散痹汤加减治疗寒湿痹阻型腰椎间盘突出症临床观察

Lumbar Disc Herniation Case with Cold-dampness Syndrome Treated with Sanbitang

目的:观察散痹汤加减治疗寒湿痹阻型腰椎间盘突出症的疗效及安全性。方法:将192例符合条件的患者随机分为中药组、西药组和中西药组,各64例。中药组给予散痹汤加减治疗,西药组给予依托考昔片治疗,中西药组同时给予散痹汤加减结合依托考昔片治疗,疗程均为28 d。观察各组治疗前后改良日本骨科协会腰疼痛评分量表(M-JOA),Oswestry功能障碍指数问卷评分量表(ODI),视觉模拟评分法(VAS)和中医辨证寒湿痹阻型腰椎间盘突出症中医证候评分;检测治疗前后检测各组血清肿瘤坏死因子-α(TNF-α),白细胞介素-1β(1L-1β),C-反应蛋白(CRP)和超氧化物歧化酶(SOD)的变化;比较各组有效率和不良事件发生率。结果:治疗后中西药组总有效率95.1%,高于中药组的79.4%和西药组的82.3%(P<0.05);中药组与西药组比较无明显差异;中西药组和中药组中医证候评分较西药组改善更为明显(P<0.05);其他临床症状中西药组改善较中药组和西药组更为明显(P<0.05);不良事件发生率中药组低于西药组和中西药。结论:散痹汤加减治疗寒湿痹阻型腰椎间盘突出症的疗效与西药依托考昔片无明显差异,具有有效性,且不良事件的发生率较依托考昔片低;散痹汤加减结合依托考昔片治疗寒湿痹阻型腰椎间盘突出症具有协同增效作用,疗效优于单用散痹汤加减和依托考昔片。

Objective：To explore the therapeutic effect of Sanbitang recipe in treating lumbar disc Herniation（LDH） case with cold-dampness syndromeand its safety.Method：A total of 192 cases with colddampness syndrome were randomly divided into the traditional Chinese medicine（TCM） group,the western medicine group and the traditional Chinese and western medicine group,with 64 cases in each group.The TCM group was treated with Sanbitang.Etoricoxib tablets were applied in the western medicine group.Sanbitang and etoricoxib tablets were adopted in the traditional Chinese and western medicine group.One course of treatment was28 d.Meliorate-Japanese orthopaedic association（M-JOA）,oswestry disability index（ODI）,visual analogue scale（VAS） and TCM cold-dampness syndrome score（TCM syndrome score） were analyzed to estimate the efficacy of three group before and after treatment.Tumor necrosis factor-α（TNF-α）,interleukins-β（1L-1β）,C-reactive protein（CRP） and superoxide dismutase（SOD） were detected.The efficient rates and adverse event rates among three groups were compared.Result：The total effective rate of the Chinese and western medicine group was 95.1%,which was better than TCM group（79.4%） and the chemical medicine group（82.3%,P〈0.05）.After treatment,as for the score of radiotherapy,the traditional Chinese and western medicine group and the TCM group were better than western medicine group（P〈0.05）.Regarding the other symptoms,the traditional Chinese and western medicine group showed more significant alleviations（P〈0.05）.The adverse event rate of the TCM group was the lowest among three groups（P〈0.05）.Conclusion：Modified Sanbitang is effective in treating LDH caseswith cold-dampness syndrome.To compare with western medicine Etoricoxib tablets,it shows no obvious difference and fewer adverse events.Sanbitang recipe shows a remarkable efficacy in treating LDH caseswith cold-dampness syndrome.