中西医结合治疗腰椎间盘突出症患者的临床疗效观察及对血清炎性因子的影响

Clinical Efficacy of Integrated Chinese and Western Medicine Treatment in Prolapse of Lumbar Intervertebral Disc and Its Influence on Inflammatory Factors

目的:探讨中西医结合治疗腰椎间盘突出症患者的临床疗效及对血清炎性因子的影响。方法:将105例腰椎间盘突出症疼痛患者随机分为观察组(n=53例)和对照组(n=52例),2组均给予理疗、按摩等基础治疗,对照组在此基础上给予硬膜外封闭治疗,观察组在对照组基础上加用自拟身痛逐瘀汤治疗,2组均连续治疗2周。观察2组治疗前、治疗第1周、2周的血清肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、及白细胞介素-6(IL-6)水平;记录2组治疗前、治疗第1周、2周的VAS评分及日本骨科学会下腰痛评分(JOA)及治疗的临床疗效。结果:2组患者治疗第1周、2周的血清TNF-α、hs-CRP、IL-6水平均较治疗前下降(P<0.05),观察组上述炎性指标低于对照组(P<0.05);治疗第1周、2周的VAS、JOA评分均较治疗前有所改善(P<0.05),观察组的改善情况优于对照组(P<0.05);治疗第1周、2周观察组治疗有效率显著高于对照组(P<0.05)。2组治疗期间均发现严重不良药物事件。结论:中西医结合治疗能够显著抑制腰椎间盘突出痛患者的炎性因子,降低炎性状态,缓解患者疼痛及临床症状,综合治疗疗效满意,且治疗安全可靠,值得临床推荐。

Objective：To explore the clinical curative effect of integrated traditional Chinese and western medicine treatment for patients with lumbar disc prolapse and its influence on serum inflammatory factors.Methods：A total number of 105 patients with pain due to lumbar disc prolapse were randomly divided into observation group （n=53 cases） and control group （n=52 cases）.Two groups were both given fundamental therapies, including physical therapy and massage.Patients in the control group were given epidural closed treatment, while patients in the observation group were additionally treated with Shentong Zhuyu Decoction.Both groups received treatment for 2 weeks.The serum tumor necrosis factor alpha （TNF alpha）, hypersensitive creactive protein （hs-CRP） and interleukin-6 （IL-6） level were observed in the two groups before treatment, 1 week and 2 weeks after treatment.VAS score and Japanese orthopedic society of low back pain score （JOA） and the clinical curative effect of treatment of the two groups before treatment, 1 week and 2 weeks treatment after treatment.Results：Serum TNF alpha, hs-CRP and IL-6 of patients in the two groups of after a week and 2-week treatment were reduced （P〈0.05）, compared with those before the treatment.The inflammatory indexes were lower in the treatment group than those of the control group （P〈0.05）.VAS and JOA score after a week and 2-week treatment was improved in both groups （P〈0.05）, but the improvement of the observation group was much more obvious than that of control group （P〈0.05）.The effective rate after a week and 2-week treatment was superior in the treatment group compared with that of the control group （P〈0.05）.Serious adverse drug events occurred in both the two groups during the treatment.Conclusion：Integrated Chinese and western medicine treatment may significantly inhibit inflammatory factors of patients with lumbar intervertebral disc prolapse pain, relieve the inflammatory state and alleviate patient′s pain and symptoms.The curative effect of this comprehensive treatment is satisfied, safe and reliable, worthy of clinical recommendation.