补肾活血方联合针灸治疗腰椎骨质增生性腰痛(肝肾不足证)临床研究

Bushen Huoxue Decoction Combined with Acupuncture in the Treatment of Lumbago due to Lumbar Hyperosteogeny: A Clinical Study of Deficiency Syndrome of Liver and Kidney

目的:观察补肾活血方汤联合针灸治疗腰椎骨质增生性腰痛(肝肾不足证)的临床疗效。方法:按照随机数表法将本院收治的符合纳入标准的腰椎骨质增生性腰痛患者158例分为治疗组和对照组,每组79例。对照组给予抗骨增生胶囊口服进行治疗,治疗组给予自拟补肾活血方口服并联合针灸疗法进行治疗。对比两组患者治疗前后血清DKK1和SOST水平的变化和临床疗效总有效率,并对两组患者腰椎功能按照日本骨科协会评估治疗分数(JOA)进行评分,疼痛强度及其变化的量化采用目测类比评分法(VAS)进行评分。结果:经过8周治疗后,治疗组总有效率(97. 47%,77/79)高于对照组(86. 08%,68/79)(P <0. 05),观察组JOA、VAS评分低于对照组(P <0. 01),两组患者血清DKK1和SOST水平较治疗前都有明显升高(P <0. 05),且治疗组治疗后血清DKK1和SOST水平较对照组升高更显著(P <0. 05)。结论:补肾活血方汤联合针灸治疗可明显改善腰椎骨质增生性腰痛(肝肾不足证)的腰功能,降低JOA、VAS评分,提高患者的生活质量,其作用机制可能与提高血清DKK1、SOST水平密切相关。

Objective: To observe the clinical effect of Bushen Huoxue Decoction combined with acupuncture in the treatment of lumbago due to lumbar hyperosteogeny of the deficiency syndrome of Liver and Kidney. Methods: 158 cases of lumbago due to lumbar hyperosteogeny with TCM diagnosis of the deficiency syndrome of Liver and Kidney were randomly divided into the observation group(n=79) and the control group(n=79). The control group was treated with Kanggu Zengsheng Capsule;the observation group was treated with Bushen Huoxue Decoction combined with acupuncture. The treatment course was 8 weeks. The serum levels of DKK1 and SOST were compared before and after the treatment in the two groups;the clinical efficacy, JOA score, and VAS score were observed in the two groups. Results: After 8 weeks of treatment, the total effective rate of the observation group was 97.47%(77/79) which was higher than 86.08%(68/79), of the control group( P < 0.05). JOA score and VAS score were significantly lower in the observation group than those in the control group( P<0.01). The serum levels of DKK1 and SOST were significantly increased in the two groups after the treatment( P<0.05);the increase was more significant in the observation group compared to that in the control group( P<0.05). Conclusion: Bushen Huoxue Decoction combined with acupuncture can obviously improve the lumbago due to lumbar hyperosteogeny of the deficiency syndrome of Liver and Kidney, it can reduce JOA score and VAS score, it can improve the life quality of the patients. The mechanism may be closely related to the increase of serum levels of DKK1 and SOST.