补肾通痹汤治疗腰椎间盘突出症的效果及对炎性因子的影响
|
摘要
目的研究补肾通痹汤治疗腰椎间盘突出症(LDH)的效果及对炎性因子的影响。方法选择2017年1月～2018年6月石家庄市第一医院接受治疗的LDH患者80例进行研究。按随机数字表法将患者分成观察组及对照组,每组各40例。对照组给予牵引及理疗治疗,观察组在对照组的治疗基础上再增加补肾通痹汤,两组均治疗3周。比较两组临床效果,治疗前及治疗3周后的功能及疼痛评分,炎性因子以及不良反应发生率。结果观察组的总有效率高于对照组(P <0.05)。治疗后两组的视觉模拟评分及Oswestry功能障碍指数(ODI)评分均低于治疗前,且观察组低于对照组;而日本骨科协会评估治疗(JOA)评分高于治疗前,且观察组高于对照组(P <0.05)。治疗后两组的C反应蛋白、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α及白细胞介素-6均低于治疗前(P <0.05),且观察组低于对照组(P <0.05)。观察组药物不良反应的总发生率与对照组比较,差异无统计学意义(P> 0.05)。结论应用补肾通痹汤治疗LDH的效果与安全性均较好,还可有效地改善患者的功能及疼痛评分,以及机体的炎症状态。
Objective To study the effect of Bushen Tongbi Decoction on lumbar disc herniation(LDH) and its influence on inflammatory factors. Methods From January 2017 to September 2018, 80 LDH patients treated in the First Hospital of Shijiazhuang were studied. According to random number table method, patients were randomly divided into observation group and control group, there were 40 cases in each group. The control group was treated with traction and physiotherapy, the observation group was treated with Bushen Tongbi Decoction on the basis of control group, both groups were treated for 3 weeks. The efficacy, functional and pain score, inflammatory factor, and incidence of adverse reaction before treatment and 3 weeks after treatment was compared between the two groups. Results The total effective rate of the observation group was higher than the control group(P < 0.05). After treatment, the visual analogue scale(VAS) and osuesery dability index(ODI) score in the two groups was lower than before treatment, and the observation group was lower than the control group, the Japanese Orthpaedic assoiationscores(JOA) score was higher than before treatment, and the observation group was higher than that of the control group(P < 0.05). The C-reactive protein,interleukin-1β, tumor necrosis factor-α and IL-6 were lower in the two groups after treatment than before treatment(P <0.05), and lower in the observation group than in the control group(P < 0.05). The incidence of adverse drug reactions in the observation group was not significantly different compared with that in the control group(P > 0.05). Conclusion The efficacy and safety of Bushen Tongbi Decoction in the treatment of LDH is good. It can also effectively improve the function, pain score and inflammatory state of the patients.
Objective To study the effect of Bushen Tongbi Decoction on lumbar disc herniation(LDH) and its influence on inflammatory factors. Methods From January 2017 to September 2018, 80 LDH patients treated in the First Hospital of Shijiazhuang were studied. According to random number table method, patients were randomly divided into observation group and control group, there were 40 cases in each group. The control group was treated with traction and physiotherapy, the observation group was treated with Bushen Tongbi Decoction on the basis of control group, both groups were treated for 3 weeks. The efficacy, functional and pain score, inflammatory factor, and incidence of adverse reaction before treatment and 3 weeks after treatment was compared between the two groups. Results The total effective rate of the observation group was higher than the control group(P < 0.05). After treatment, the visual analogue scale(VAS) and osuesery dability index(ODI) score in the two groups was lower than before treatment, and the observation group was lower than the control group, the Japanese Orthpaedic assoiationscores(JOA) score was higher than before treatment, and the observation group was higher than that of the control group(P < 0.05). The C-reactive protein,interleukin-1β, tumor necrosis factor-α and IL-6 were lower in the two groups after treatment than before treatment(P <0.05), and lower in the observation group than in the control group(P < 0.05). The incidence of adverse drug reactions in the observation group was not significantly different compared with that in the control group(P > 0.05). Conclusion The efficacy and safety of Bushen Tongbi Decoction in the treatment of LDH is good. It can also effectively improve the function, pain score and inflammatory state of the patients.
