复方乌头微乳剂治疗寒湿痹阻型腰椎间盘突出症的观察

Observation on Compound Wutou Microemulsion Treating Lumbar Disc Herniation

目的:探讨复方乌头微乳剂治疗寒湿痹阻型腰椎间盘突出症的临床效果。方法:92例寒湿痹阻型腰椎间盘突出症患者依据随机数字的方法分为对照组和观察组各46例,患者入院后均常规治疗,对照组给予西医治疗,观察组在对照组治疗方法基础上给予复方乌头微乳剂治疗。对两组治疗前后的M-JOA量表评分与VAS量表评分进行比较。对两组治疗前后的中医症候评分进行比较。对两组治疗前后的肿瘤坏死因子-α(TNF-α),白细胞介素-1β(IL-1β),C反应蛋白(CRP),超氧化物歧化酶(SOD)浓度进行比较。对治疗过程中的不良反应进行对比。结果:经过治疗后,对照组的M-JOA量表得分从(14.35±5.13)分降低到(8.63±3.02)分,VAS量表得分从(6.31±2.44)分降低到(2.35±1.78)分,观察组的M-JOA量表得分从(14.44±5.07)分降低到(4.85±1.32)分,VAS量表得分从(6.07±2.35)分降低到(1.35±0.91)分,观察组的变化幅度大于对照组,数据差异均具有统计学意义(t=7.779,3.393,P<0.05),经过治疗后,对照组的"腰部疼痛"评分从(7.21±2.04)分降低到(3.89±1.02)分,"受寒加重"评分从(6.73±2.14)分降低到(3.37±0.97)分,"活动受限"评分从(5.61±2.11)分降低到(2.91±0.79)分,"活动疼痛加剧"评分从(5.21±1.81)分降低到(2.77±1.23)分,"舌质黯紫"评分从(6.83±1.92)分降低到(3.67±1.13)分,"脉沉迟"评分从(4.91±1.57)分降低到(2.63±0.87)分,观察组的"腰部疼痛"评分从(7.18±2.01)分降低到(2.34±0.81)分,"受寒加重"评分从(6.84±2.15)分降低到(1.95±0.88)分,"活动受限"评分从(5.64±2.07)分降低到(1.42±0.66)分,"活动疼痛加剧"评分从(5.32±1.93)分降低到(1.43±0.81)分,"舌质黯紫"评分从(6.81±1.87)分降低到(2.11±1.05)分,"脉沉迟"评分从(4.89±1.45)分降低到(1.73±0.94)分,观察组的变化幅度大于对照组,数据差异均具有统计学意义(t=8.071,7.354,9.817,6.171,6.859,4.766,P<0.05),经过治疗后,对照组的TNF-α从(2.03±0.34)μg/L降低到(1.62±0.12)μg/L,IL-1β从(0.45±0.08)μg/L降低到(0.31±0.11)μg/L,CRP从(26.21±8.32)μmol/L降低到(18.64±5.67)μmol/L,SOD从(71.39±8.15)μU/L升高到(79.61±7.05)μU/L,观察组的TNF-α从(2.07±0.35)μg/L降低到(1.1±0.25)μg/L,IL-1β从(0.47±0.07)μg/L降低到(0.21±0.12)μg/L,CRP从(27.08±7.35)μmol/L降低到(11.57±4.71)μmol/L,SOD从(70.54±8.61)μU/L升高到(91.35±9.25)μU/L,观察组的变化幅度大于对照组,数据差异均具有统计学意义(t=12.718,4.166,6.505,-6.846,P<0.05),两组的恶心[4.35%(2/46)VS. 2.17%(1/46)],头晕[6.52%(3/46)VS. 2.17%(1/46)],湿疹[2.17%(1/46)VS. 6.52%(3/46)],斑丘疹[4.35%(2/46)VS. 8.70%(4/46)],失眠[2.17%(1/46)VS. 4.35%(2/46)],发生率数据差异均不具有统计学意义(χ^2=0.000,0.261,0.261,0.178,0.000,P>0.05)。结论:利用复方乌头微乳剂治疗寒湿痹阻型腰椎间盘突出症的患者,可以改善症状,缓解疼痛,提升治疗效果,安全性良好。

