补肾温阳止痛汤联合推拿治疗腰椎骨质增生的疗效及对血清DKK1、SOST、TXB2、6-Keto-PGFlα的影响

Effect of Bushen Wenyang Zhitong Decoction(补肾温阳止痛汤)Combined with Tuina on Lumbar Hyperosteogeny and Its Effect on Serum DKK1,SOST,TXB2 and 6-Keto-PGFlα.

目的探讨补肾温阳止痛汤联合推拿治疗腰椎骨质增生的疗效及对血清Dickkopf相关蛋白1(DKK1)、硬骨素(SOST)、血栓素B2(TXB2)、6-酮前列腺素Flα(6-Keto-PGFlα)的影响。方法随机选取诊治的腰椎骨质增生患者80例,随机分为对照组与观察组,每组40例,对照组给口服塞来昔布胶囊及推拿治疗,观察组在以上治疗基础上联合补肾温阳止痛汤治疗,治疗4周。观察患者治疗前后中医证候变化,采用改良Oswestry功能障碍指数问卷(ODI)及腰椎生活量表(QLS-DSD)对患者腰功能及生活质量进行评价,观察血清DKK1、SOST、TXB2、6-Keto-PGFlα的变化。结果两组治疗后主证及次证积分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.001);两组治疗后ODI及QLS-DSD评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.001);两组治疗后血清DKK1、SOST、6-Keto-PGFlα水平均高于治疗前,且观察组高于对照组,TXB2低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.001)。结论补肾温阳止痛汤配合推拿治疗腰椎骨质增生可有效缓解症状,促进腰功能的恢复,提高生活质量,其作用可能与改善血清DKK1、SOST、TXB2、6-Keto-PGFlα水平有关。

Objective To discuss the effect of Bushen Wenyang Zhitong Decoction(补肾温阳止痛汤) combined with Tuina on lumbar hyperosteogeny and its effect on serum dickkopf related protein 1(DKK1), sclerostin(SOST), thromboxane B2(TXB2) and 6-ketone prostaglandin Flα(6-Keto-PGFlα). Methods We collected 80 cases of patients with lumbar hyperosteogeny and the patients were randomly divided into control group and observation group, with 40 cases in each group. The control group was treated with Celecoxib Capsules orally and Tuina. The observation group on the basis of the above treatment combined with Bushen Wenyang Zhitong Decoction. The treatment lasted for 4 weeks. The changes of TCM symptoms were observed before and after treatment. The Oswestry dysfunction index questionnaire(ODI) and lumbar life scale(QLS-DSD) were used to evaluate the lumbar function and quality of life of the patients. The changes of serum DKK1, SOST, TXB2 and 6-Keto-PGFlα were observed. Results The scores of primary and secondary symptoms in both groups after treatment were lower than those before treatment and the observation group’s score was lower than that of the control group. The difference was statistically significant(P<0.001). The scores of ODI and QLS-DSD in both groups after treatment were lower than those before treatment and the observation group’s score was lower than that of the control group and the difference was statistically significant(P<0.001). The levels of DKK1,SOST and 6-Keto-PGFlα in both groups after treatment were higher than those before treatment and the observation group’s levels were higher than those of the control group. The difference was statistically significant(P<0.001). The levels of TXB2 in both groups after treatment were lower than those before treatment and the observation group’s level was lower than that of the control group. The difference was statistically significant(P<0.001). Conclusion Bushen Wenyang Zhitong Decoction combined with Tuina on lumbar hyperosteogeny helps to improve the patients’ clinical symptoms, promote the recovery of waist function and improve the quality of life. Its effect may be related to the improvement of serum levels of DKK1, SOST, TXB2 and 6-Keto-PGFlα.