独活寄生汤加味联合中医手法治疗腰椎间盘突出症

Effect of modified Duhuo Jisheng Decoction combined with TCM manipulations in the treatment of lumbar disc herniation with the liver-kidney deficiency pattern

目的探讨独活寄生汤加味联合中医手法对腰椎间盘突出(肝肾亏虚型)的效果、症状积分、功能恢复及炎症因子水平的影响。方法选择2020年9月-2022年2月我院收治的80例腰椎间盘突出症患者,依照随机数字表法分为观察组和对照组,各40例。对照组给予双氯芬酸钠、甲钴胺治疗,观察组在对照组基础上,联合独活寄生汤加味、中医手法治疗,均持续治疗14 d。比较2组治疗后的临床疗效以及症状积分、Oswestry功能障碍指数问卷表(ODI)评分、日本骨科学会(JOA)评分、血清C反应蛋白(CRP)、白细胞介素-6(IL-6)的变化和治疗期间不良反应发生情况。结果治疗后,观察组的总有效率为92.50%,高于对照组的72.50%,差异有统计学意义(P<0.05);治疗后,观察组腰部疼痛、下肢放射性疼痛、感觉麻木和膝腿无力积分、ODI评分、血清CRP、IL-6水平均低于对照组,JOA评分高于对照组,差异有统计学意义(P<0.05);治疗期间,2组均未发生严重不良反应。结论独活寄生汤加味联合中医手法对腰椎间盘突出症(肝肾亏虚型)的效果明显,能有效改善症状积分,促进功能恢复,并积极降低炎症因子水平的表达,值得临床推广。

Objective To investigate the effect of the modified Duhuo Jisheng Decoction combined with TCM manipulations on lumbar disc herniation(with the liver-kidney deficiency pattern),symptom scores,function recovery and the levels ofinflammatory factors.Methods A total of 80 lumbar disc herniation patients treated in our hospital from September 2020 to February 2022 were selected and divided into an observation group and a control group according to the random number table method,with 40 cases in each group.The control group was treated with diclofenac sodium and mecobalamin,while the observation group was treated with the modified Duhuo Jisheng Decoction and TCM manipulations on the basis of the control group,both for 14 consecutive days.The clinical efficacy,the changes of the symptom scores,Oswestry Disability Index(ODI)scores,Japanese Orthopedic Society(JOA)scores,levels of serum C-reactive protein(CRP)and interleukin-6(IL-6)after treatment,and the incidence of adverse reactions during treatment were compared between the two groups.Results After treatment,the total effective rate of the observation group was 92.50%,which was significantly higher than the control group(72.50%)(P<0.05).After treatment,the scores of waist pain,lower limb radiation pain,sensory numbness,knee and leg weakness,the ODI scores,the levels of serum CRP and IL-6 in the observation group were all significantly lower than those in the control group,while the JOA scores were significantly higher than the control group(P<0.05).No serious adverse reactions occurred in both groups during treatment.Conclusion The effect of the modified Duhuo Jisheng Decoction combined with TCM manipulations on lumbar disc herniation(with the liver-kidney deficiency pattern)is obvious,which can effectively improve symptom scores,promote the function recovery and actively reduce the expression ofinflammatory factors,worthy of clinical promotion.