in both groups after treatment(P<0.05).The study group had higher ADL scores than the control gro

关 键 词：腰椎间盘突出症 疼痛 温针灸 血府逐瘀汤 疼痛因子 

分 类 号：R245.8[医药卫生—针灸推拿学] R274.981.53[医药卫生—中医临床基础]