化瘀消痛汤联合小针刀治疗气滞血瘀型腰椎间盘突出症的疗效观察
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摘要
目的:观察化瘀消痛汤联合小针刀治疗气滞血瘀型腰椎间盘突出症的临床疗效。方法:95例气滞血瘀型腰椎间盘突出症患者,随机分为观察组和对照组。对照组采用小针刀治疗,观察组在对照组基础上加以化瘀消痛汤治疗。比较两组患者临床疗效及临床症状改善情况,比较两组患者治疗前后McGill疼痛评分(PRI、PPI及VAS)、Oswestry功能障碍评分(ODI)、JOA评分;比较两组治疗前后炎性因子及疼痛介质水平。结果:观察组的临床总有效率显著高于对照组,两组比较有统计学意义(P<0.05)。治疗后两组患者的腰部疼痛不适、下肢疼痛与麻木、下肢行走能力、工作生活能力评分明显降低(P<0.05),而观察组的临床症状较对照组改善更为显著(P<0.05)。两组治疗1周、4周后ODI评分明显降低(P<0.05),JOA评分明显上升(P<0.05),并且观察组的每项评分均比对照组变化明显(P<0.05)。治疗后两组的PRI、PPI、VAS及SF-MPQ总分较治疗前明显降低(P<0.05),并且观察组各评分较对照组降低幅度大(P<0.05)。对照组治疗后TNF-α及PEG_2水平低于治疗前(P<0.05),观察组hs-CRP、TNF-α、IL-6、5-HT及PEG_2的水平显著低于治疗前(P<0.05),并且明显低于对照组(P<0.05)。结论:化瘀消痛汤联合小针刀治疗气滞血瘀型腰椎间盘突出症疗效显著,值得临床推广。
Objective:To observe the clinical efficacy of Huayu Xiaotong Decoction combined with small needle scalpel in the treatment of lumbar disc herniation due to Qi stagnation and blood stasis.Methods:95 patients with lumbar disc herniation due to Qi stagnation and blood stasis were randomly divided into the observation group and the control group. The control group was treated with small needle knife, while the observation group was treated with Huayu Xiaotong Decoction on the basis of the control group. The clinical curative effect and clinical symptom improvement of the two groups were compared. The McGill pain score(PRI, PPI and VAS), Oswestry dysfunction score(ODI) and JOA score were compared before and after treatment in the two groups, and the levels of inflammatory factors and pain media before and after treatment were compared between the two groups.Results:The total effective rate of the observation group was significantly higher than that of the control group, and the two groups had statistical significance(P<0.05). After treatment, the scores of low back pain, pain and numbness of lower limbs, lower limb walking ability and working life ability were significantly lower in the two groups(P<0.05), but the clinical symptoms of the observation group were more significant than those in the control group(P<0.05).The scores of ODI in the two groups were significantly lower(P>0.05) after 1 and 4 weeks, and the JOA score increased significantly(P>0.05), and the scores of each group in the observation group were significantly higher than those in the control group(P>0.05). After treatment, the total scores of PRI, PPI, VAS and SF-MPQ in the two groups were significantly lower than those before treatment(P<0.05), and the scores of each group in the observation group were significantly lower than those in the control group(P<0.05). The levels of TNF-alpha and PEG2 in the control group were lower than those before treatment(P<0.05). The levels of hs-CRP, TNF-, IL-6, 5-HT and PEG2 in the observation group were significantly lower than those before treatment(P<0.05), and the observation group's were significantly lower than those of the control group(P<0.05). Conclusion:Huayu Xiaotong Decoction combined with small needle knife is effective in treating lumbar intervertebral disc herniation due to Qi stagnation and blood stasis, and is worthy of clinical promotion.
