温经活血汤行中药熏蒸治疗腰椎间盘突出疗效及患者体内炎症因子水平变化
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摘要
目的:观察温经活血汤行中药熏蒸治疗腰椎间盘突出的疗效及对患者体内炎症因子的影响。方法:将2014年4月—2017年3月来本院就诊的135例腰椎间盘突出症患者按照随机数字表法分为两组,实验组68例,男41例,女27例;年龄24~68岁,平均年龄(42.3±17.6)岁;病程(6.7±3.1)个月。对照组67例,男41例,女26例;年龄23~69岁,平均年龄(44.1±19.2)岁;病程(6.5±3.3)个月。其中L3~4 38例,L4~5 55例,L5~S1 42例。实验组温经活血汤行中药熏蒸治疗,对照组温经活血汤内服联合推拿治疗,观察并记录两组患者临床疗效、疼痛情况及血清TNF-α、PEG2、IL-6、IL-10水平。结果:实验组总有效率为95.5%,对照组总有效率79.1%,实验组显著高于对照组,两组比较差异有统计学意义(P<0.05);实验组治疗后疼痛评分(1.15±0.97)分,对照组治疗后疼痛评分(3.35±1.03)分,实验组明显低于对照组,两组比较差异有统计学意义(P<0.05);实验组患者治疗前血清TNF-α(18.61±7.75)pg/m L,PEG2(165±12)pg/m L,IL-6(42.45±14.79)pg/m L,IL-10(47.52±6.31)pg/m L,对照组治疗前血清TNF-α(18.26±7.83)pg/m L,PEG2(163±13)pg/m L,IL-6(42.74±15.28)pg/m L,IL-10(48.56±6.44)pg/m L,两组对比差异无统计学意义(P>0.05);治疗后实验组血清TNF-α(6.77±3.35)pg/m L,PEG2(107±10)pg/m L,IL-6(18.11±8.68)pg/m L,IL-10(22.24±3.15)pg/m L,对照组血清TNF-α(9.21±4.93)pg/m L,PEG2(130±11)pg/m L,IL-6(22.46±9.93)pg/m L,IL-10(30.68±4.71)pg/m L,两组对比差异有统计学意义(P<0.05)。结论:温经活血汤行中药熏蒸治疗对比温经活血汤联合推拿治疗腰椎间盘突出,前者可以提高治疗疗效,减轻患者疼痛,降低患者血清TNF-α、PEG2、IL-6、IL-10水平。
Objective:To observe the curative effect of Wenjing Huoxue Decoction with traditional Chinese medicine fumigation on lumbar disc herniation and the changes of inflammatory factors in the patients. Methods:From April 2014 to March 2017 in our hospital 135 cases of lumbar disc herniation were randomly divided into two groups,experimental group 68 cases,male 41 cases,female 27 cases,age 24-68 years old,average age(42.3±17.6)years old,duration(6.7±3.1)months;control group of 67 cases,male 41 cases,female 26 cases,age 23-69 years old,average age(44.1±19.2)years old,duration(6.5±3.3)months;the L3-4 38 cases,L4-5 55 cases,L5-S1 42 cases. The experimental group was treated with traditional Chinese medicine fumigation therapy,and the control group was treated with Wenjing HuoxueDecoction orally combined with massage. The clinical efficacy,pain status and serum TNF-α,PEG2,IL-6 and IL-10 levels were observed and recorded in the two groups. Results:The total effective rate was 95.5%,the total efficiency of the control group 79.1%,the experimental group was significantly higher than the control group,there was significant difference between two groups(P<0.05);pain score after treatment of the experimental group(1.15 + 0.97)points,the control group after treatment,the pain score(3.35±1.03)points,the experimental group was significantly lower than that of the control group,there was significant difference between two groups(P<0.05);before treatment of patients in the experimental group serum TNF-α(18.61+7.75)pg/m L,PEG2(165±12)pg/m L,IL-6(42.45±14.79)pg/m L,IL-10(47.52±6.31)pg/m L and the control group before treatment serum TNF-α(18.26+7.83)pg/m L,PEG2(163+13)pg/m L,IL-6(42.74±15.28)pg/m L,IL-10(48.56±6.44)pg/m L,there was no significant difference between the two groups(P>0.05);the experimental group after treatment of serum TNF-α(6.77±3.35)pg/m L,PEG2(107±10)pg/m L,IL-6(18.11±8.68)pg/m L,IL-10(22.24±3.15)pg/m L. The serum TNF-α of the control group(9.21±4.93)pg/m L,PEG2(130±11)pg/m L,IL-6(22.46±9.93)pg/m L,IL-10(30.68±4.71)pg/m L,the difference between the two groups was statistically significant(P<0.05). Conclusion:Wenjing Huoxue Decoction of traditional Chinese medicine fumigation treatment compared with Wenjing Huoxue Decoction combined with massage for treatment of lumbar disc herniation,the former can improve curative effect,reduce the pain of patients,reduce serum TNF-α,PEG2,IL-6,IL-10 level.
