摘要
目的评价补肾活血舒筋汤联合雷火灸治疗腰椎间盘突出症肾虚血瘀证的临床疗效。方法随机对照试验研究。选取2021年1-12月北京中医药大学东直门医院200例腰椎间盘突出症患者作为观察对象,采用电脑随机抽签法分为联合组66例、对照1组67例、对照2组67例。对照1组给予常规西药+雷火灸,对照2组给予常规西药+补肾活血舒筋汤,联合组给予常规西药+补肾活血舒筋汤+雷火灸。3组均14 d为1个疗程,共治疗3个疗程。分别于治疗前后进行中医证候评分,采用肌肉状态测试分析仪测量腰椎关节活动度;采用ELISA法检测NF-κB、前列腺素E2(PGE2)、缺氧诱导因子-2α(HIF-2α)水平;记录治疗期间的不良反应,评价临床疗效。结果联合组总有效率为92.42%(61/66)、对照1组为71.64%(48/67)、对照2组为74.63%(50/67),3组比较差异有统计学意义(χ2=10.28,P=0.006)。治疗后,联合组腰腿疼痛、腰部板硬、下肢麻木、舌质黯紫积分低于对照1组、对照2组(F值分别为15.25、12.21、11.77、14.49,P<0.01);腰椎关节前屈、后伸、侧屈、侧旋活动度大于对照1组、对照2组(F值分别为19.66、29.50、33.33、24.54,P<0.01);血清NF-κB[(41.29±5.91)ng/L比(49.97±5.98)ng/L、(50.92±6.02)ng/L,F=47.00]、PGE2[(67.09±8.08)ng/L比(80.22±9.92)ng/L、(78.17±9.09)ng/L,F=40.27]、HIF-2α[(16.95±3.46)ng/L比(20.83±3.98)ng/L、(19.67±3.89)ng/L,F=18.38]水平低于对照1组、对照2组(P<0.01)。治疗期间,联合组不良反应发生率为15.15%(10/66)、对照1组为8.96%(6/67)、对照2组为10.45%(7/67),3组比较差异无统计学意义(χ2=1.36,P=0.506)。结论补肾活血舒筋汤联合雷火灸可较好改善腰椎间盘突出症肾虚血瘀证患者的中医证候及腰椎关节活动度,抑制炎症因子表达,提高临床疗效且安全性较好。
Objective To evaluate the clinical efficacy of Bushen Huoxue Shujin Decoction combined with thunder fire moxibustion in the treatment of lumbar intervertebral disc herniation with kidney deficiency and blood stasis syndrome.Methods Randomized controlled trial.A total of 200 lumbar intervertebral disc herniation patients from Dongzhimen Hospital of Beijing University of Chinese Medicine from January to December 2021 were selected as observation objects and the computer random method was used to divide 66 patients into combination group,67 in the control group 1,and 67 in the control group 2.The Control group 1 was given conventional western medicine and thunder fire moxibustion,the control group 2 was given conventional western medicine and Bushen Huoxue Shujin Decoction,and the combined group was given conventional western medicine and Bushen Huoxue Shujin Decoction and thunder fire moxibustion.All the groups were treated with 14 days as a course of treatment,a total of 3 courses.TCM syndrome scores were performed before and after treatment,and lumbar joint activity was measured by using a muscle state testing analyzer;the levels of NF-κB,prostaglandin E2(PGE2)and hypoxia-inducible factor-2α(HIF-2α)were determined by ELISA;adverse reactions during treatment were recorded and clinical efficacy was evaluated.Results The total effective rate of the combination group was 92.42%(61/66),the control group 1 was 71.64%(48/67),and the control group 2 was 74.63%(50/67),with a statistically significant difference among the three groups(χ2=10.28,P=0.006).After treatment,the scores of waist and leg pain,lumbar stiffness,lower limb numbness,and tongue dullness in the combination group were significantly lower than those in the control group 1 and control group 2(F values were 15.25,12.21,11.77,14.49,respectively,P<0.01);the range of motion of lumbar joint forward flexion,backward extension,lateral flexion,and lateral rotation in the combination group were significantly greater than those in the control group 1 and control
作者
罗佳晶
李明
李琦
张佳诺
吴圣贤
刘向春
Luo Jiajing;Li Ming;Li Qi;Zhang Jianuo;Wu Shengxian;Liu Xiangchun(Department of Pharmacy,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;Department of International,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;Department of Neurology,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;Department of Orthopaedics,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)
出处
《国际中医中药杂志》
2023年第12期1502-1507,共6页
International Journal of Traditional Chinese Medicine
基金
国家自然科学基金项目(82174340)。
关键词
腰椎
椎间盘移位
肾虚血瘀证
雷火灸疗法
补肾活血舒筋汤
关节活动度
炎症因子
Lumbar vertebrae
Intervertebral disc displacement
Syndrome of kidney deficiency and blood stasis
Thunderbolt moxibustion therapy
Bushen Huoxue Shujin Decoction
Joint range of motion
Inflammatory factor
