摘要
目的观察独活桂辛方联合布洛芬缓释胶囊治疗腰椎间盘突出症(LDH)急性期的临床疗效。方法将92例LDH急性期患者按入组时间顺序编号,随机分为2组。对照组46例(脱落1例)予布洛芬缓释胶囊治疗,治疗组46例(脱落1例)在对照组治疗基础上加独活桂辛方治疗,2组均治疗2周,治疗结束后随访4周。比较2组临床疗效,比较2组治疗前后及随访时疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)评分、日本骨科协会(JOA)腰椎评估治疗分数(以下简称JOA评分),比较2组治疗前后血清白细胞介素1β(IL-1β)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)水平以及胫神经、腓总神经运动传导速度。结果治疗后及随访时2组疼痛VAS、ODI评分均较本组治疗前显著降低(P<0.05),且治疗组均明显低于对照组同期(P<0.05);治疗后及随访时2组JOA评分均较本组治疗前明显升高(P<0.05),且治疗组均明显高于对照组同期(P<0.05)。治疗后2组血清IL-1β、IL-6、TNF-α水平与本组治疗前比较均明显下降(P<0.05),且治疗组均低于对照组(P<0.05)。治疗后2组胫神经和腓总神经运动传导速度均较本组治疗前显著增快(P<0.05),且治疗组均快于对照组(P<0.05)。治疗组总有效率91.11%(41/45),对照组总有效率73.33%(33/45),治疗组总有效率高于对照组(P<0.05)。结论加用独活桂辛方可以减轻LDH急性期患者腰部及下肢疼痛症状,改善患者腰椎功能,抑制炎症,其效果优于单用布洛芬缓释胶囊治疗。
Objective To observe the clinical efficacy of DuhuoGuixin decoction combined with Ibuprofen in the treatment of the acute stage of Lumbar disc herniation(LDH).Methods A total of 92 patients with the acute stage of LDH were randomly in 1∶1 ratio assigned to two groups according to the time sequence.The observation group(1 case of shedding)was treated with DuhuoGuixin decoction combined with ibuprofen,and while the control group(1 case of shedding)with ibuprofen alone.A four week follow-up was performed after 2-weeks treatment,aiming to compareclinical efficacy,visual analogue scale(VAS)score,Oswestry dysfunction index(ODI)score,the Japanese Orthopedic Association Back Pain Evaluation Questionnaire(JOA-BPEQ)score,as well as serum interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),and motor nerve conduction velocity of tibial nerve and common peroneal nerve.Results After treatment and during follow-up,the scores of VAS and ODI in two groups were significantly lower than those before treatment(P<0.05),which in the observation group were significantly lower than those in the concurrent control group(P<0.05).The JOA scores of the two groups after treatment and during follow-up were significantly higher than those before treatment(P<0.05),which in the observation group were significantly higher than the concurrent control group(P<0.05).After treatment,the serum levels of IL-1β,IL-6 and TNF-αin the two groups were significantly decreased compared with those before treatment(P<0.05),and the decrease was more obvious in the observation group(P<0.05).After treatment,and motor nerve conduction velocity of tibial nerve and common peroneal nervein the two groups was significantly faster than those before treatment(P<0.05),and the improvementof the observation group was more than the control group(P<0.05).The total effective rate in the observation group was superior to the control group(91.11%vs 73.33%,P<0.05).Conclusion DuhuoGuixin decoction combined with Ibuprofen can relieve the pain symptoms of lower back and lower limbs in patients withacute stage of LDH,and improve the lumbar function of patients.The effect is better than Ibuprofen alone,and the clinical use is safe and effective.
作者
王冠军
解纪惠
王大伟
梁晖
李倩
魏鹏洲
WANG Guanjun;XIE Jihui;WANG Dawei;LIANG Hui;LI Qian;WEI Pengzhou(Department of Orthopaedic,Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang,Hebei 050051;Department of Acupuncture and Moxibustion,Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang,Hebei 050051)
出处
《河北中医》
2023年第5期760-764,共5页
Hebei Journal of Traditional Chinese Medicine
基金
河北省中医药管理局2019年度中医药类科研计划项目(编号:2019447)。
关键词
椎间盘移位
腰椎
急性期
中医药疗法
腰椎功能
炎症因子
Lumbar disc herniation
Acute stage
chinese medicine therapy
Lumbar function
inflammatory factors
