健步强督方在腰椎间盘突出症疼痛-负性情绪患者中临床疗效的研究

Clinical effects of the Jianbu Qiangdu prescription on pain and negative emotions of lumbar disc herniation patients

目的:探讨健步强督方对腰椎间盘突出症疼痛-负性情绪患者的临床疗效。方法:选取2020年1-12月在山西中医药大学附属中西医结合医院住院治疗的腰椎间盘突出症60例患者,分为治疗组和对照组。治疗组口服健步强督方,对照组治疗方式:口服甲钴胺片、塞来昔布胶囊,两组患者均口服药物2个疗程。对照组和治疗组都配合中药热奄包、中频电疗。评估两组患者治疗前后视觉模拟评分法(Visual Analogue Scale,VAS)评分、抑郁自评量表(Self-rating Depression Scale,SDS)评分、焦虑自评量表(Self-rating Anxiety Scale,SAS)评分;血清学指标神经肽物质P物质、神经肽Y的水平;炎性应激指标白细胞介素-1β、肿瘤坏死因子-α的水平。结果:治疗2个疗程后,两组患者的SDS、SAS评分差异存在统计学意义(P <0.05),治疗组优于对照组。治疗后两组患者的VAS评分均优于治疗前(P <0.05),且治疗组VAS评分改善情况优于对照组。治疗前两组患者P物质、神经肽Y、白细胞介素-1β、肿瘤坏死因子-α水平比较差异无统计学意义,P> 0.05。两组治疗方法对这4项指标均是有效的,治疗后两组P物质、神经肽Y进行组间比较,治疗组改善程度优于对照组(P <0.05)。治疗后两组白细胞介素-1β、肿瘤坏死因子-α的改善程度差异无统计学意义(P> 0.05)。结论:使用健步强督方与甲钴胺联合塞来昔布相比可有效改善VAS评分,改善炎性指标白细胞介素-1β、肿瘤坏死因子-α,降低血清神经肽物质P物质、神经肽Y浓度,且SAS、SDS评分显示其在改善腰椎间盘突出症疼痛-负性情绪中焦虑、抑郁情绪上效果更佳。

Objective:To explore the clinical effect of the Jianbu Qiangdu prescription(健步强督方)on pain and negative emotions of lumbar disc herniation patients.Methods:A total of 60 cases were selected and divided into the treatment group and the control group.The treatment group was given the Jianbu Qiangdu prescription orally,and the control group was treated with oral administration of mecobalamin tablets and celecoxib capsules.The patients in both groups were given orally administered medicines for 2 courses of treatment.Both groups were given additionally Chinese materia medica hot pack and medium frequency electrotherapy.Results:After 2courses of treatment,there were significant differences in SDS and SAS scores between the two groups(P<0.05),and the levels of SDS score and SAS score in the treatment group were better than the control group.After treatment,the VAS scores in the two groups were better than those before treatment(P<0.05),and the amelioration of VAS scores in the treatment group was better than the control group.After treatment,the levels of substance P,neuropeptide Y,interleukin-1β,and tumor necrosis factor-αin the two groups were compared,P>0.05,and the treatment method in the two groups were all effective on these four indicators.After treatment,substance P and neuropeptide Y between the two groups were compared,and the amelioration degree in the treatment group was better than the control group(P<0.05).There was no significant difference in the amelioration of interleukin-1βand tumor necrosis factor-αbetween the two groups after treatment(P>0.05).Conclusion:Compared with mecobalamin plus celecoxib,the Jianbu Qiangdu prescription on lumbar disc herniation in patients with pain and negative emotions can more effectively ameliorate the VAS score,ameliorate the inflammatory indexes such as interleukin-1β,and tumor necrosis factor-α,and reduce the levels of serum substance P and neuropeptide Y.The SAS and SDS scores after treatment indicate that the Jianbu Qiangdu prescription showed better effects in ameliorating anxiety and depression of lumbar disc herniation patients.