根据《肘后备急方》制作“葛氏腰痛方”治疗腰椎间盘突出症的临床应用效果观察

Clinical application of Gzhi's Lumbago Prescription in treatment of lumbar disc herniation based on “Zhouhou Beiji Fang”

目的根据《肘后备急方》制作"葛氏腰痛方",研究古代方剂和治法对腰椎间盘突出症的疗效,为下一步研究提供参考。方法选取2015-06~2017-05该院收治的200例确诊为腰椎间盘突出症的住院患者为研究对象,随机分为两组,各100例。对照组采用双氯芬酸钠缓释片+甘露醇治疗,观察组采用"葛氏腰痛方"治疗。治疗2周后,采用日本骨科协会(JOA)腰痛疗效评分标准评价两组治疗前后的症候积分;采用视觉模拟评分法(VAS)和swestry腰背、下肢功能障碍评分量表分别对两组治疗前后的腰背部疼痛程度及腰背、下肢功能障碍进行评价;比较两组临床效果及不良反应情况。结果两组治疗后VAS评分及swestry腰背、下肢功能障碍评分及症候总积分均较治疗前显著改善,治疗后观察组均明显优于对照组(P <0. 05)。观察组临床疗效优于对照组(Z=-5. 828,P=0. 000),观察组总有效率为98. 0%,明显高于对照组的90. 0%(P <0. 01)。两组治疗前后血尿常规、心电图、肝肾功能等均未见明显变化,治疗中也未有其他明显不良反应情况发生。结论根据《肘后备急方》制作的"葛氏腰痛方"能有效改善腰椎间盘突出症患者的临床症状及体征,疗效显著,安全性高,可在临床推广应用。

Objective To collect and sort out Ge Hong′s academic thoughts, and to make Gzhi′s Lumbago Prescription based on “Zhouhou Beiji Fang”（Handbook of Prescriptions for Emergency） and to study the effect of ancient prescription and treatment on lumbar disc herniation to provide reference for further study. Methods 200 hospitalized patients with lumbar disc herniation were selected as the study objects in our hospital from June 2015 to May 2017, and were randomly divided into two groups, with 100 cases in each group. The control group was treated with diclofenac sodium sustained-release tablets＋Mannitol, and the observation group was treated with Gzhi′s Lumbago Prescription. The syndrome scores were evaluated by the criteria for the evaluation of curative effect for lumbar intervertebral disc herniation（JOA）, and the Visual Acuity Score（VAS） and Swestry Lower Aack and Lower Limb Dysfunction Score Scale were used to evaluate the degree of lower back pain and back and lower extremity dysfunction before and 2 weeks after treatment. The clinical effects and adverse reactions were compared between the two groups. Results Compared with those before treatment, the VAS scores and Swestry scores were significantly improved in both of the two groups（P〈0.05）. The scores of the observation group were significantly higher than those of the control group after treatment（P〈0.05）. The clinical effect of the observation group was better than that of the control group after treatment（Z=-5.828, P=0.000）. The total effective rate of the observation group（98.0%） was significantly higher than that of the control group（90.0%）（P〈0.01）. Compared with those before treatment, the blood and urine routine, electrocardiogram, liver and kidney function were not significantly changed in both of the two groups after treatment. No other obvious adverse reactions occurred in the two groups after treatment. Conclusion Gzhi′s Lumbago Prescription is safe and effectively improves the clinical symptoms and signs in the patients with lumbar disc herniation.