Objective:To observe the curative effect of Wenjing Huoxue Decoction with traditional Chinese medicine fumigation on lumbar disc herniation and the changes of inflammatory factors in the patients. Methods:From April 2014 to March 2017 in our hospital 135 cases of lumbar disc herniation were randomly divided into two groups,experimental group 68 cases,male 41 cases,female 27 cases,age 24-68 years old,average age(42.3±17.6)years old,duration(6.7±3.1)months;control group of 67 cases,male 41 cases,female 26 cases,age 23-69 years old,average age(44.1±19.2)years old,duration(6.5±3.3)months;the L3-4 38 cases,L4-5 55 cases,L5-S1 42 cases. The experimental group was treated with traditional Chinese medicine fumigation therapy,and the control group was treated with Wenjing HuoxueDecoction orally combined with massage. The clinical efficacy,pain status and serum TNF-α,PEG2,IL-6 and IL-10 levels were observed and recorded in the two groups. Results:The total effective rate was 95.5%,the total efficiency of the control group 79.1%,the experimental group was significantly higher than the control group,there was significant difference between two groups(P<0.05);pain score after treatment of the experimental group(1.15 + 0.97)points,the control group after treatment,the pain score(3.35±1.03)points,the experimental group was significantly lower than that of the control group,there was significant difference between two groups(P<0.05);before treatment of patients in the experimental group serum TNF-α(18.61+7.75)pg/m L,PEG2(165±12)pg/m L,IL-6(42.45±14.79)pg/m L,IL-10(47.52±6.31)pg/m L and the control group before treatment serum TNF-α(18.26+7.83)pg/m L,PEG2(163+13)pg/m L,IL-6(42.74±15.28)pg/m L,IL-10(48.56±6.44)pg/m L,there was no significant difference between the two groups(P>0.05);the experimental group after treatment of serum TNF-α(6.77±3.35)pg/m L,PEG2(107±10)pg/m L,IL-6(18.11±8.68)pg/m L,IL-10(22.24±3.15)pg/m L. The serum TNF-α of the control group(9.21±4.93)pg/m L,PEG2(130±11)pg/m L,IL-6(22.46±9.93)pg/m L,IL-10(30.68±4.71)pg/m L,the difference between the two groups was statistically significant(P<0.05). Conclusion:Wenjing Huoxue Decoction of traditional Chinese medicine fumigation treatment compared with Wenjing Huoxue Decoction combined with massage for treatment of lumbar disc herniation,the former can improve curative effect,reduce the pain of patients,reduce serum TNF-α,PEG2,IL-6,IL-10 level.
引文
[1]曹秦辉,赵静,原野,等.p-P38MAPK与TGF-β1在腰椎间盘退变组织中的表达研究[J].中国煤炭工业医学杂志,2016,19(10):1410-1413.
[2]康玉南,刘华水.炎症在椎间盘退行性病变中的研究[J].中国实用医药,2017,12(12):188-189.
[3]郭刚,王文辉.腰椎间盘组织髓核内TNF-α、PGE2、PLA2表达与神经根性疼痛的相关性[J].实用疼痛学杂志,2016,12(6):402-405.
[4]胡增平,王聪,马红英,等.化瘀补肾通督方及中药熏蒸治疗腰椎间盘突出症的临床疗效[J].临床合理用药杂志,2017,10(9):26-28.
[5]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:136-137.
[6]朱换平,赵继荣,邓强.杜仲腰痛丸对腰椎间盘突出症患者血清TNF-α、IL-1β的影响[J].西部中医药,2015,28(4):103-106.
[7]付宏伟,郭虎林,马海召,等.益腰方联合骨疏康治疗腰椎间盘突出症的疗效研究[J].辽宁中医杂志,2017,44(9):1903-1904.
[8]Unknown.Treatment of lumbar intervertebral disc protrusion by non steroidal anti-inflammatory drugs with shentongzhuyu Decoction[J].Popular Science&Technology,2016,18(204):109-111.
[9]黄哲真,刘海起,曾密,等.刘海起治疗腰椎间盘突出症的临床经验[J].辽宁中医杂志,2017,44(10):2042-2044.
[10]刘彬.针灸理疗对药物治疗腰椎间盘突出症患者生活质量影响的研究[J].辽宁中医杂志,2017,44(10):2162-2165.
