身痛逐瘀汤联合运动针刺法、中药贴敷疗法治疗急性腰扭伤临床研究

Clinical Research of Using Shentong Zhuyu Decoction Combined with Acupuncture Kinesitherapy and Traditional Chinese Medicine Application Therapy in the Treatment of Acute Lumbar Sprain

目的:观察身痛逐瘀汤联合运动针刺法、中药贴敷疗法治疗急性腰扭伤的临床疗效。方法:将120例符合要求的患者采用随机数字表法分为观察组60例和对照组60例。两组均给予中药贴敷疗法治疗,每日1次,连续两周。对照组予以口服布洛芬缓释胶囊每次300mg,每日3次。观察组予以口服身痛逐瘀汤,每日1剂;运动针刺法,每周3次;两组患者均连续治疗两周。两组患者均于治疗后统计其临床总有效率,分别于治疗前后测定患者VAS评分、M-JOA评分及ODI评分,同时分别于治疗前后检测患者血清中hs-CRP、ESR、IL-6、IL-10指标,另外在治疗期间密切观察两组患者的不良反应发生情况。结果:观察组的临床总有效率为92.98%(53/57),明显高于对照组的78.18%(43/55),且差异具有统计学意义(χ^(2)值=4.248,P=0.036)。治疗后,观察组VAS评分[(1.47±0.57)分比(4.24±0.48)分,t=24.564]、M-JOA评分[(4.58±2.83)分比(12.47±3.57)分,t=35.752]、ODI评分[(8.26±4.65)分比(17.43±4.74)分,t=27.276]、血清hs-CRP[(3.57±2.48)mg/L比(9.73±3.84)mg/L,t=6.385]、ESR[(8.37±4.26)mm/h比(18.21±5.28)mg/L,t=12.363]、IL-6[(12.75±7.60)pg/mL比(25.37±12.72)pg/mL,t=15.384]、IL-10[(26.46±12.52)pg/mL比(45.84±18.54)pg/mL,t=14.634]明显低于对照组(P<0.05)。观察组不良反应发生率为7.02%,对照组为3.63%,两组不良反应发生率无统计学差异(χ^(2)值=0.456,P=0.342)。结论:在中药贴敷基础上,身痛逐瘀汤联合运动针刺法治疗急性腰扭伤的临床疗效显著,能够明显改善患者腰部疼痛和功能障碍,降低血清中炎症因子水平,且安全性较好。

Objective:To investigate the clinical application of using Shentong Zhuyu Decoction combined with acupuncture kinesitherapy and traditional Chinese medicine application therapy in the treatment of acute lumbar sprain.Methods:According to the random table method,120 cases of patients with acute lumbar sprain were divided into a controlled group(n=60)and the research group(n=60).Both groups give traditional Chinese medicine applied treatment method,once a day,two consecutive weeks.The patients in the controlled group was oral Ibuprofen Sustained Release Capsule 300 mg/time,3 times/day.while the patients in the research group were treated with Shentong Zhuyu Decoction 1 dose/day combined with acupuncture kinesitherapy 3 times/week.The two groups of patients were treated for 2 weeks.The clinical total effective rate of the two groups of patients after treatment was counted.The VAS scores,M-JOA scores,ODI scores were determined respectively before and after treatment,at the same time,the levels of serum hs-CRP,ESR,IL-6,IL-10 was detected respectively before and after treatment.In addition,the incident occurrence of adverse reactions in the two groups were observed during treatment.Results:The total effective rate of the research group was 92.98%(53/57),while the total effective rate of the controlled group was 78.18%(43/55).The difference between two groups was statistically significant(χ^(2)=4.248,P=0.036).After treatment,the VAS score[(1.47±0.57)vs(4.24±0.48),t=24.564],M-JOA score[(4.58±2.83)vs(12.47±3.57),t=35.752],ODI score[(8.26±4.65)vs(17.43±4.74),t=27.276],hs-CRP[(3.57±2.48)mg/L vs(9.73±3.84)mg/L,t=6.385],ESR[(8.37±4.26)mm/h vs(18.21±5.28)mg/L,t=12.363],IL-6[(12.75±7.60)pg/ml vs(25.37±12.72)pg/ml,t=15.384],IL-10[(26.46±12.52)pg/ml vs(45.84±18.54)pg/ml,t=14.634],of the research group were significantly lower than the controlled group(P<0.05).Patients in the observation group the adverse reaction rate was 7.02%,the controlled group of patients with adverse reaction rate was 3.63%,and there was no significant difference of the twogroups(χ^(2)=0.456,P=0.342).Conclusion:On the basis of traditional Chinese medicine,the clinical curative effect of Shentong Zhuyu Decoction combined with acupuncture kinesitherapy for the treatment of acute lumbar sprain is significantly,which can significantly improve the patient’s waist pain and dysfunction,reduce the inflammatory factor levels,and has good security.