通络汤联合常规西医治疗腰椎间盘突出症的效果观察

Clinical Effect of Tongluo Decoction Combined with Conventional Western Medicine in Treatment of Lumbar Disc Herniation

目的观察通络汤联合常规西医治疗腰椎间盘突出症的临床疗效。方法选取2016年3月至2018年3月承德县中医院接诊的94例腰椎间盘突出症患者为研究对象,按照治疗方法不同分为对照组和研究组,各47例。两组患者均进行基础牵引治疗;对照组采用双氯芬酸钠缓释片治疗,研究组在对照组的基础上采用通络汤治疗,连续治疗4周。比较两组患者的临床疗效,分别记录两组患者治疗前、治疗后2周和治疗后4周视觉模拟评分法(VAS)、Oswestry功能障碍指数问卷表(ODI)、日本骨科协会评分(JOA),治疗前和治疗后2周白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、高敏C反应蛋白(hs-CRP)水平,观察记录患者治疗过程中不良反应发生情况。结果研究组总有效率高于对照组[91.49%(43/47)比65.96%(31/47)](P<0.05)。治疗后2周、治疗后4周两组患者VAS、ODI评分呈下降趋势,JOA评分呈升高趋势,研究组各时点VAS、ODI评分低于对照组,JOA评分高于对照组,两组间各指标组间、时点间、组间和时点间交互作用比较差异有统计学意义(P<0.05)。治疗后,两组患者IL-6、TNF-α和hs-CRP水平均低于治疗前,且研究组低于对照组(P<0.05),两组间各指标组间、时点间、组间和时点间交互作用比较差异有统计学意义(P<0.05)。研究组总不良反应发生率低于对照组[8.51%(4/47)比17.02%(8/47)](P<0.05)。结论通络汤联合常规西医治疗腰椎间盘突出症的临床疗效显著,不良反应发生率低。

Objective To observe the clinical effect of Tongluo decoction combined with conventional western medicine on patients with lumbar disc herniation.Methods A total of 94 patients with lumbar disc herniation admitted to Chengde Hospital of Traditional Chinese Medicine from Mar.2016 to Mar.2018 were included in the study.According to treatment methods,they were divided into a control group and a study group,47 cases each.Basic traction therapy was performed in both groups.The control group was treated with diclofenac sodium sustained-release tablets;the study group was treated with Tongluo decoction combined with diclofenac sodium sustained-release tablets for 4 weeks.The clinical efficacy of the two groups was compared.The visual analog scale(VAS),Oswestry dysfunction index questionnaire(ODI),and Japanese Orthopaedic Association(JOA),pre-and post-treatment levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),and high-sensitivity C-reactive protein(hs-CRP)of the two groups before treatment,2 weeks,and 4 weeks after treatment were recorded.The occurrence of adverse reactions during the treatment was observed and recorded.Results The total effective rate in the study group was higher than that in the control group[91.49%(43/47)vs 65.96%(31/47)](P<0.05).At 2 weeks after treatment,4 weeks after treatment,the VAS,ODI score of the two groups decreased and the JOA score increased.The VAS,ODI score of the study group was lower than those of the control group,and the JOA score was higher than that of the control group;there were significant differences between groups,time points and the interactions of groups and time points(P<0.05).After treatment,the levels of IL-6,TNF-αand hs-CRP in both groups were lower than those before treatment,and there was a statistically significant difference between the two groups(P<0.05);there were significant differences between groups,time points and the interactions of groups and time points(P<0.05).The incidence of total adverse reactions in the study group was lower than that in the control group[8.51%(4/47)vs 17.02%(8/47)](P<0.05).Conclusion Tongluo decoction combined with conventional western medicine has significant clinical effect in the treatment of patients with lumbar disc herniation,with low adverse reaction rate.