Objective:To observe the clinical efficacy of Huayu Xiaotong Decoction combined with small needle scalpel in the treatment of lumbar disc herniation due to Qi stagnation and blood stasis.Methods:95 patients with lumbar disc herniation due to Qi stagnation and blood stasis were randomly divided into the observation group and the control group. The control group was treated with small needle knife, while the observation group was treated with Huayu Xiaotong Decoction on the basis of the control group. The clinical curative effect and clinical symptom improvement of the two groups were compared. The McGill pain score(PRI, PPI and VAS), Oswestry dysfunction score(ODI) and JOA score were compared before and after treatment in the two groups, and the levels of inflammatory factors and pain media before and after treatment were compared between the two groups.Results:The total effective rate of the observation group was significantly higher than that of the control group, and the two groups had statistical significance(P<0.05). After treatment, the scores of low back pain, pain and numbness of lower limbs, lower limb walking ability and working life ability were significantly lower in the two groups(P<0.05), but the clinical symptoms of the observation group were more significant than those in the control group(P<0.05).The scores of ODI in the two groups were significantly lower(P>0.05) after 1 and 4 weeks, and the JOA score increased significantly(P>0.05), and the scores of each group in the observation group were significantly higher than those in the control group(P>0.05). After treatment, the total scores of PRI, PPI, VAS and SF-MPQ in the two groups were significantly lower than those before treatment(P<0.05), and the scores of each group in the observation group were significantly lower than those in the control group(P<0.05). The levels of TNF-alpha and PEG2 in the control group were lower than those before treatment(P<0.05). The levels of hs-CRP, TNF-, IL-6, 5-HT and PEG2 in the observation group were significantly lower than those before treatment(P<0.05), and the observation group's were significantly lower than those of the control group(P<0.05). Conclusion:Huayu Xiaotong Decoction combined with small needle knife is effective in treating lumbar intervertebral disc herniation due to Qi stagnation and blood stasis, and is worthy of clinical promotion.
引文
[1] 杨得光,李培真,何光远.“动”法治疗腰椎间盘突出症研究简况[J]. 中医药临床杂志,2018,30(4):598-601.
[2] 王明熹. 六味地黄丸联合四妙丸治疗肾阴虚夹湿热型腰椎间盘突出症[J]. 中医药临床杂志,2018,30(3):529-532.
[3] 袁冬,李慧英.蠲痹汤加减联合双氯芬酸钠治疗腰椎间盘突出症肾虚寒湿证的疗效观察[J].中国实验方剂学杂志,2018,24(9):184-189.
[4] 王泽,叶才锦,邵加润,等. 小针刀结合美式整脊治疗腰椎间盘突出症的疗效观察[J]. 中国医药指南,2018,16(4):169-171.
[5] 葛明富,王柏卿,高曦,等.针刀松解夹脊穴配合深刺次髎穴治疗腰椎间盘突出症的疗效分析[J].针灸临床杂志,2018,34(1):40-43.
[6] 胡有谷.腰椎间盘突出症[M].3版.北京: 人民卫生出版社,1995:50.
[7] 国家中医药管理局. 中医病证诊断疗效标准[S] . 南京:南京大学出版社,1994:51-52.
[8] 姚啸生,杨鸫祥,张哲,等.中药熨疗治疗腰椎间盘突出症(寒湿痹阻证)多中心随机平行对照临床研究[J].中华中医药学刊,2017,35(10):2600-2603.
[9] 王芳,张秀琢,王明洁. 小针刀联合中药热封包治疗腰椎间盘突出症的临床观察[J]. 中医药导报,2018,24(6):60-63.
[10] 江建春,邱德华,蔡奇文,等. 石氏理气固腰汤治疗气滞血瘀型腰椎间盘突出症的临床研究[J]. 上海中医药杂志,2016,50(6):58-60.
[11] 安富. 小针刀、推拿联合运用于腰椎间盘突出症治疗中的效果观察[J]. 中医临床研究,2017,9(20):94-96.
[12] 刘毅,刘胜,陈振. 小针刀疗法治疗腰椎间盘突出症的临床观察探讨[J]. 中医临床研究,2017,9(2):107-108.
[13] 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.
[14] 孙凯强. 葛根汤结合小针刀对腰椎间盘突出的临床疗效观察[J]. 内蒙古中医药,2016,35(15):71.
[15] 赵黎明,崔建英.小针刀加穴位埋线治疗腰椎间盘突出症98例临床观察[J].河北中医,2012,34(6):878-879.
[16] 张圣宏,吴耀持.小针刀整体松解术联合远道取穴针刺治疗腰椎间盘突出症的疗效及作用机理研究[J].四川中医,2017,35(10):177-180.
[17] 徐昆,郝佳颖,杜元良,等. 小针刀联合神经妥乐平对腰椎间盘突出症术后残余神经痛炎性因子水平及腰部功能影响[J]. 临床军医杂志,2017,45(11):1156-1158.
