针刺联合肾痹汤加味治疗腰椎间盘突出症肾虚血瘀证的疗效以及对血清IL-6、IL-17水平的影响

Effect of Acupuncture Combined with Shenbi Decoction(肾痹汤)in Treatment of Lumbar Intervertebral Disc Herniation with Syndrome of Kidney Deficiency and Blood Stasis and Its Effect on Serum Levels of IL-6 and IL-17

目的探讨针刺联合肾痹汤加味治疗腰椎间盘突出症(LDH)肾虚血瘀证的疗效以及对血白细胞介素(IL)-17和IL-6水平的影响。方法选取2019年5月—2020年5月在该院就诊的LDH病人80例,采用随机数字表法将80例病人分为对照组和观察组(均40例),对照组给予依托考昔片(每天1次,每次120 mg)和康复治疗;观察组在对照组基础上针刺(1次/2 d,每周3次)联合肾痹汤加味治疗(1剂/d,2次内服)。两组疗程均4周。比较两组疼痛、腰椎功能、中医肾虚血瘀证评分,评估疗效,酶联免疫吸附法测定血清IL-17、IL-6水平。结果治疗后,观察组视觉模拟评分(VAS)、JOA指标的评分及总评分、肾虚血瘀证症状评分显著少于对照组(P <0.01);观察组总有效率显著高于对照组(P<0.05);治疗后,观察组血清IL-17、IL-6水平明显少于对照组(P <0.01)。结论针刺联合肾痹汤加味治疗LDH肾虚血瘀证的疗效显著,可减轻患者的疼痛,改善腰椎功能和中医证候,下调血清IL-17和IL-6水平可能是其疗效途径之一。

Objective To investigate the efficacy of acupuncture combined with Shenbi Decoction( 肾痹汤) in the treatment of lumbar intervertebral disc herniation with syndrome of kidney deficiency and blood stasis and its effect on serum levels of interleukin( IL)-6 and IL-17. Methods Eighty LDH patients admitted to the hospital from May of 2019 to May of 2020 were selected and divided into control group and observation group( 40 patients in each group) by random number table method. The control group was given with etoricoxib tablets( 1 time/day and 120 mg/time) and rehabilitation treatment. On the basis of the control group,the observation group received acupuncture( 1 time/2 d and 3 times/week) combined with Shenbi Decoction treatment( 1 dose/day and 2 times internal administration). The course of treatment was 4 weeks in both groups. The scores of pain,lumbar function and traditional Chinese medicine syndrome of kidney deficiency and blood stasis were compared between the two groups.The efficacy was evaluated and serum levels of IL-17 and IL-6 were measured by ELISA method. Result After treatment,scores of visual analogue scale( VAS) and JOA index and total score and symptom scores of syndrome of kidney deficiency and blood stasis in the observation group were significantly lower than those in the control group( P < 0. 01). The total effective rate of the observation group was significantly higher than that of the control group( P < 0. 05). After treatment,serum levels of IL-17 and IL-6 in the observation group were significantly lower than those in the control group( P < 0. 05). Conclusion The efficacy of acupuncture combined with Shenbi Decoction in the treatment of lumbar intervertebral disc herniation with syndrome of kidney deficiency is significant. The treatment can alleviate the pain of patients,improve the lumbar function and traditional Chinese medicine syndrome and down-regulation of serum levels of IL-17 and IL-6 may be one of the therapeutic approaches.