壮腰通络方治疗腰椎间盘突出症45例

Clinical Observation on Zhuangyao Tongluo Decoction in the Treatment of 45 Patients with Lumbar Disc Herniation

目的:探讨壮腰通络方治疗腰椎间盘突出症(肝肾亏虚、瘀血阻络证)的临床疗效和安全性。方法:采用壮腰通络方内服治疗45例(肝肾亏虚、瘀血阻络证)腰椎间盘突出症患者,疗程4周,分别于治疗前、治疗2周后、治疗4周后及治疗结束后2周随访时记录患者JOA评分、腰痛VAS评分及中医证候积分,并观察用药安全性。结果:患者的JOA评分、VAS评分及中医证候积分在治疗2周后、治疗4周后及治疗结束后2周随访与治疗前比较,差异均有统计学意义(P<0.05);治疗4周后及治疗结束后2周随访与治疗2周后比较,差异有统计学意义(P<0.05)。在JOA评分中,主观症状评分及日常活动受限程度评分在治疗2周后、治疗4周后及治疗结束后2周随访与治疗前比较,差异均有统计学意义(P<0.05);治疗4周后及治疗结束后2周随访与治疗2周后比较,差异有统计学意义(P<0.05);而临床体征评分仅在治疗4周后及治疗结束后2周随访与治疗前比较,差异均有统计学意义(P<0.05)。经过治疗2周及治疗4周后,JOA疗效评价有效率分别为77.78%和82.22%;在治疗结束后2周随访时,有效率为80%。在观察期内未发现因服用本药而引起的不良事件。结论:壮腰通络方能改善腰椎间盘突出症(肝肾亏虚、瘀血阻络证)患者腰膝酸软等中医证候积分及主观症状、日常活动受限程度等腰椎功能评分,具有较稳定的临床疗效和安全性。

Objective:To explore the clinical efficacy and safety of Zhuangyao Tongluo decoction in the treatment of lumbar disc herniation(LDH)of liver-kidney deficiency,blood stasis syndrome.Methods:45patients with LDH were treated with Zhuangyao Tongluo decoction for 4weeks.JOA scores,VAS scores,traditional Chinese medicine(TCM)syndrome scores and drug safety were recorded before treatment,2weeks,4 weeks after treatment and 2 weeks’follow-up.Results:Compared with those before treatment,JOA scores,VAS scores and TCM syndrome scores were respectively significantly changed at 2weeks,4weeks after treatment and 2 weeks’follow-up(P<0.05).Compared with those of 2 weeks after treatment,there were significant differences after 4weeks treatment and 2weeks of follow-up(P<0.05).In terms of clinical sign scores,compared with that before treatment,there was significant difference after 4weeks of treatment and 2weeks of follow-up(P<0.05).After 2weeks and 4weeks treatment,the effective rates of JOA efficacy evaluation were 77.78%and 82.22%respectively.The effective rate was 80%after 2weeks’follow-up.During the observation period,there was no side-effects caused by medication.Conclusion:Zhuangyao Tongluo decoction can effectively improve the scores of TCM syndromes such as sore waist and knees of patients with LDH of liver-kidney deficiency,blood stasis syndrome,and can also improve the scores of lumbar function such as subjective symptoms and limits of daily activities,which has stable clinical efficacy and safety.