Objective:To explore the clinical effect of Compound Wutou Microemulsion in the treatment of lumbar disc herniation.Methods:Ninety-two patients with cold and dampness type lumbar disc herniation were accorded to the method of random number.It was divided into control group(n=46)and observation group(n=46).The patients were treated routinely after admission,and the patients in the control group were treated with Western medicine.The patients in the observation group were treated with Compound Wutou Microemulsion on the basis of the treatment methods of the control group.The M-JOA scale scores before and after treatment were compared with the VAS scale scores.The TCM symptom scores before and after treatment were compared between the two groups.The concentrations of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),C-reactive protein(CRP)and superoxide dismutase(SOD)were compared before and after treatment.The adverse reactions during treatment were compared.Results:After treatment,the M-JOA scale score of the control group decreased from(14.35±5.13)points to(8.63±3.02)points,and the VAS scale score decreased from(6.31±2.44)points to(2.35±1.78)points.The M-JOA scale score of the observation group decreased from(14.44±5.07)points to(4.85±1.32)points,and the VAS scale score decreased from(6.07±2.35)points to(1.35±0.91)points.The change of the observation group was larger than that of the control group,and the data was statistically significant(t=7.779,3.393,P<0.05).After treatment,the lumbar pain score of the control group decreased from(7.21±2.04)points to(3.89±1.02)points,and the cold aggravation score decreased from(6.73±2.14)points to(3.37±0.97)points.The limited activity score decreased from(5.61±2.11)points to(2.91±0.79)points,and the active pain intensification score decreased from(5.21±1.81)points to(2.77±1.23)points.The tongue dark purple score decreased from(6.83±1.92)points to(3.67±1.13)points and the deep and slow pulse score decreased from(4.91±1.57)points to(2.63±0.87)points.In the observation group,the lumbar pain score decreased from(7.18±2.01)points to(2.34±0.81)points,and the cold aggravation score decreased from(6.84±2.15)points to(1.95±0.88)points.The limited activity score decreased from(5.64±2.07)points to(1.42±0.66)points,and the active pain intensification score decreased from(5.32±1.93)points to(1.43±0.81)points,and the tongue dark purple score reduced from(6.81±1.87)points to(2.11±1.05)points,and the deep and slow pulse score was reduced from(4.89±1.45)points to(1.73±0.94)points.The change of the observation group was larger than that of the control group,and the data was statistically significant(t=8.071,7.354,9.818,6.171,6.859,4.766,P<0.05).After treatment,the TNF-αof the control group decreased from(2.03±0.34)μg/L to(1.62±0.12)μg/L,and IL-1βdecreased from(0.45±0.08)μg/L to(0.31±0.11)μg/L,CRP decreased from(26.21±8.32)μmol/L to(18.64±5.67)μmol/L,and SOD increased from(71.39±8.15)μU/L to(79.61±7.05)μU/L.The TNF-αof the observation group decreased from(2.07±0.35)μg/L to(1.1±0.25)μg/L,and IL-1βdecreased from(0.47±0.07)μg/L to(0.21±0.12)μg/L.The CRP decreased from(27.08±7.35)μmol/L to(11.57±4.71)μmol/L,and the SOD increased from(70.54±8.61)μU/L to(91.35±9.25)μU/L.The change of the observation group was larger than that of the control group,and the data was statistically significant(t=12.718,4.166,6.505,-6.846,P<0.05).Nausea[4.35%(2/46)vs.2.17%(1/46)],dizziness[6.52%(3/46)vs.2.17%(1/46)],eczema[2.17%(1/46)VS.6.52%(3/46)],maculopapular rash[4.35%(2/46)vs.8.70%(4/46)]and insomnia[2.17%(1/46)vs.4.35%(2/46)]in both groups were not statistically significant(χ^2=0.000,0.261,0.261,0.178,0.000,P>0.05).Conclusion:The use of Compound Wutou Microemulsion in the treatment of patients with cold and dampness and obstruction type lumbar disc herniation can improve symptoms,relieve pain,improve the treatment effect,and has good safety.