血府逐瘀汤配合互动式针刺与布洛芬缓释胶囊联用治疗急性腰扭伤临床研究

Clinical study of Xuefu-Zhuyu decoction combined with interactive acupuncture and ibuprofen sustained-release capsule in the treatment of acute lumbar sprain

目的评价血府逐瘀汤配合互动式针刺与布洛芬缓释胶囊联用治疗急性腰扭伤的疗效。方法将符合入选标准的102例急性腰扭伤患者按随机数字表法分为2组,每组51例。对照组口服布洛芬缓释胶囊,研究组在对照组基础上加用血府逐瘀汤联合互动式针刺治疗。2组均治疗2周。采用VAS量表评价腰痛程度,采用改良日本骨科学会量表(Japanese Orthopaedic Association Scores, M-JOA)评价腰部功能改善情况,采用Oswestry功能障碍指数(Oswestry Dability Index, ODI)评价腰部功能障碍程度,采用ELISA法检测血清hs-CRP、IL-6、IL-10及前列腺素E2(prostaglandin E2, PGE2)水平,评价临床疗效。结果研究组总有效率为80.4%(41/51)、对照组为62.8%(32/51),2组比较差异有统计学意义(χ2=3.903,P=0.048)。治疗后,研究组VAS[(1.85±0.40)分比(4.06±0.67)分,t=20.226]、M-JOA[(4.41±1.35)分比(11.18±2.25)分,t=18.426]及ODI[(9.66±3.34)分比(16.37±3.64)分,t=9.700]评分均低于对照组(P<0.01)。研究组治疗后血清hs-CRP、IL-6、IL-10及PGE2水平均低于对照组(t值分别为6.694、8.416、22.110、12.137,P值均<0.01)。结论血府逐瘀汤配合互动式针刺与布洛芬缓释胶囊联用可明显改善急性腰扭伤患者腰痛及腰部功能障碍程度,降低血清炎性细胞因子水平,提高临床疗效。

Objective To evaluate the effect of Xuefu-Zhuyu decoction combined with interactive acupuncture and ibuprofen sustained-release capsule in the treatment of acute lumbar sprain. Methods A total of 102 patients with acute lumbar sprain were randomly divided into two groups, 51 in each group.The control group received ibuprofen sustained-release capsules orally. The study group was treated with Xuefu-Zhuyu decoction combined with interactive acupuncture on the basis of the control group. Both groups were treated for 2 weeks. The degree of low back pain was assessed by VAS and the improvement of lumbar function was assessed by modified Japanese Orthopaedic Association Scores (M-JOA). The Oswestry dysfunction index (ODI) was used to evaluate the degree of lumbar dysfunction. The serum hs-CRP, IL-6, IL-10 and prostaglandin E2 (PGE2) level was detected by ELISA. The clinical efficacy was evaluated. Results The total effective rate was 80.4%(41/51) in the study group and 62.8%(32/51) in the control group. There was significant difference between the two groups (χ2=3.903, P=0.048). After treatment, the VAS (1.85 ± 0.40 vs. 4.06 ± 0.67, t=20.226), M-JOA (4.41 ± 1.35 vs. 11.18 ± 2.25, t=18.426), and ODI (9.66 ± 3.34 vs. 16.37 ± 3.64, t=9.700) in the study group were significantly lower than those in the control group (P<0.01). The serum level of hs-CRP, IL-6, IL-10 and PGE2 in the study group were significantly lower than those in the control group after treatment (t were 6.694, 8.416, 22.110 and 12.137, respectively, all Ps<0.01). Conclusions The Xuefu-Zhuyu decoction combined with interactive acupuncture and ibuprofen sustained-release capsule can improve the degree of lumbago and lumbar dysfunction in patients with acute lumbar sprain, reduce the level of serum inflammatory cytokines, and improve the clinical efficacy.