[18] 徐清平,宋登峰,朱晓峰,等.中药内服联合中医手法、针灸治疗腰椎间盘突出症的临床疗效[J].中华中医药学刊,2018,36(3):765-768.
[19] 杨铁军,李华南,赵祥,等. 王金贵教授中医综合疗法治疗气滞血瘀型腰椎间盘突出症的有序治疗方案[J]. 四川中医,2017,35(6):14-16.
[20] 龚政.小柴胡汤配合穴位埋针治疗腰椎间盘突出症55例[J].河北中医,2017,39(10):1510-1513.
[21] 牟成林,朱慧娟,沈向楠,等. 展筋活血方配合腰椎正骨手法治疗气滞血瘀型腰椎间盘突出症的临床研究[J]. 时珍国医国药,2017,28(10):2472-2475.
[2] 王明熹. 六味地黄丸联合四妙丸治疗肾阴虚夹湿热型腰椎间盘突出症[J]. 中医药临床杂志,2018,30(3):529-532.
[3] 袁冬,李慧英.蠲痹汤加减联合双氯芬酸钠治疗腰椎间盘突出症肾虚寒湿证的疗效观察[J].中国实验方剂学杂志,2018,24(9):184-189.
[4] 王泽,叶才锦,邵加润,等. 小针刀结合美式整脊治疗腰椎间盘突出症的疗效观察[J]. 中国医药指南,2018,16(4):169-171.
[5] 葛明富,王柏卿,高曦,等.针刀松解夹脊穴配合深刺次髎穴治疗腰椎间盘突出症的疗效分析[J].针灸临床杂志,2018,34(1):40-43.
[6] 胡有谷.腰椎间盘突出症[M].3版.北京: 人民卫生出版社,1995:50.
[7] 国家中医药管理局. 中医病证诊断疗效标准[S] . 南京:南京大学出版社,1994:51-52.
[8] 姚啸生,杨鸫祥,张哲,等.中药熨疗治疗腰椎间盘突出症(寒湿痹阻证)多中心随机平行对照临床研究[J].中华中医药学刊,2017,35(10):2600-2603.
[9] 王芳,张秀琢,王明洁. 小针刀联合中药热封包治疗腰椎间盘突出症的临床观察[J]. 中医药导报,2018,24(6):60-63.
[10] 江建春,邱德华,蔡奇文,等. 石氏理气固腰汤治疗气滞血瘀型腰椎间盘突出症的临床研究[J]. 上海中医药杂志,2016,50(6):58-60.
[11] 安富. 小针刀、推拿联合运用于腰椎间盘突出症治疗中的效果观察[J]. 中医临床研究,2017,9(20):94-96.
[12] 刘毅,刘胜,陈振. 小针刀疗法治疗腰椎间盘突出症的临床观察探讨[J]. 中医临床研究,2017,9(2):107-108.
[13] 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.
[14] 孙凯强. 葛根汤结合小针刀对腰椎间盘突出的临床疗效观察[J]. 内蒙古中医药,2016,35(15):71.
[15] 赵黎明,崔建英.小针刀加穴位埋线治疗腰椎间盘突出症98例临床观察[J].河北中医,2012,34(6):878-879.
[16] 张圣宏,吴耀持.小针刀整体松解术联合远道取穴针刺治疗腰椎间盘突出症的疗效及作用机理研究[J].四川中医,2017,35(10):177-180.
[17] 徐昆,郝佳颖,杜元良,等. 小针刀联合神经妥乐平对腰椎间盘突出症术后残余神经痛炎性因子水平及腰部功能影响[J]. 临床军医杂志,2017,45(11):1156-1158.
[18] 徐清平,宋登峰,朱晓峰,等.中药内服联合中医手法、针灸治疗腰椎间盘突出症的临床疗效[J].中华中医药学刊,2018,36(3):765-768.
[19] 杨铁军,李华南,赵祥,等. 王金贵教授中医综合疗法治疗气滞血瘀型腰椎间盘突出症的有序治疗方案[J]. 四川中医,2017,35(6):14-16.
[20] 龚政.小柴胡汤配合穴位埋针治疗腰椎间盘突出症55例[J].河北中医,2017,39(10):1510-1513.
[21] 牟成林,朱慧娟,沈向楠,等. 展筋活血方配合腰椎正骨手法治疗气滞血瘀型腰椎间盘突出症的临床研究[J]. 时珍国医国药,2017,28(10):2472-2475.
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