中药熏蒸疗法联合牵引治疗腰椎增生性脊柱炎（寒湿瘀阻证）62例临床观察

Clinical Observation on 62 Cases of Lumbar Hyperplastic Spondylitis with Cold-dampness-stasis Syndrome Treated by TCM Fumigation Combined with Traction

目的:观察中药熏蒸疗法联合牵引治疗腰椎增生性脊柱炎(寒湿瘀阻证)的临床疗效和安全性。方法:以随机、盲法、安慰剂平行对照的临床研究方法,纳入腰椎增生性脊柱炎患者130例,分为治疗组和对照组,每组65例。治疗组采用中药熏蒸联合牵引治疗,对照组采用安慰剂熏蒸联合牵引治疗。2组均以14 d为1个疗程。观察2组患者治疗前后视觉模拟评分法(VAS)评分、Oswestry功能障碍指数(ODI)等变化情况,并根据ODI改善率评定其临床疗效。结果:治疗组完成62例,对照组完成64例。治疗后,2组VAS评分均有不同程度下降,且治疗组优于对照组(P <0.05)。2组ODI评分均逐渐下降,在治疗后1周、治疗后2周及随访时,治疗组改善更为显著(P <0.05)。治疗组优5例,良38例,可16例,差3例,总有效率为95.16%;对照组优2例,良34例,可18例,差10例,总有效率为84.38%。2组比较,差异有统计学意义(P <0.05)。结论:中药熏蒸联合牵引治疗腰椎增生性脊柱炎具有较好的临床疗效,中药熏蒸标准化操作能较好地改善患者的腰椎活动功能,简单有效,安全性高,便于临床推广。

Objective:To observe the clinical efficacy and safety of TCM fumigation combined with traction in the treatment of lumbar hyperplastic spondylitis with cold-dampness-stasis syndrome.Methods:A randomized,blinded,placebo-controlled clinical study was carried out to select 130 patients with lumbar hyperplastic spondylitis and divide them into a treatment group and a control group,65 cases in each group.The treatment group was treated with TCM fumigation and traction,while the control group was treated with placebo fumigation and traction.Both groups were treated for 14 days as a course.The changes of visual analogue score(VAS)and Oswestry dysfunction index(ODI)were observed before and after treatment,and the clinical effect was evaluated according to the improvement rate of ODI.Results:Sixty-two cases in the treatment group and 64 cases in the control group were completed.After treatment,the VAS scores of both groups decreased in different degrees,and the treatment group was better than the control group(P < 0.05).The ODI scores of the two groups decreased gradually,and the improvement of the treatment group was more significant respectively after 1 week and 2 weeks treatment and each follow-up(P < 0.05).In the treatment group,5 cases were markedly improved,38 cases were improved,there was no obvious improvement in 16 cases,there was no improvement in 3 cases,and the total effective rate was 95.16%;while in the control group,2 cases were markedlyimproved,34 cases were improved,there was no obvious improvement in 18 cases,there was no improvement in 10 cases,and the total effective rate was 84.38%.The difference between the two groups was statistically significant(P < 0.05).Conclusion:TCM fumigation combined with traction has a good clinical effect in the treatment of lumbar hyperplastic spondylitis.The standardized operation of TCM fumigation in this study can better improve the lumbar activity function of patients,which is simple,effective,safe and convenient for clinical promotion.