独活寄生汤加减联合硬膜外冲击治疗肝肾亏虚型腰椎间盘突出症30例

30 Case of Prolapse of Lumbar Intervertebral Disc with Symptom of Liver and Kidney Deficiency Treatment with Duhuo Jisheng Decoction Combined with Epidural Shock

目的:探讨独活寄生汤加减联合硬膜外冲击治疗腰椎间盘突出症肝肾亏虚型的临床效果。方法:选取我院2018年3月—2019年2月期间因腰突症(中医肝肾亏虚型)患者共90例,随机分为观察组和对照1、2组,每组30例。比较三组治疗前后VAS、JOA、SF-36量表评分和炎性因子水平。结果:三组治疗前JOA、VAS、SF-36量表评分相持平,无统计学差异(P>0.05);观察组治疗后VAS评分低于两对照组治疗后以及本组治疗前,均具有统计学差异(P<0.05);观察组治疗后JOA评分高于两对照组治疗后及本组治疗前,均具有统计学差异(P<0.05);三组治疗前IL-1(白细胞介素-1)、IL-6(白细胞介素-6)、和TNF-α(血清坏死肿瘤因子-α)水平相持平,无统计学差异(P>0.05)),三组治疗后5d和15d的IL-1、IL-6和TNF-α水平值均低于本组治疗前。除去对照1组和对照2组治疗后5天TNF-α水平与本组治疗前无统计学差异(P>0.05)),余各均有统计学差异(P<0.05)。除去观察组治疗后5d的IL-6水平值与对照1、2组同时期值无统计学差异(P>0.05)),余观察组治疗后的IL-1、IL-6和TNF-α水平值均低于两对照组治疗后同时期值,均具有统计学差异(P<0.05)。结论:中西医联合方案治疗肝肾亏虚型腰突症效果好,能降低患者的炎性因子水平且更好更快恢复患肢功能,改善预后,推荐临床广泛应用。

Objective:To investigate the clinical effect of treatment with Duhuo Jisheng decoction combined with Epidural Shock on Lumbar intervertebral disc protrusion with deficiency of liver and kidney.Methods:90 patients with above type of Lumbar intervertebral disc needed to be treated in our hospital from March 2018 to February 2019 were selected,They were randomly divided into three groups,The observation group was treated with modified duhuo Jisheng decoction combined with peridural impact therapy,Control Group 1 only received peridural impact therapy,Control Group 2 only treated with traditional Chinese medicine.The VAS score,JOA score,SF-36 score and inflammatory factors were compared before and after treatment.Results:The scores of Joa,Vas and SF-36 were the same in the 3 groups before treatment,there was no significant difference(P>0.05);The JOA score in the observation group was significantly higher than that in the Control Group(P<0.05);After treatment,the Vas score of the observation group was lower than that of the control group before treatment,Control Group 1 and Control Group 2,the difference was statistically significant(P<0.05);Before treatment,the levels of IL-1(interleukin-1),IL-6(IL6)and TNF-a(serum necrosis tumor factor-a)were the same in the three groups,there was no significant difference(P>0.05),The levels of IL-1,IL-6 and TNF-a in the three groups were lower than those in the control group at the 5 th and 15 th day after treatment.There was no significant difference in TNF-a level Between Control Groups 5 days after treatment and before Treatment(P>0.05),but there was significant difference in the rest(P<0.05).There was no significant difference in the level of IL-6 between the Observation Group and the Control Groups 5 days after Treatment(P>0.05),The levels of IL-1,IL-6 and TNF-a in the observation group were lower than those in the Control Groups(P<0.05).Conclusion:The combination of TCM and peridural impact therapy is effective in treating lumbar intervertebral disc protrusion with deficiency of liver and kidney.The recovery of affected limb function is faster and the pain is less.It can reduce inflammatory reaction and improve prognosis.