自拟补肝健腰方联合穴位贴敷治疗非特异性慢性下腰痛临床研究

Clinical Study on Self-made Bugan Jianyao Decoction(自拟补肝健腰方)Combined with Acupoint Application in Treatment of Non-Specific Chronic Low Back Pain

目的 观察自拟补肝健腰方联合穴位贴敷对非特异性慢性下腰痛的临床疗效。方法 选取临汾市中心医院2018年3月—2020年1月收治的非特异性慢性下腰痛患者,分为观察组(自拟补肝健腰方联合穴位贴敷治疗)和对照组(常规西药联合穴位贴敷治疗)各40例,治疗4周,比较两组临床疗效,治疗前、后中医证候积分,治疗前、治疗4周和治疗后3个月日本骨科协会(JOA)评分、Oswestry功能障碍指数(ODI)、腰椎活动度、改良Barthel指数以及治疗期间不良反应。结果 治疗后,观察组总有效率为90.00%(36/40),高于对照组的72.50%(29/40),差异有统计学意义(P<0.05);治疗4周后,两组中医证候积分均降低(P<0.05),观察组低于对照组(P<0.05);随着时间延长,两组患者腰椎JOA评分逐渐升高(P<0.05),ODI指数逐渐降低(P<0.05),组内不同时间点比较差异具有统计学意义(P<0.05),在治疗4周、治疗后3个月时,观察组JOA评分均高于对照组(P<0.05),ODI指数均低于对照组(P<0.05);随着时间延长,两组前屈、后伸、左侧屈、右侧屈的腰椎活动度均逐渐升高,观察组不同时间点比较差异具有统计学意义(P<0.05),对照组治疗后3个月与4周比较,腰部活动度差异无统计学意义(P>0.05),观察组治疗4周和治疗后3个月时各部位腰椎活动度均显著高于对照组(P<0.05);两组患者Barthel指数均随时间延长而逐渐升高,组内不同时间点比较差异具有统计学意义(P<0.05),在治疗后、治疗后3个月时,观察组Barthel指数均高于对照组(P<0.05);治疗期间两组均未发生不良反应。结论 自拟补肝健腰方联合穴位贴敷可减轻非特异性慢性下腰痛患者临床症状,改善腰椎功能障碍和腰部活动度,提高日常生活能力,无明显不良反应,值得临床推广。

Objective To observe the clinical efficacy of Self-made Bugan Jianyao Decoction(自拟补肝健腰方)combined with acupoint application on non-specific chronic low back pain.Methods Patients with non-specific chronic low back pain admitted to the hospital were selected between March 2018 and January 2020,and they were divided into the observation group(Self-made Bugan Jianyao Decoction combined with acupoint application therapy)and the control group(conventional western medicine combined with acupoint application therapy),40 cases in each group.Both groups were treated for 4周eeks.The clinical efficacy,scores of TCM symptoms before and after treatment,Japanese Orthopaedic Association(JOA)score,Oswestry Disability Index(ODI)score,lumbar range of motion and modified Barthel index before treatment and at 4周eeks and 3 months after treatment and adverse reactions during the treatment were compared between the two groups.Results After treatment,the total effective rate in the observation group was 90.00%(36/40),which was higher than 72.50%(29/40)in the control group(P<0.05).After 4 weeks of treatment,the TCM syndromes scores in both groups were decreased(P<0.05),and the scores in the observation group were lower than those of the control group(P<0.05).With the prolongation of time,the lumbar JOA score of the two groups was gradually enhanced(P<0.05)while the ODI index was gradually reduced(P<0.05),and the differences at different time points within the group were statistically significant(P<0.05),and the JOA score in the observation group at 4 weeks and 3 months after treatment was higher than that in the control group(P<0.05)while the ODI index was lower than that in the control group(P<0.05).With the prolongation of time,the lumbar ranges of motions of forward flexion,backward extension,left flexion and right flexion in the two groups were gradually enlarged,and the differences were statistically significant at different time points in the observation group(P<0.05),but there were no statistical differences in lumbar ranges of motions in the control group at 3 months after treatment compared to those before treatment(P>0.05).The lumbar ranges of motions in the observation group were significantly higher than those in the control group at 4 weeks and 3 months after treatment(P<0.05).The Barthel index was gradually increased with time,and the difference was statistically significant at different time points within the group(P<0.05).At 4 weeks and 3 months after treatment,the Barthel index in the observation group was higher than that in the control group(P<0.05).No adverse reactions occurred in both groups during the treatment.Conclusion Self-made Bugan Jianyao Decoction combined with acupoint application can relieve the clinical symptoms of patients with non-specific chronic low back pain,improve the lumbar dysfunction and lumbar range of motion,and enhance the ability of daily life,without obvious adverse reactions.