加味肾着汤治疗寒湿型腰椎间盘突出症的临床观察

Clinical observation of Jiawei Shenzhuo Decoction in the treatment of cold-dampness-type lumbar disc herniation

目的:观察加味肾着汤治疗寒湿型腰椎间盘突出症的临床疗效。方法:将符合诊断标准的100例患者随机分为研究组、对照组各50例,分别予加味肾着汤煎剂和美洛昔康片口服2周。疗效评价采用日本骨科协会下腰痛评分(JOA)、视觉模拟评分(VAS)、阿森斯失眠评分(AIS)、汉密尔顿焦虑评分(HAMA)。观察时点为治疗前和治疗后1、2、3、4周。结果:治疗前,两组基本资料具有统计学可比性,失眠、焦虑总体发生率分别高达75%和96%。治疗后,研究组、对照组总有效率分别为88%和76%,研究组高于对照组(P<0.05),两组腰痛、下肢疼痛麻木、畏寒怕冷、失眠、焦虑等症状均较治疗前明显改善(P<0.01),但研究组疗效优于对照组(P<0.05,P<0.01)。结论:寒湿型腰椎间盘突出症多伴失眠、焦虑等阳郁表征,加味肾着汤疗效确切。

Objective： To observe the clinical effect of Jiawei Shenzhuo Decoction in treating cold-dampness-type lumbar disc herniation. Methods： A total of 100 patients with diagnostic criteria were randomly divided into two groups, study group, control group, 50 cases in each group, respectively to Jiawei Shenzhuo Decoction and meloxicam tablets orally for 2 weeks. JOA low back pain score, visual analogue scale（VAS）, Athens insomnia score（AIS）, and Hamilton Anxiety Score（HAMA） were used as the therapeutic evaluation. The time points of observation were before treatment and after treatment 1 week, 2 weeks, 3 weeks and 4 weeks. Results： Before treatment, the basic data of two groups were statistically comparable. The overall incidence of insomnia and emotional anxiety were as high as 75% and 96%. After treatment, the total effective rate of study group and control group were 88% and 76% respectively. The low back pain, lower limbs pain and numbness, cold chills, insomnia and other clinical symptoms of two groups were significantly improved, but the study group was better than the control group. However, the study group is better than the control group（P0.05, P0.01）. Conclusion： Cold-dampness-type lumbar disc herniation is accompanied by insomnia, emotional anxiety and other symptoms of yangqi stagnation. The curative effect of Jiawei Shenzhuo Decoction is exact.