独活寄生汤加减联合大面积灸法对寒湿型腰椎间盘突出症镇痛效果及生活质量的影响研究

Effect of Duhuo Jisheng Decoction combined with large area moxibustion on analgesic effect and quality of life of cold-damp type lumbar disc herniation

目的探讨独活寄生汤加减联合大面积灸法对寒湿型腰椎间盘突出症镇痛效果及生活质量的影响,为临床应用提供依据。方法将2018年1月—2019年10月浙江中医药大学附属第三医院中医护理门诊收治的90例寒湿型腰椎间盘突出症患者,采用随机数字表法将患者随机分为对照组和治疗组,每组45例。对照组采用独活寄生汤加减口服治疗,治疗组在对照组的基础上联合大面积灸法(火龙灸)治疗。评价2组患者治疗前后临床疗效、视觉模拟(VAS)评分及改良的日本骨科学会下腰痛(M-JOA)评分、生活质量评分及不良反应发生情况。结果治疗14 d后治疗组和对照组临床有效率分别为95.56%和77.78%,明显高于对照组(P<0.05);VAS评分分别为(2.56±0.69)分和(3.82±0.83)分,均较治疗前降低(均P<0.001),且治疗组显著低于对照组,有统计学差异(P<0.001);M-JOA评分分别为(23.11±3.55)分和(20.36±3.39)分,显著高于治疗前(P<0.001),且治疗组要优于对照组(P<0.001);2组患者生活质量评分比较,治疗组患者身体机能、健康状况、情感职能和社会功能评分分别为(85.49±1.82)分、(84.42±1.75)分、(82.84±5.68)分和(81.49±11.46)分,均优于对照组的评分(63.44±3.24)分、(62.47±2.90)分、(62.76±2.31)分和(62.96±1.83)分(均P<0.001)。结论独活寄生汤加减联合大面积灸法对寒湿型腰椎间盘突出症疗效显著,可有效缓解患者临床症状,提高生活质量,且安全性好。

Objective To research the effect of Duhuo Jisheng Decoction combined with large area moxibustion on the analgesic effect and quality of life of cold and damp type lumbar disc herniation, and provide the evidence for clinical application. Methods A total of 90 patients with cold-damp type lumbar disc herniation admitted to the Third Affiliated Hospital of Zhejiang University of Chinese Medicine from January 2018 to October 2019 were randomly divided into control group and treatment group by using the random number table method, with 45 patients in each group. The control group was treated with Duhuo Jisheng Decoction oral treatment, and the treatment group was treated with large area moxibustion(fire dragon moxibustion) on the basis of the control group. The clinical efficacy, visual analogue(VAS) score, modified Japanese Orthopedic Association lower back pain(M-JOA) score, quality of life score, and adverse reactions were evaluated before and after treatment in both groups. Results After 14 days of treatment, the clinical effective rate of the treatment group was 95.56% and the control group was 77.78%, the difference was statistically significant(P<0.05). The VAS scores were(2.56±0.69) and(3.82±0.83) respectively, which were lower than those before treatment(all P<0.001), and the treatment group was significantly lower than the control group(P<0.001). The M-JOA score was(23.11±3.55) and(20.36±3.39) respectively, which was significantly higher than that before treatment(P<0.001), and the treatment group was better than the control group(P<0.001). The scores of physical function, health status, emotional function and social function in the treatment group were 85.49±1.82, 84.42±1.75, 82.84±5.68 and 81.49±11.46, respectively, which were better than those of the control group(63.44±3.24, 62.47±2.90, 62.76±2.31 and 62.96±1.83, respectively, all P<0.001). Conclusion Duhuo Jisheng Decoction combined with large scale moxibustion treatment of cold-damp type lumbar disc herniation can significantly improve clinical symptoms, effectively improve the quality of life, and have good safety.