复方五灵脂糖浆治疗腰椎间盘突出症术后残留痛临床观察

Clinical Observation on Fufang Wulingzhi Syrup in Treating Postoperative Residual Pain of Lumbar Disc Herniation

目的观察我院自制剂复方五灵脂糖浆治疗腰椎间盘突出症(LDH)患者单纯髓核摘除术后残留腰腿痛症状的临床疗效。方法选择我院96例腰椎间盘突出症单纯髓核摘除术后仍残留腰腿痛的患者,随机分为治疗组(基础治疗+复方五灵脂糖浆)与对照组(基础治疗+塞来昔布)各48例。两组疗程均为2周,比较两组治疗前、治疗后2周、治疗后8周及末次随访的模拟视觉比例评分法(VAS)评分、下腰痛评分系统(JOA)评分、血清炎症因子变化情况、不良反应情况并评价临床疗效。结果两组患者治疗前后不同时间点VAS评分较治疗前显著降低,JOA评分较治疗前显著升高(P<0.05);治疗2周后、8周后、末次随访(>6个月)时,两组间JOA评分、VAS评分比较有显著性差异(P<0.05),治疗后,治疗组血清血清白介素-6(IL-6)、白介素-1β(IL-1β)和肿瘤坏死因子-α(TNF-α)含量明显下降(P<0.01)。结论复方五灵脂糖浆有较好的治疗腰椎间盘突出症单纯髓核摘除术后残留腰腿痛的作用,能够降低体内炎性因子IL-6、IL-1β和TNF-α,且安全性高,值得临床推广应用。

Objective To observe the clinical efficacy of Fufang Wulingzhi Syrup(FWS)in treatment of postoperative residual pain of lumbar disc herniation(LDH). Methods 96 patients with low back and leg pain after LDH surgery were randomly divided into treatment group(basic treatment + FWS)and control group(basic treatment + celecoxib)for 2 weeks.The Visual Analog Scale(VAS)scores,Japanese Orthopeadic Association(JOA)scores,changes of serum inflammatory factor,side-effects and efficacy rates were documented at the 2 nd and 8 th weeks and the last follow-up. Results After treatment,VAS scores of the two groups were significantly lower than before treatment,JOA scores were significantly higher than before treatment(P<0.05);there were significant differences in JOA scores and VAS scores between the two groups at different time points after treatment(P<0.01). The interleukin-6(IL-6),IL-1β and tumor necrosis factor(TNF-α)levels of treatment group decreased significantly(P<0.01). Conclusion FWS has a satisfied efficacy in treatment of postoperative residual pain of LDH.It can reduce IL-6,IL-1β and TNF-α in vivo,and it is safe and worthy of clinical application.