引文
[1]刘秀剑.补肾祛瘀汤治疗腰椎间盘突出症的临床研究[J].湖南中医药大学学报,2018,38(5):562-565.
[2]陈俊枢.腰椎间盘突出症患者经综合保守治疗的临床分析[J].临床医学工程,2015,22(5):612-613.
[3]王晓宁.探讨补肾健骨汤治疗腰椎间盘突出症的治疗效果[J].中医临床研究,2017,9(35):101-102.
[4]胡思进,龚兆阳,徐蓉,等.调脊手法联合补肾强筋汤治疗腰椎间盘突出症47例[J].浙江中医杂志,2014,49(11):815-816.
[5]周谋望,岳寿伟,何成奇,等.“腰椎间盘突出症的康复治疗”中国专家共识[J].中国康复医学杂志,2017,32(2):129-135.
[6]周仲瑛.中医内科学[M].2版.北京:中国中医药出版社,2007:446-447.
[7] Fairbank JC,Pynsent PB. The Oswestry Disability Index[J].Spine(Phila Pa 1976),2000,25(22):2940-2952.
[8]何丽英,魏洁,刘俊英,等.JOA评分量化诊断系统在腰椎术后个性化护理方案制定中的意义[J].河北医药,2010,32(12):1640-1641.
[9]严广斌.视觉模拟评分法[J].中华关节外科杂志:电子版,2014,8(2):273.
[10]盛有根,徐海波,夏建洪,等.补肾通络方联合热敏药灸治疗仪对腰椎间盘突出症患者疗效及对炎症因子的影响[J].中国临床药理学与治疗学,2018,23(4):451-455.
[11]杨俊.补肾壮腰镇痛汤治疗中老年性腰椎间盘突出症疗效观察[J].临床医药文献电子杂志,2018,5(5):186-187.
[12]陈丽华,金远林,周凌云,等.补肾祛湿汤联合刺络放血治疗腰椎间盘突出症疗效及对β-内啡肽、SOD及炎性细胞因子水平的影响[J].中国中医急症,2018,27(4):694-696.
[13]管亦坚,潘寒松,梁一民,等.补肾通痹汤治疗腰椎间盘突出症临床观察[J].新中医,2017,49(1):87-89.
[14]杨谦祥.自拟补肾通痹汤治疗腰椎间盘突症40例[J].云南中医中药杂志,2014,35(8):46-47.
[15]孟利锋,王春成.补肾培元推拿法联合补肾活血汤治疗老年肾虚型腰椎间盘突出症的临床研究[J].陕西中医,2018,39(3):368-370.
[16]张斌.经皮椎间孔镜技术联合补肾活血汤治疗腰椎间盘突出症38例[J].湖南中医杂志,2017,33(7):80-82.
[17]冯伟良.独活寄生汤加减配合牵引手法综合治疗腰椎间盘突出症[J].浙江创伤外科,2014,19(2):195-196.
[18]周小芳,庄素芳.加味乌头散火龙灸对寒湿型腰椎间盘突出症患者JOA及SF-36评分影响研究[J].中国现代医生,2017,55(11):104-108.
[19]杨俊.补肾壮腰镇痛汤治疗中老年性腰椎间盘突出症疗效观察[J].临床医药文献电子杂志,2018,5(5):186-187.
[20]肖寒.微创手术联合补肾活血汤治疗腰椎间盘突出症的临床疗效观察[J].陕西中医,2016,37(5):567-569.
[21]张泽宇,朱权,黄建芬,等.红外线穴位照射联合补肾活血汤治疗腰椎间盘突出症临床效果评价[J].河北中医,2018,40(1):65-67.
[22]毕殿海,曾欢高,廖勇,等.右归丸联合硬膜外封闭治疗腰椎间盘突出症患者的疗效及对血清TNF-α、hs-CRP和疼痛介质的影响[J].中国医学创新,2017,14(30):12-15.
[23]张利献.加味补肾活血汤联合经皮侧路椎间孔镜下椎间盘髓核摘除术对腰椎间盘突出症患者术后生活质量的影响[J].北方药学,2018,15(1):189-190.
[24]吴名波,廖荣鑫,饶秀珍,等.补肾强督治尪汤治疗肾虚型腰椎间盘突出症临床疗效观察[J].中国医药科学,2017,7(3):66-69.
