身痛逐瘀汤联合推拿及针灸治疗气滞血瘀型腰椎间盘突出症的临床效果

Clinical effect of Shentong Zhuyu Decoction Combined with massage and acupuncture on lumbar disc herniation of Qizhi Xieyu type

目的探讨身痛逐瘀汤联合推拿及针灸治疗气滞血瘀型腰椎间盘突出症的效果。方法选取2019年1月-2021年1月我科治疗的气滞血瘀型腰椎间盘突出症患者112例,按随机抽签法分为对照组和观察组,每组56例。对照组实施推拿+针灸治疗,观察组给予身痛逐瘀汤联合推拿及针灸治疗,比较两组患者治疗前及治疗后第1天、第2周及1个月时的疼痛情况、腰椎功能、炎症因子水平及临床效果。结果观察组患者治疗后第1天、第2周及1个月时的VAS评分均低于对照组(均P<0.05),腰腿痛、膝反射、步态、下肢麻木、直腿抬高、拇背伸力、跟腱反射等JOA腰椎功能指标评分均低于对照组(均P<0.05),TNF-α、IL-2、IL-10等炎症因子水平降低幅度优于对照(均P<0.05)。两组患者的治疗效果比较,观察组为98.21%高于对照组的83.93%,差异有统计学意义(P<0.05)。结论身痛逐瘀汤与推拿、针灸联合治疗气滞血瘀型腰椎间盘突出症的疗效可靠,能有效缓解疼痛感,改善患者腰椎功能,值得推广应用。

Objective To observe the therapeutic effect of Shentong Zhuyu Decoction plus massage and acupuncture on lumbar disc herniation of Qizhi Xieyu type.Methods 112 patients with lumbar disc herniation of Qizhi Xieyu type in our department from January 2019 to January 2021 were selected and randomly divided into control group(56 cases,massage+acupuncture)and observation group(56 cases,massage+acupuncture+Shentong Zhuyu Decoction).The pain conditions,lumbar spine function,inflammatory factor levels and curative effect before and after treatment were compared between the two groups before and 1 d,2 weeks,and 1 month after treatment.Results The VAS scores of the observation group were lower than those of the control group(P<0.05 for each)at different time points 1 d,2 weeks,and 1 month after treatment.After treatment,the observation group had low back and leg pain,knee reflexes,gait,lower limb numbness.The scores of JOA lumbar function indexes such as straight leg elevation,thumb back extension and Achilles tendon reflexes were lower than those of the control group(P<0.05 for each);the observation group's levels of inflammatory factors such as TNF-α,IL-2,and IL-10 after treatment Are better than the control(P<0.05 for each).The curative effect of the observation group was 98.21%,which was higher than 83.93%of the control group(P<0.05).Conclusion Shentong Zhuyu Decoction Combined with massage and acupuncture in the treatment of lumbar disc herniation of Qizhi Xieyu type type can reduce the pain of patients,improve the lumbar function and inflammatory symptoms of patients,and the curative effect is reliable,which is worthy of promotion.