[11]杨敏,石秦川,徐桂华.针灸单独或联合拔罐、推拿治疗腰椎间盘突出症的网状Meta分析[J].中华中医药学刊,2016,34(9):2153-2157.
[12]廖烨纯,李峰梅.手法推拿配合中药热敷治疗腰椎间盘突出症82例[J].中医外治杂志,2015,24(6):22-23.
[13]胡婷婷,张振凌.中药牛膝化学成分、药理作用及储藏保管[J].中国老年学,2016,36(13):3321-3322.
[14]徐小云,王云霞,李智勇.威灵仙化学成分和药理作用研究进展[J].甘肃中医学院学报,2015,32(5):67-69.
[15]李岩.白芍及其化学成分的药理研究进展[J].职业与健康,2015,31(15):2153-2156.
[16]朱小芳,管咏梅,刘莉,等.乳香、没药药对的研究进展[J].江西中医药,2016,47(12):72-75.
[17]史磊,张天锡,杜聪颖,等.中药全蝎活性成分、药理作用及临床应用研究进展[J].辽宁中医药大学学报,2015,17(4):89-91.
[18]李银燕.甘草及其活性成分的药理活性研究进展[J].医药,2017,3(1):122.
[19]孙江涛,李宇卫,沈晓峰,等.枳壳甘草汤对腰椎间盘突出模型大鼠炎症及退变的影响[J].中国中医急症,2016,25(8):1488-1492.
[20]潘建科,罗斌,郭达,等.龙鳖胶囊对膝骨关节炎大鼠IL-1β、IL-6、IL-10水平的影响[J].中华中医药杂志,2015(5):1675-1679.
[2]康玉南,刘华水.炎症在椎间盘退行性病变中的研究[J].中国实用医药,2017,12(12):188-189.
[3]郭刚,王文辉.腰椎间盘组织髓核内TNF-α、PGE2、PLA2表达与神经根性疼痛的相关性[J].实用疼痛学杂志,2016,12(6):402-405.
[4]胡增平,王聪,马红英,等.化瘀补肾通督方及中药熏蒸治疗腰椎间盘突出症的临床疗效[J].临床合理用药杂志,2017,10(9):26-28.
[5]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:136-137.
[6]朱换平,赵继荣,邓强.杜仲腰痛丸对腰椎间盘突出症患者血清TNF-α、IL-1β的影响[J].西部中医药,2015,28(4):103-106.
[7]付宏伟,郭虎林,马海召,等.益腰方联合骨疏康治疗腰椎间盘突出症的疗效研究[J].辽宁中医杂志,2017,44(9):1903-1904.
[8]Unknown.Treatment of lumbar intervertebral disc protrusion by non steroidal anti-inflammatory drugs with shentongzhuyu Decoction[J].Popular Science&Technology,2016,18(204):109-111.
[9]黄哲真,刘海起,曾密,等.刘海起治疗腰椎间盘突出症的临床经验[J].辽宁中医杂志,2017,44(10):2042-2044.
[10]刘彬.针灸理疗对药物治疗腰椎间盘突出症患者生活质量影响的研究[J].辽宁中医杂志,2017,44(10):2162-2165.
[11]杨敏,石秦川,徐桂华.针灸单独或联合拔罐、推拿治疗腰椎间盘突出症的网状Meta分析[J].中华中医药学刊,2016,34(9):2153-2157.
[12]廖烨纯,李峰梅.手法推拿配合中药热敷治疗腰椎间盘突出症82例[J].中医外治杂志,2015,24(6):22-23.
[13]胡婷婷,张振凌.中药牛膝化学成分、药理作用及储藏保管[J].中国老年学,2016,36(13):3321-3322.
[14]徐小云,王云霞,李智勇.威灵仙化学成分和药理作用研究进展[J].甘肃中医学院学报,2015,32(5):67-69.
[15]李岩.白芍及其化学成分的药理研究进展[J].职业与健康,2015,31(15):2153-2156.
[16]朱小芳,管咏梅,刘莉,等.乳香、没药药对的研究进展[J].江西中医药,2016,47(12):72-75.
[17]史磊,张天锡,杜聪颖,等.中药全蝎活性成分、药理作用及临床应用研究进展[J].辽宁中医药大学学报,2015,17(4):89-91.
[18]李银燕.甘草及其活性成分的药理活性研究进展[J].医药,2017,3(1):122.
[19]孙江涛,李宇卫,沈晓峰,等.枳壳甘草汤对腰椎间盘突出模型大鼠炎症及退变的影响[J].中国中医急症,2016,25(8):1488-1492.
[20]潘建科,罗斌,郭达,等.龙鳖胶囊对膝骨关节炎大鼠IL-1β、IL-6、IL-10水平的影响[J].中华中医药杂志,2015(5):1675-1679.
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