补肾调三焦法治疗盘源性腰痛急性期的临床疗效观察

Clinical Observation on Treatment of Acute Discogenic Lumbago by Therapy of Tonifying Kidney and Regulating Triple Energizer

【目的】探讨关宏刚教授基于中医藏象学说和脏腑别通理论的补肾调三焦法治疗盘源性腰痛急性期的临床疗效。【方法】将90例盘源性腰痛急性期患者随机分为治疗组和对照组,每组各45例。2组患者均给予中药玉龙散外敷及常规对症处理,在此基础上,对照组给予口服止痛药塞来昔布治疗,治疗组给予补肾调三焦法的中药方剂治疗,疗程为2周,并随访1个月。观察2组患者治疗前后及治疗后1个月末次随访时疼痛视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)评分的变化情况,并评价2组患者的疗效及安全性。【结果】(1)研究过程中,有3例患者退出,2例患者失访,最终有85例患者完成试验,其中治疗组43例,对照组42例。(2)治疗后1个月,治疗组与对照组的总有效率分别为88.4%和78.6%,治疗组的疗效明显优于对照组(P<0.05)。(3)治疗1周和2周后,2组患者的VAS评分和ODI评分均较治疗前明显降低(P<0.05),但组间比较,差异均无统计学意义(P>0.05);治疗后1个月,2组患者VAS评分和ODI评分仍较治疗前明显降低(P<0.05),且治疗组对VAS评分和ODI评分的降低作用均明显优于对照组(P<0.05)。(4)试验过程中,除3例患者皮肤对玉龙散过敏而暂停使用外,其余患者均未发现有明显不良反应。【结论】在外敷玉龙散及常规对症处理的基础上,应用补肾调三焦法治疗盘源性腰痛急性发作的短期疗效良好,能有效缓解患者疼痛,改善患者腰部功能,其作用优于采用西药治疗的对照组。

Objective To investigate the clinical effect of therapy of tonifying kidney and regulating triple energizer,a method established by Professor GUAN Hong-Gang based on the theories of visceral manifestation and connection between the zang and fu organs,in treating acute discogenic lumbago.Methods Ninety patients with acute discogenic lumbago were randomly divided into treatment group and control group,45 patients in each group.The two groups were given external application of Yulong Powder and conventional symptomatic treatment.And additionally,the control group was given oral use of analgesic of celecoxib tablets,while the treatment group was given oral use of Chinese medicine prescription for tonifying kidney and regulating triple energizer.The treatment lasted 2 weeks and the follow-up covered one month.Before and after treatment and at the end of onemonth follow-up,pain scores assessed with visual analogue scale(VAS)and Oswestry disability index(ODI)scores were compared between the two groups.After treatment,the clinical efficacy and safety of the two groups were also evaluated.Results(1)During the trial,3 cases quitted and 2 cases lost to be followed up,and finally a total of 85 cases finished the trial,43 cases in the treatment group and 42 cases in the control group.(2)One month after treatment,the total effective rate in the treatment group was 88.4%and that in the control group was 78.6%,and the efficacy of the treatment group was superior to that of the control group(P<0.05).(3)After treatment for one and 2 week(s),the scores of VAS and ODI in the two groups were obviously decreased(P<0.05 compared with those before treatment),but the differences between the two groups were insignificant(P>0.05).One month after treatment,the scores of VAS and ODI in the two groups were still obviously decreased as compared with those before treatment(P<0.05),and the decrease in the treatment group was superior to that in the control group(P<0.05).(4)During the trial,3 cases had cutaneous anaphylaxis to Yulong Powder and then suspended the medication,while other patients had no obviously adverse reaction.Conclusion Based on external application of Yulong Powder and conventional symptomatic treatment,therapy of tonifying kidney and regulating triple energizer exerts stronger short-term efficacy for the treatment of acute onset of discogenic lumbago than conventional western medicine through relieving pain and improving lumbar function.