杜仲腰痛丸治疗腰椎间盘突出症临床研究
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R681.5+3

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甘肃省中医药管理局科研课题(GZK-2018-65,GZKP-2020-40)


Clinical Study on Duzhong Yaotong Pills for Lumbar Disc Herniation
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    摘要:

    目的:观察杜仲腰痛丸对腰椎间盘突出症(LDH) 患者血瘀状态及炎性因子的影响。方法:选取80 例LDH 患者,按随机数字表法分为治疗组与对照组各40 例。对照组服用双氯芬酸钠缓释片,治疗组服用杜仲腰痛丸,2 组均治疗2 周。比较2 组临床疗效,比较2 组治疗前后血清血栓素A2 (TXA2)、前列环素(PGI2)、白细胞介素-1 (IL-1)、白细胞介素-10 (IL-10)、肿瘤坏死因子-α (TNF-α) 表达含量,并测定血瘀相关实验室指标的水平[红细胞沉降率(ESR)、超敏C-反应蛋白(hs-CRP)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(FIB)、D-二聚体(D-D)、血小板计数(BPC)] 变化。观察2 组视觉模拟评分法(VAS)、症状积分变化。结果:治疗后,治疗组临床疗效总有效率为87.5%,对照组临床疗效总有效率为85.0%,2 组比较,差异无统计学意义(P>0.05)。治疗后,2 组APTT、PT、PGI2指标值均较治疗前升高(P<0.05),血瘀积分、BPC、FIB、D-D、TXA2 指标值均较治疗前下降(P<0.05);治疗组BPC、血瘀积分均低于对照组,差异有统计学意义(P<0.05)。治疗后,2 组IL-1、TNF-α、CRP、ESR、CRP 水平均较治疗前下降(P<0.05),IL-10 水平较治疗前上升(P<0.05)。治疗组IL-1、TNF-α 水平低于对照组(P<0.05),IL-10 水平高于对照组(P<0.05)。治疗后,下腰痛2 组日本骨科协会评估治疗分数(JOA) 评分均较治疗前上升(P<0.05),症状积分、VAS 评分均较治疗前下降(P<0.05)。结论:杜仲腰痛丸能改善LDH 血瘀状态,减轻腰背部疼痛,提高日常生活能力,可作为中药抗腰腿痛的用药选择之一。

    Abstract:

    Abstract:Objective:To observe the effect of Duzhong Yaotong pills combined with diclofenac sodium sustained release tablets on blood stasis and inflammatory factors in patients with lumbar disc herniation(LDH). Methods:A total of 80 cases of LDH patients were divided into the treatment group and the control group according to the random number table method, with 40 cases in each group. The control group was treated with diclofenac sodium sustained release tablets , and the treatment group was additionally treated with Duzhong Yaotong pills based on the treatment of the control group. Both groups were treated for two weeks. The changes in expression contents of thromboxane A2(TXA2), prostacyclin(PGI2), interleukin-1(IL-1),interleukin-10(IL-10) and tumor necrosis factor-α(TNF-α) in serum before and after treatment as well as the clinical effects in the two groups were compared. The changes in levels of laboratory indexes related to blood stasis including erythrocyte sedimentation rate(ESR),high-sensitivity C-reactive protein(hs-CRP),activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),fibrinogen(FIB) and D-dimer(D-D),blood platelets count(BPC) were measured. The changes in scores of Visual Analogue Scale(VAS) and symptoms in the two groups were observed. Results: After treatment,the total effective rate of clinical effect was 87.5% in the treatment group and 85.0% in the control group, there being no significant difference between the two groups(P>0.05). After treatment,the values of APTT,PT and PGI2 in the two groups were increased when compared with those before treatment(P<0.05),and the blood stasis scores and the values of BPC,FIB,D-D and TXA2 were decreased(P<0.05);BPC level and blood stasis score in the treatment group were lower than those in the control group, the difference being significant(P<0.05). After treatment, the levels of IL- 1, TNF- α, CRP, ESR and CRP in the two groups were decreased when compared with those before treatment(P<0.05), and IL-10 levels were increased(P<0.05). The levels of IL-1 and TNF- α in the treatment group were lower than those in the control group(P<0.05),and IL-10 level was higher(P<0.05). After treatment,the scores of low back pain of Japanese Orthopoedic Association(JOA) in the two groups were increased when compared with those before treatment(P<0.05),and scores of symptoms and VAS were decreased(P<0.05);the score of low back pain of JOA in the treatment group was higher than that in the control group,and scores of symptoms and VAS were higher,there being no significant difference(P>0.05). Conclusion:Duzhong Yaotong pills can improve the blood stasis in LDH patients,relieve pain of the waist and back,and enhance abilities of daily living,which can be used as one of the medication choices of Chinese medicine treating pain of low back and leg.

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方鹏飞,温剑涛,刘宗玮.杜仲腰痛丸治疗腰椎间盘突出症临床研究[J].新中医,2021,53(21):125-129

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  • 在线发布日期: 2021-11-12
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