补阳还五汤联合三维牵引正脊疗法治疗腰椎间盘突出症效果及安全性

Effect and Safety of Buyang Huanwu Decoction Combined with Three-dimensional Traction Chiropractic Therapy in the Treatment of Lumbar Disc Herniation

目的:探究补阳还五汤联合三维牵引正脊疗法治疗腰椎间盘突出症效果及安全性。方法:选择2019年3月-2021年3月在佳木斯市中医院接受治疗的腰椎间盘突出症患者134例,随机分为研究组、对照组,每组67例。对照组进行补阳还五汤治疗,研究组在对照组基础上进行三维牵引正脊疗法治疗。比较两组日本骨科协会评估治疗分数(JOA评分)、疼痛视觉模拟评分法(VAS评分)、功能障碍指数(ODI)评分、血液学指标、凝血指标。结果:治疗前,两组JOA评分、VAS评分、ODI评分比较,差异均无统计学意义(P>0.05),治疗4周后,较对照组,研究组JOA评分更高,VAS评分、ODI评分均更低(P<0.05);治疗前,两组神经肽Y(NPY)、白介素-1β(IL-1β)、疼痛P物质(SP)、肿瘤坏死因子-α(TNF-α)等血液学指标比较,差异均无统计学意义(P>0.05),治疗4周后,两组NPY、IL-1β、SP、TNF-α等血液学指标均明显降低,但较对照组,研究组更低(P<0.05);治疗前,两组各项症状积分比较,差异均无统计学意义(P>0.05),治疗4周后,与对照组比较,研究组各项症状积分均更低(P<0.05);治疗前,两组血小板计数、APTT、PT比较,差异均无统计学意义(P>0.05),治疗4周后,两组血小板计数均明显降低,APTT、PT均明显升高,但较对照组,研究组血小板计数更低,APTT、PT均更高(P<0.05);对照组、研究组治疗有效率分别为89.6%、98.5%,研究组治疗有效率更高(P<0.05)。结论:补阳还五汤联合三维牵引正脊疗法在腰椎间盘突出症治疗中发挥重要作用,可改善血液学及凝血指标,同时可提高生活质量,是一种安全且有效治疗方法。因此,补阳还五汤联合三维牵引正脊疗法治疗值得广泛应用。

Objective:To explore the efficacy and safety of Buyang Huanwu Decoction combined with three-dimensional traction chiropractic therapy in the treatment of lumbar disc herniation.Method:A total of 134 patients with lumbar intervertebral disc herniation who were treated in Jiamusi Hospital of Traditional Chinese Medicine from March 2019 to March 2021 were selected and randomly divided into study group and control group,with 67 cases in each group.The control group was treated with Buyang Huanwu Decoction.The study group was treated with three-dimensional traction chiropractic on the basis of the control group.The Japanese Orthopaedic Association’s assessment of treatment score(JOA score),pain visual analogue scale(VAS)score,functional disability index(ODI)score,hematological index and coagulation index were compared between the two groups.Result:Before treatment,there were no significant differences in JOA,VAS and ODI scores between the two groups(P>0.05).After 4 weeks of treatment,compared with the control group,the JOA score of the study group was higher,and the VAS and ODI scores were lower(P<0.05).Before treatment,the comparison of hematological indexes such as neuropeptide Y(NPY),interleukin-1β(IL-1β),pain substance P(SP),tumor necrosis factor-α(TNF-α)between the two groups,the differences were no statistical significance(P>0.05).After 4 weeks of treatment,NPY,IL-1β,SP,TNF-αand other hematological indexes in the two groups were significantly decreased,but compared with the control group,the study group were lower(P<0.05).Before treatment,there were no significant differences in symptom scores between the two groups(P>0.05).After 4 weeks of treatment,compared with the control group,the symptom scores in the study group were lower(P<0.05).Before treatment,the platelet counts,APTT,PT in two groups were no statistically significant(P>0.05).After 4 weeks of treatment,the platelet counts of the two groups were significantly decreased,and the APTT and PT were significantly increased.After 4 weeks of treatment,compared with the control group,the platelet counts of the study was lower,the APTT and PT were higher(P<0.05).The treatment effective rates of the control group and the study group were 89.6%and 98.5%,respectively,and the study group was higher(P<0.05).Conclusion:Buyang Huanwu Decoction combined with three-dimensional traction chiropractic therapy plays an important role in the treatment of lumbar intervertebral disc herniation,can improve hematology and coagulation indexes,and can improve the quality of life at the same time,it is a safe and effective treatment method.Therefore,Buyang Huanwu Decoction combined with three-dimensional traction chiropractic therapy is worthy of wide application.