[2]陈俊枢.腰椎间盘突出症患者经综合保守治疗的临床分析[J].临床医学工程,2015,22(5):612-613.
[3]王晓宁.探讨补肾健骨汤治疗腰椎间盘突出症的治疗效果[J].中医临床研究,2017,9(35):101-102.
[4]胡思进,龚兆阳,徐蓉,等.调脊手法联合补肾强筋汤治疗腰椎间盘突出症47例[J].浙江中医杂志,2014,49(11):815-816.
[5]周谋望,岳寿伟,何成奇,等.“腰椎间盘突出症的康复治疗”中国专家共识[J].中国康复医学杂志,2017,32(2):129-135.
[6]周仲瑛.中医内科学[M].2版.北京:中国中医药出版社,2007:446-447.
[7] Fairbank JC,Pynsent PB. The Oswestry Disability Index[J].Spine(Phila Pa 1976),2000,25(22):2940-2952.
[8]何丽英,魏洁,刘俊英,等.JOA评分量化诊断系统在腰椎术后个性化护理方案制定中的意义[J].河北医药,2010,32(12):1640-1641.
[9]严广斌.视觉模拟评分法[J].中华关节外科杂志:电子版,2014,8(2):273.
[10]盛有根,徐海波,夏建洪,等.补肾通络方联合热敏药灸治疗仪对腰椎间盘突出症患者疗效及对炎症因子的影响[J].中国临床药理学与治疗学,2018,23(4):451-455.
[11]杨俊.补肾壮腰镇痛汤治疗中老年性腰椎间盘突出症疗效观察[J].临床医药文献电子杂志,2018,5(5):186-187.
[12]陈丽华,金远林,周凌云,等.补肾祛湿汤联合刺络放血治疗腰椎间盘突出症疗效及对β-内啡肽、SOD及炎性细胞因子水平的影响[J].中国中医急症,2018,27(4):694-696.
[13]管亦坚,潘寒松,梁一民,等.补肾通痹汤治疗腰椎间盘突出症临床观察[J].新中医,2017,49(1):87-89.
[14]杨谦祥.自拟补肾通痹汤治疗腰椎间盘突症40例[J].云南中医中药杂志,2014,35(8):46-47.
[15]孟利锋,王春成.补肾培元推拿法联合补肾活血汤治疗老年肾虚型腰椎间盘突出症的临床研究[J].陕西中医,2018,39(3):368-370.
[16]张斌.经皮椎间孔镜技术联合补肾活血汤治疗腰椎间盘突出症38例[J].湖南中医杂志,2017,33(7):80-82.
[17]冯伟良.独活寄生汤加减配合牵引手法综合治疗腰椎间盘突出症[J].浙江创伤外科,2014,19(2):195-196.
[18]周小芳,庄素芳.加味乌头散火龙灸对寒湿型腰椎间盘突出症患者JOA及SF-36评分影响研究[J].中国现代医生,2017,55(11):104-108.
[19]杨俊.补肾壮腰镇痛汤治疗中老年性腰椎间盘突出症疗效观察[J].临床医药文献电子杂志,2018,5(5):186-187.
[20]肖寒.微创手术联合补肾活血汤治疗腰椎间盘突出症的临床疗效观察[J].陕西中医,2016,37(5):567-569.
[21]张泽宇,朱权,黄建芬,等.红外线穴位照射联合补肾活血汤治疗腰椎间盘突出症临床效果评价[J].河北中医,2018,40(1):65-67.
[22]毕殿海,曾欢高,廖勇,等.右归丸联合硬膜外封闭治疗腰椎间盘突出症患者的疗效及对血清TNF-α、hs-CRP和疼痛介质的影响[J].中国医学创新,2017,14(30):12-15.
[23]张利献.加味补肾活血汤联合经皮侧路椎间孔镜下椎间盘髓核摘除术对腰椎间盘突出症患者术后生活质量的影响[J].北方药学,2018,15(1):189-190.
[24]吴名波,廖荣鑫,饶秀珍,等.补肾强督治尪汤治疗肾虚型腰椎间盘突出症临床疗效观察[J].中国医药科学,2017,7(3):66-69.