摘要
目的探讨益肾活血舒筋方联合椎间孔镜治疗肾虚血瘀型腰椎间盘突出症的临床疗效及对白介素1β(Interleukin-1β,IL-1β)、白介素6(Interleukin-6,IL-6)及前列腺素E 2(Prostaglandin E 2,PGE 2)、5-羟色胺(5-Hydroxytryptamine,5-HT)的影响。方法选择2018年2月—2019年7月收治的肾虚血瘀型腰椎间盘突出症患者120例,依据随机数字表法将患者分为联合中药组(62例)和单纯孔镜组(58例)。单纯孔镜组患者行椎间孔镜下腰椎间盘髓核摘除术治疗。联合中药组在单纯孔镜组治疗的基础上,口服益肾活血舒筋方治疗4周。分别记录两组治疗优良率(根据改良MacNab评分标准),比较中医证候积分、IL-1β、IL-6、PGE 2、5-HT水平以及腰痛及腿痛视觉模拟评分(Visual analogue score,VAS)和日本矫形外科协会评分(Japanese Orthopaedic association,JOA)。结果联合中药组治疗总有效率高于单纯孔镜组,差异有统计学意义(P<0.05);治疗后两组患者中医证候积分均低于术前,但联合中药组积分低于单纯孔镜组,差异有统计学意义(P<0.05);两组患者治疗后IL-1β、IL-6、PGE 2、5-HT水平均较本组术前降低,但联合中药组降低水平优于单纯孔镜组,差异有统计学意义(P<0.05);联合中药组治疗后VAS评分低于单纯孔镜组,而JOA评分高于单纯孔镜组(P<0.05),差异有统计学意义。结论益肾活血舒筋方结合椎间孔镜治疗肾虚血瘀型腰椎间盘突出症疗效确切,可有效改善患者的临床症状,降低炎性因子IL-1β、IL-6及疼痛介质PGE 2、5-HT的水平。
Objective To investigate the clinical efficacy of Yishen Huoxue Shujin Decoction combined with percutaneous transforaminal endoscopic discectomy in the treatment of lumbar disc herniation of kidney deficiency and blood stasis,and the treatment of interleukin-1β(Interleukin-1β,IL-1β)and interleukin-6(Interleukin-6,IL-6)and the effects of Prostaglandin E 2(PGE 2)and 5-Hydroxytryptamine(5-HT).Methods 120 patients with lumbar disc herniation admitted to our department from February 2018 to July 2019 were selected.Based on the randomized control method,the patients were divided into the combined group(n=62)and the simple group(n=58).Patients in the simple foraminal endoscopy group(Control group)underwent lumbar disc nucleus excision under intervertebral foraminal endoscopy.The combined group was treated with Yishen Huoxue Shujin Decoction for 4 weeks on the basis of the control group.The therapeutic effect,TCM symptom scores,IL-1β、IL-6、PGE 2 and 5-HT levels,VAS and JOA scores were compared before and after treatment.Results The total rate of excellent and good in the combined group was higher than that in the simple group(P<0.05).The scores of TCM syndromes in both groups were lower than those before surgery,but those in the combined TCM group were lower than those in the simple group(P<0.05).After treatment,IL-1β、IL-6、PGE 2 and 5-HT levels in the two groups were all lower than those before surgery,but the reduced levels in the combined group were lower than those in the simple group(P<0.05).VAS score and JOA score of the combined Chinese medicine group were lower than those of the simple group(P<0.05).Conclusion Yishen Huoxue Shujin Decoction combined with percutaneous transforaminal endoscopic discectomy in the treatment of lumbar disc herniation has an effective effect in treating lumbar disc herniation of kidney deficiency and blood stasis,which can effectively improve the clinical symptoms and reduce the level of inflammatory factors IL-1β,IL-6 and pain mediators PGE 2,5-HT level.
作者
康晓乐
鹿洪辉
陈江
姜涛
王秋洁
穆晓红
KANG Xiao-le;LU Hong-hui;CHEN Jiang;JIANG Tao;WANG Qiu-jie;MU Xiao-hong(Beijing University of Chinese Medicine,Beijing 100029;Department of Orthopedics and Traumatology,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700)
出处
《世界中西医结合杂志》
2021年第7期1184-1188,1200,共6页
World Journal of Integrated Traditional and Western Medicine
基金
北京中医药大学2019年度基本科研业务费项目(2019-JYB-JS-042)。
关键词
腰椎间盘突出症
经皮椎间孔镜髓核摘除术
益肾活血舒筋方
炎性因子
Lumbar Disc Herniation
Percutaneous Transforaminal Endoscopic Discectomy
Yishen Huoxue Shujin Decoction
Inflammatory Factors
