温经强腰合剂治疗风寒痹阻型腰椎间盘突出症临床研究
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R681.5+3;R274.9

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上海市卫生和计划生育委员会中医药科研项目(2018LQ006);上海市黄浦区科研项目(HKQ201805)


Clinical Study on Wenjing Qiangyao Mixture for Lumbar Disc Herniation of Wind-Cold Obstruction Type
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    摘要:

    目的:观察温经强腰合剂治疗风寒痹阻型腰椎间盘突出症临床研究。方法:选取130 例腰椎间盘 突出患者,按随机数字表法分为试验组及对照组各65 例。试验组采用温经强腰合剂治疗,对照组采用风湿骨 痛胶囊治疗。观察2 组临床疗效及不良反应发生情况,比较2 组治疗前后腰部疼痛情况[疼痛视觉模拟评分 法(VAS)、日本骨科协会(JOA) 下腰疼评分]及中医证候评分、白细胞介素-6 (IL-6)、肿瘤坏死因子- α(TNF-α)、超氧化物歧化酶(SOD)、一氧化氮(NO)、环氧化物酶-2(COX-2)、内皮素-1(ET-1)、前列 腺素E2 (PGE2)、白细胞介素-1β(IL-1β) 水平的变化。结果:试验组临床总有效率为98.46%,对照组临床 总有效率为80.00%,2 组比较,差异有统计学意义(P<0.05)。治疗后3 d、10 d、20 d,2 组VAS 评分均低于 治疗前,JOA 评分均高于治疗前,差异有统计学意义(P<0.05);治疗后3 d、10 d、20 d,试验组VAS 评分 低于对照组,JOA 评分高于对照组,差异有统计学意义(P<0.05)。治疗后,2 组腰部重痛、受寒加重、活动 痛甚、活动受限中医证候评分均较治疗前下降(P<0.05),试验组上述4 项中医证候评分均低于对照组(P< 0.05)。治疗后,2 组血清炎性因子IL-6、TNF-α、NO 水平均较治疗前下降(P<0.05),SOD 水平均较治疗前 上升(P<0.05),试验组IL-6、NO、TNF-α 水平均低于对照组(P<0.05),SOD 水平高于对照组(P< 0.05)。治疗后,2 组血清疼痛介质因子COX-2、ET-1、PGE2、IL-1β 水平均较治疗前下降(P<0.05),试验 组上述4 项血清疼痛介质因子水平均低于对照组(P<0.05)。2 组治疗期间均未出现明显不良反应。结论:温 经强腰合剂治疗腰椎间盘突出症效果较优,可有效降低患者腰部疼痛感,改善腰部功能,安全有效。

    Abstract:

    Abstract: Objective: To observe the clinical study on Wenjing Qiangyao Mixture for lumbar disc herniation of wind-cold obstruction type. Methods:A total of 130 patients with lumbar disc herniation were selected and divided into the trial group and the control group,with 65 cases in each group. The trial group was given Wenjing Qiangyao Mixture for treatment, and the control group was treated with Fengshi Gutong Capsules. The clinical effects and incidence of adverse reactions in both groups were observed;the changes of lumbar pain, including scores of Visual Analogue Scale (VAS) and Japanese Orthopaedic Association (JOA),traditional Chinese medicine (TCM) syndrome scores,and levels of interleukin-6 (IL-6), tumor necrosis factor- α (TNF- α) , superoxide dismutase (SOD) , nitric oxide (NO) , cyclooxygenase- 2 (COX-2), endothelin-1 (ET-1), prostaglandin E2 (PGE2) and interleukin-1 β (IL-1 β) were compared between the two groups before and after treatment. Results:The total clinical effective rate was 98.46% in the trial group and 80.00% in the control group,the difference being significant (P<0.05). Three days,ten days and twenty days after treatment, the VAS scores in the two groups were lower than those before treatment,and the JOA scores were higher than those before treatment,the difference being significant (P<0.05). After treatment, the TCM syndrome scores of heavy pain in the lumbar, cold- induced aggravation, great pain when moving and limited movement in both groups were decreased when compared with those before treatment (P<0.05),and the above scores in the trial group were lower than those in the control group (P<0.05). After treatment,the levels of serum inflammatory factors,including IL- 6,NO and TNF- α in both groups were decreased when compared with those before treatment (P< 0.05),the SOD levels were increased when compared with those before treatment (P<0.05);the levels of IL-6,NO and TNF-α in the trial group were lower than those in the control group (P<0.05),and the SOD level was higher than that in the control group (P<0.05). After treatment, the levels of serum pain mediators, including COX- 2, ET- 1, PGE2 and IL- 1β in both groups were decreased when compared with those before treatment (P<0.05),and the above levels in the trial group were lower than those in the control group (P<0.05). There was no obvious adverse reaction in the two groups during treatment. Conclusion: Wenjing Qiangyao Mixture has a good curative effect on lumbar disc herniation, which can effectively reduce the lumbar pain of patients,and improve the lumbar function with good safety.

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张吉仁,吴军豪,屠安琪,余益群,沈祉培,吴海洋.温经强腰合剂治疗风寒痹阻型腰椎间盘突出症临床研究[J].新中医,2023,55(23):125-129

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  • 在线发布日期: 2023-12-13
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