归附汤联合正清风痛宁椎旁注射治疗腰椎间盘突出症肾虚寒凝证的临床观察——骨伤名师孙达武学术思想与临床经验研究(五)

Clinical observation of Guifu Decoction combined with Zhengqing Fengtongning paravertebral injection in the treatment of lumbar intervertebral disc herniation with kidney deficiency and cold coagulation syndrome:Study on the academic thoughts and clinical experience of famous orthopaedic teacher Sun Dawu(5)

目的探讨归附汤口服联合正清风痛宁椎旁注射治疗腰椎间盘突出症肾虚寒凝证的临床疗效和安全性。方法将2020年1月至2021年3月就诊于湖南中医药大学第二附属医院骨伤科门诊的90例腰椎间盘突出症肾虚寒凝证患者随机分为观察组和对照组,各45例。对照组予以藤黄健骨片3 g/次,2次/d;观察组予以归附汤口服(2次/d)联合正清风痛宁椎旁注射(1次/d),两组疗程均为2周。治疗前后分别观察两组疼痛视觉模拟评分法(visual analogue scale,VAS)评分和日本骨科协会评估治疗分数(Japanese Orthopaedic Association scores,JOA),检测治疗前、治疗后全血黏度、血清炎性因子TNF-α、IL-1β、IL-6,并观察用药安全性。结果治疗后,观察组VAS评分、JOA评分、全血黏度、血清炎性因子TNF-α、IL-1β、IL-6与对照组比较,明显改善,差异有统计学意义(P<0.05);观察组总有效率93.33%,高于对照组的82.22%,两组疗效比较,差异有统计学意义(P<0.01)。结论归附汤口服联合正清风痛宁椎旁注射可有效缓解腰椎间盘突出症肾虚寒凝证患者症状,减轻腰腿疼痛,改善腰椎功能,且安全性高,值得临床推广应用。

Objective To investigate the clinical efficacy and safety of oral administration of Guifu Decoction combined with paravertebral injection of Zhengqing Fengtongning in the treatment of lumbar intervertebral disc herniation with kidney deficiency and cold coagulation syndrome.Methods A total of 90 patients with lumbar intervertebral disc herniation with kidney deficiency and cold coagulation syndrome who were treated in the Department of Orthopedics and Traumatology of The Second Affiliated Hospital of Hunan University of Chinese Medicine from January 2020 to March 2021 were randomly divided into observation group and control group,with 45 cases in each group.The control group was given Tenghuangjiangu tablet 3 g/time,2 times/d;the observation group was given oral administration of Guifu Decoction(2 times/d)combined with Zhengqing Fengtongning paravertebral injection(1 time/d),the course of treatment in both groups was 2 weeks.Before and after treatment,the pain visual analogue scale(VAS)score and the Japanese Orthopaedic Association scores(JOA)in the two groups were observed respectively.The whole blood viscosity and serum inflammatory factor TNF-α,IL-1β,IL-6 were detected before and after treatment,and the drug safety was observed.Results After treatment,the VAS score,JOA score,whole blood viscosity,serum inflammatory factors TNF-α,IL-1β,IL-6 in the observation group were significantly improved compared with those in the control group,and the difference was statistically significant(P<0.05).The total effective rate of the observation group was 93.33%,which was higher than 82.22% of the control group,and the difference was statistically significant between the two groups(P<0.01).Conclusion Oral administration of Guifu Decoction combined with paravertebral injection of Zhengqing Fengtongning can effectively relieve the symptoms of lumbar intervertebral disc herniation in patients with kidney deficiency and cold coagulation syndrome,relieve lumbar and leg pain,and improve lumbar spine function,with high safety,and it is worthy of clinical application.