药罐联合独活寄生汤治疗寒湿瘀阻型腰椎间盘突出症临床研究
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R255.6;R681.5+3

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Clinical Study on Medicated Cupping Combined with Duhuo Jisheng Decoction in the Treatment of Lumbar Disc Herniation of Cold-Damp Stagnation and Obstruction Type
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    摘要:

    目的:观察药罐联合独活寄生汤治疗寒湿瘀阻型腰椎间盘突出症(LDH) 的临床疗效。方法:回 顾性分析浙江中医药大学附属温州市中医院2023年6月—2024年6月期间骨科接诊的162例寒湿瘀阻型LDH患 者的临床资料,按排除标准剔除22例,最终纳入140例作为研究对象,根据治疗方案的不同分为独活寄生组 64 例和药罐联合组76 例。独活寄生组采用独活寄生汤治疗,药罐联合组在独活寄生组的基础上联合药罐 治疗。比较2组临床疗效、日本骨科协会评分法(JOA) 评分、中医证候评分、血清炎症因子[转化生长因 子-β1 (TGF-β1)、基质金属蛋白酶-2(MMP-2)、白细胞介素(IL) -23]、疼痛相关因子[环氧化酶(COX-2)、 神经生长因子(NGF)、降钙素基因相关肽(CGRP)] 水平及不良反应发生率。结果:药罐联合组总有效率为 93.42%(71/76),独活寄生组为81.25%(52/64),2组比较,差异有统计学意义(P<0.05)。治疗后,2组中医 证候评分较治疗前降低(P<0.05),JOA评分较治疗前升高(P<0.05);且药罐联合组中医证候评分低于独活 寄生组(P<0.05),JOA评分高于独活寄生组(P<0.05)。治疗后,2组血清TGF-β1、MMP-2、IL-23水平均 较治疗前降低(P<0.05),且药罐联合组上述3项指标水平均低于独活寄生组(P<0.05)。治疗后,2组COX-2、 NGF、CGRP水平均较治疗前降低(P<0.05),且药罐联合组上述3项指标水平均低于独活寄生组(P<0.05)。 药罐联合组不良反应发生率为5.26% (4/76),独活寄生组为4.69% (3/64),2 组比较,差异无统计学意 义(P>0.05)。结论:药罐联合独活寄生汤治疗寒湿瘀阻型LDH疗效较好,能下调血清炎症因子及疼痛相关 因子水平,改善中医证候及腰椎功能。

    Abstract:

    Abstract: Objective: To observe the clinical efficacy of medicated cupping combined with Duhuo Jisheng Decoction in the treatment of lumbar disc herniation (LDH) with cold-damp stagnation and obstruction syndrome. Methods:A retrospective analysis was conducted on the clinical data of 162 LDH patients with cold-damp stagnation and obstruction syndrome who were admitted to the Department of Orthopedics of Wenzhou TCM Hospital of Zhejiang Chinese Medical University between June 2023 and June 2024. After excluding 22 cases based on exclusion criteria, 140 patients were ultimately included as study subjects. They were divided into the Duhuo Jisheng group (64 cases) and the medicated cupping combination group (76 cases) based on their treatment regimens. The Duhuo Jisheng group received treatment with Duhuo Jisheng Decoction alone, while the medicated cupping combination group received combined treatment with medicated cupping on the basis of treatment of Duhuo Jisheng group. The clinical efficacy, Japanese Orthopaedic Association (JOA) assessment scores, traditional Chinese medicine syndrome scores, serum inflammatory factor levels [transforming growth factor- β1 (TGF- β1), matrix metalloproteinase-2 (MMP-2), interleukin-23 (IL-23)], levels of pain-related factors [cyclooxygenase-2 (COX-2), nerve growth factor (NGF), calcitonin gene-related peptide (CGRP)],and incidence of adverse reactions were compared between the two groups. Results:The total effective rate was 93.42% (71/76) in the medicated cupping combination group and 81.25% (52/ 64) in the Duhuo Jisheng group, with a statistically significant difference between the two groups (P<0.05). After treatment,traditional Chinese medicine syndrome scores decreased (P<0.05) and JOA scores increased (P<0.05) in both groups compared to before treatment. The medicated cupping combination group had lower traditional Chinese medicine syndrome scores (P<0.05) and higher JOA scores (P<0.05) than the Duhuo Jisheng group. After treatment, serum levels of TGF-β1,MMP-2,and IL-23 decreased in both groups compared to before treatment (P<0.05),and the levels of these indicators in the medicated cupping combination group were lower than those in the Duhuo Jisheng group (P<0.05). After treatment, the levels of COX-2, NGF, and CGRP decreased in both groups compared to before treatment (P<0.05),and the levels of these indicators in the medicated cupping combination group were lower than those in the Duhuo Jisheng group (P<0.05). The incidence of adverse reactions was 5.26% (4/76) in the medicated cupping combination group and 4.69% (3/64) in the Duhuo Jisheng group,with no statistically significant difference between the two groups (P>0.05). Conclusion:The combination of medicated cupping and Duhuo Jisheng Decoction demonstrates good efficacy in the treatment of LDH with cold-damp stagnation and obstruction syndrome. It can downregulate serum levels of inflammatory factors and pain-related factors, and improve traditional Chinese medicine syndromes and lumbar function.

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何应平,林叶艳,包展程.药罐联合独活寄生汤治疗寒湿瘀阻型腰椎间盘突出症临床研究[J].新中医,2026,58(8):99-103

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  • 在线发布日期: 2026-04-29
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