化瘀消痛汤联合小针刀治疗气滞血瘀型腰椎间盘突出症的疗效观察

Clinical Observation of Huayu Xiaotong Decoction Combined with Small Needle Scalpel in Treatment of Lumbar Disc Herniation Due to Qi Stagnation and Blood Stasis

目的:观察化瘀消痛汤联合小针刀治疗气滞血瘀型腰椎间盘突出症的临床疗效。方法:95例气滞血瘀型腰椎间盘突出症患者,随机分为观察组和对照组。对照组采用小针刀治疗,观察组在对照组基础上加以化瘀消痛汤治疗。比较两组患者临床疗效及临床症状改善情况,比较两组患者治疗前后McGill疼痛评分(PRI、PPI及VAS)、Oswestry功能障碍评分(ODI)、JOA评分;比较两组治疗前后炎性因子及疼痛介质水平。结果:观察组的临床总有效率显著高于对照组,两组比较有统计学意义(P<0.05)。治疗后两组患者的腰部疼痛不适、下肢疼痛与麻木、下肢行走能力、工作生活能力评分明显降低(P<0.05),而观察组的临床症状较对照组改善更为显著(P<0.05)。两组治疗1周、4周后ODI评分明显降低(P<0.05),JOA评分明显上升(P<0.05),并且观察组的每项评分均比对照组变化明显(P<0.05)。治疗后两组的PRI、PPI、VAS及SF-MPQ总分较治疗前明显降低(P<0.05),并且观察组各评分较对照组降低幅度大(P<0.05)。对照组治疗后TNF-α及PEG_2水平低于治疗前(P<0.05),观察组hs-CRP、TNF-α、IL-6、5-HT及PEG_2的水平显著低于治疗前(P<0.05),并且明显低于对照组(P<0.05)。结论:化瘀消痛汤联合小针刀治疗气滞血瘀型腰椎间盘突出症疗效显著,值得临床推广。

Objective:To observe the clinical efficacy of Huayu Xiaotong Decoction combined with small needle scalpel in the treatment of lumbar disc herniation due to Qi stagnation and blood stasis.Methods:95 patients with lumbar disc herniation due to Qi stagnation and blood stasis were randomly divided into the observation group and the control group.The control group was treated with small needle knife, while the observation group was treated with Huayu Xiaotong Decoction on the basis of the control group.The clinical curative effect and clinical symptom improvement of the two groups were compared.The McGill pain score(PRI, PPI and VAS), Oswestry dysfunction score(ODI)and JOA score were compared before and after treatment in the two groups, and the levels of inflammatory factors and pain media before and after treatment were compared between the two groups.Results:The total effective rate of the observation group was significantly higher than that of the control group, and the two groups had statistical significance(P<0.05).After treatment, the scores of low back pain, pain and numbness of lower limbs, lower limb walking ability and working life ability were significantly lower in the two groups(P<0.05), but the clinical symptoms of the observation group were more significant than those in the control group(P<0.05).The scores of ODI in the two groups were significantly lower(P>0.05)after 1 and 4 weeks, and the JOA score increased significantly(P>0.05), and the scores of each group in the observation group were significantly higher than those in the control group(P>0.05).After treatment, the total scores of PRI, PPI, VAS and SF-MPQ in the two groups were significantly lower than those before treatment(P<0.05), and the scores of each group in the observation group were significantly lower than those in the control group(P<0.05).The levels of TNF-alpha and PEG2 in the control group were lower than those before treatment(P<0.05).The levels of hs-CRP, TNF-, IL-6, 5-HT and PEG2 in the observation group were significantly lower than those before treatment(P<0.05), and the observation group's were significantly lower than those of the control group(P<0.05).Conclusion:Huayu Xiaotong Decoction combined with small needle knife is effective in treating lumbar intervertebral disc herniation due to Qi stagnation and blood stasis, and is worthy of clinical promotion.