自拟行气化瘀健腰汤联合推拿牵引在气滞血瘀型腰椎间盘突出症患者康复治疗中的应用效果

Application Analysis of Self-Made Xingqi Huayu Jianyao Decoction Combined with Massage Traction in Rehabilitation Treatment of Patients with Lumbar Intervertebral Disc Herniation of Qi Stagnation and Blood Stasis Type

目的:探讨自拟行气化瘀健腰汤联合推拿牵引在气滞血瘀型腰椎间盘突出症患者康复治疗中的应用效果。方法:选取2016年4月至2018年5月武汉市东西湖区人民医院收治的气滞血瘀型腰椎间盘突出症患者94例作为研究对象,随机分为对照组与观察组,每组47例。其中对照组给予推拿牵引治疗,观察组在对照组基础上给予自拟的行气化瘀健腰汤治疗。比较2组治疗前后中医证候积分、疼痛视觉模拟评分法(VAS)及日本骨科协会(JOA)腰椎评分,并比较临床疗效及治疗前后血清白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)变化情况,且观察用药安全性。结果:2组治疗后中医证候积分及VAS评分均明显低于治疗前,差异有统计学意义(P<0.05),观察组治疗后中医证候积分及VAS评分明显低于对照组,差异有统计学意义(P<0.05);2组治疗后的JOA评分明显高于治疗前,差异有统计学意义(P<0.05),观察组治疗后JOA评分明显高于对照组,差异有统计学意义(P<0.05);2组临床疗效等级分布差异有统计学意义(P<0.05),观察组治疗有效率明显高于对照组,差异有统计学意义(P<0.05);2组治疗后血清IL-1β及TNF-α水平均明显低于治疗前,差异有统计学意义(P<0.05),观察组治疗后血清IL-1β及TNF-α水平均明显低于对照组,差异有统计学意义(P<0.05);治疗期间,观察组除有2例出现轻微恶心呕吐外,无其他不良反应发生。结论:自拟行气化瘀健腰汤联合推拿牵引可明显促进气滞血瘀型腰椎间盘突出症患者临床症状缓解及腰椎功能改善,提高治疗效果,降低血清IL-1β及TNF-α水平,且安全性良好。

Objective:To explore the application effects of self-made Xingqi Huayu Jianyao Decoction combined with massage traction in the rehabilitation treatment of patients with lumbar intervertebral disc herniation of qi stagnation and blood stasis type.Methods:A total of 94 patients with lumbar disc herniation of qi stagnation and blood stasis type were selected from April 2016 to May 2018 in Wuhan Dongxihu District People′s Hospital,and were randomly divided into a control group and an observation group,with 47 cases in each group.The control group was treated with massage and traction,while the observation group was treated with self-made Xingqi Huayu Jianyao Decoction on the basis of the control group.The scores of TCM syndromes,pain visual analogue scale(VAS)and Japanese Orthopaedic Association(JOA)lumbar spine were compared between the 2 groups before and after treatment,and the clinical effects and the changes of serum interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)before and after treatment were compared,also the safety of medication was observed.Results:The scores of TCM syndromes and VAS of the 2 groups after treatment were significantly lower than those before treatment(P<0.05).And TCM syndrome scores and VAS score of the observation group were significantly lower than those of the control group after treatment(P<0.05).The JOA scores of the 2 groups after treatment were significantly higher than those before treatment(P<0.05).And the JOA score of the observation group was significantly higher than that of the control group after treatment(P<0.05);There was significant difference in clinical efficacy grade distribution between the 2 groups(P<0.05),and the total effective rate of the observation group was significantly higher than that of the control group(P<0.05).The serum levels of IL-1βand TNF-αof the 2 groups after treatment were significantly lower than those before treatment(P<0.05).The levels of serum IL-1βand TNF-αin the observation group were significantly lower than those in the control group after treatment(P<0.05).During the treatment,there were no other adverse reactions in the treatment group except 2 cases with slight nausea and vomiting.Conclusion:The self-made Xingqi huayu Jianyao Decoction combined with massage and traction can significantly promote the clinical symptoms relief and lumbar function improvement of patients with lumbar disc herniation of qi stagnation and blood stasis type,improve the therapeutic effects and reduce the serum levels of IL-1βand TNF-α,with good safety,which has the value of promotion and application.