基于温肾通督理论中药内服联合经皮穴位电刺激治疗脊髓损伤的临床研究

Clinical study on treatment of spinal cord injury by oral administration of traditional Chinese herbal medicine combined with transcutaneous electrical acupoint stimulation based on the theory of warming kidneys and unblocking Du channel

目的观察基于温肾通督理论中药内服联合经皮穴位电刺激治疗脊髓损伤(SCI)的临床疗效。方法将100例SCI患者随机分为治疗组与对照组,每组50例。对照组给予基础治疗及康复训练,治疗组在对照组治疗措施基础上加用基于温肾通督理论的中药内服联合经皮穴位电刺激治疗。两组疗程均为12周,比较两组美国脊髓损伤协会(ASIA)残损分级、脊髓神经功能评分、诱发电位、神经相关生长因子变化情况,同时观察并发症发生情况。结果(1)试验过程中,治疗组脱落2例,对照组脱落4例;最终完成试验者94例,治疗组48例,对照组46例。(2)组间治疗后比较,治疗组ASIA残损分级D+E级占比高于对照组(P<0.05)。(3)组间治疗后比较,治疗组痛觉评分、触觉评分、运动评分高于对照组(P<0.05)。(4)组间治疗后比较,治疗组体感诱发电位(SEP)、运动诱发电位(MEP)波幅高于对照组(P<0.05)。(5)组间治疗后比较,治疗组血清神经生长因子(NGF)、脑源性神经生长因子(BDNF)、神经营养因子-3(NT-3)含量高于对照组(P<0.05)。(6)治疗组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论基于温肾通督理论采用中药内服联合经皮穴位电刺激治疗SCI,能够改善患者脊髓神经功能,减少并发症的发生,可能与其增强脊髓传导功能、促进神经细胞修复再生等因素有关。

Objective To study the clinical efficacy of oral administration of traditional Chinese herbal medicines(TCHMs)combined with transcutaneous electrical acupoint stimulation(TEAS)in the treatment of spinal cord injury(SCI)based on the theory of warming kidneys and unblocking Du channel.Methods Totally 100 SCI patients were randomly divided into a treatment group(n=50)and a control group(n=50).The control group was given basic treatment and rehabilitation training,while the treatment group was treated with oral administration of TCHMs plus TEAS based on the theory of warming kidneys and unblocking Du channel besides the therapeutic measures of the control group.The duration of treatment for both groups was 12 weeks.The American Spinal Injury Association(ASIA)impairment scale grade,spinal cord neurological function scores,evoked potentials,and changes in nerve-related growth factors were compared between the two groups,and the incidence of complications was also observed.Results(1)During the trial,there were 2 drop-out cases in the treatment group and 4 drop-out cases in the control group;Finally 94 cases completed the trial,with 48 cases in the treatment group and 46 cases in the control group.(2)After treatment,the percentage of grade D and E evaluated with ASIA impairment scale was higher in the treatment group than that in the control group(P<0.05).(3)After treatment,pain score,tactile score,and motor score were higher in the treatment group than those in the control group(P<0.05).(4)After treatment,the somatosensory evoked potentials(SEP)amplitude and motor evoked potentials(MEP)amplitude were higher in the treatment group than those in the control group(P<0.05).(5)After treatment,the serum levels of nerve growth factor(NGF),brain-derived neurotrophic factor(BDNF)and neurotrophin-3(NT-3)were higher in the treatment group than those in the control group(P<0.05).(6)The incidence of complications in the treatment group was lower than that in the control group,and the difference was statistically significant(P<0.05).ConclusionOral administration of TCHMs combined with TEAS based on the theory of warming kidneys and unblocking Du channel is effective in the treatment of SCI,which can improve spinal nerve function and reduce the incidence of complications.The mechanism may be related to the enhancement of spinal cord conduction and the promotion of nerve cell repair and regeneration.