自拟舒筋活血膏治疗气滞血瘀型腰椎间盘突出症的疗效及对炎性因子水平的影响

Therapeutic effects of self-made Shujinhuoxue ointment on lumbar disc herniation of Qi stagnation and blood stasis type and its influence on the levels of inflammatory factors

目的探讨自拟舒筋活血膏治疗气滞血瘀型腰椎间盘突出症(LDH)的临床疗效及对炎性因子水平的影响。方法 100例气滞血瘀型LDH患者随机分为对照组和研究组,每组50例。2组患者均进行西医常规治疗,在此基础上,对照组采用奇正消痛贴贴于痛处,1次/d,贴敷12 h后取下;研究组自拟舒筋活血方,制成黑膏药,贴于痛处,1次/d,贴敷12 h后取下。2组患者均10 d为一个疗程,共治疗2个疗程。比较2组患者Oswestry功能障碍指数(ODI)、疼痛视觉模拟评分(VAS)评分及改良日本骨科协会腰痛评分表(M-JOA)评分以及炎症因子水平变化。结果研究组临床疗效显著优于对照组(Z=2.49,P<0.05),总有效率显著高于对照组(92.00%与76.00%,χ^2=4.76,P<0.05)。治疗后研究组ODI指数显著优于对照组(Z=2.33,P<0.05),研究组ODI优良率显著高于对照组(84.00%与62.00%,χ^2=6.14,P<0.05)。2组患者M-JOA和VAS评分均随治疗时间的延长而显著降低(F时间=78.68,31.27,P<0.05),研究组M-JOA和VAS评分降低幅度显著大于对照组(F交互=6.32,4.22,P<0.05),研究组M-JOA和VAS评分整体水平显著低于对照组(F分组=8.57,6.73,P<0.05)。2组患者TNF-α,IL-6和NO水平均随治疗时间的延长而显著降低(F时间分别为13.27,37.87,26.92,P<0.05),研究组TNF-α,IL-6和NO水平降低幅度均显著大于对照组(F交互=3.53,14.64,12.47,P<0.05),研究TNF-α,IL-6和NO水平整体水平显著低于对照组(F分组=5.25,7.98,8.63,P<0.05)。结论自拟舒筋活血膏能够通过降低炎性因子水平,减轻LDH患者局部炎性反应,从而减轻患者疼痛、改善腰部活动能力。

Objective To explore the therapeutic effects of self-made Shujinhuoxue ointment on lumbar disc herniation(LDH) of Qi stagnation and blood stasis type and its influence on levels of inflammatory factors.Methods A total of 100 patients with Qi stagnation and blood stasis type LDH were randomly divided into control group(n=50) and research group(n=50). On the basis of routine treatment, the patients in control group were treated by Qizhengxiaotong paste once a day, and the paste was removed after 12 hours. The patients in research group were treated by self-made Shujinhuoxue ointment, once a day, and the ointment was removed after 12 hours. The patients in both groups were treated for two courses(ten days as a course). The ODI, VAS scores, MJOA scores and the changes of the levels of inflammatory factors were observed and compared between the two groups. Results The clinical efficacy in research group was significantly better than that in control group(Z=2.49, P<0.05). And the total effective rate(92.00%) in research group was significantly higher than that(76.00%) in control group(P<0.05). After treatment, the ODI index in research group was significantly better than that in control group(Z=2.33,P<0.05), and the excellence rate of ODI in research group was significantly higher than that in control group(84.00% vs.62.00%,χ^2=6.14,P<0.05). Moreover, the VAS scores and MJOA scores in both groups were decreased significantly with the prolongation of treatment time(F time = 78.68,31.27,P<0.05),and the decrease degree in research group was more significant than that in control group(F interaction=6.32,4.22,P<0.05). Furthermore, the levels of TNF-α,IL-6 and NO in both group were decreased significantly with the prolongation of treatment time(F time = 13.27,37.87,26.92,P<0.05), the decrease degree in research group was more significant than that in control group(F interaction=3.53, 14.64,12.47,P<0.05). In addition, the overall levels of TNF-α,IL-6 and NO in research group were significantly lower than those in control group(F group =5.25,7.98,8.63,P<0.05).Conclusion The self-made Shujinhuoxue ointment can alleviate local inflammation reaction of LDH patients by reducing the levels of inflammatory factors, thereby alleviating pain and improving lumbar motility.