和营止痛颗粒治疗腰椎间盘突出症的临床疗效观察

Clinical Observation on Treatment of Lumbar Intervertebral Disc Herniation with Heying Zhitong Granule

[目的]探讨和营止痛颗粒能否缓解腰椎间盘突出症(lumbar intervertebral disc herniation,LIDH)患者的临床症状,改善活动能力和功能,提高生活质量。[方法]根据纳入和排除标准,收集在浙江中医药大学附属第一医院骨伤中心门诊或住院治疗的120例LIDH患者的临床资料。将患者分为3组,观察组、治疗组和对照组,每组40例。观察组口服和营止痛颗粒治疗;治疗组口服塞来昔布胶囊、甲钴胺片和盐酸乙哌立松片,联合和营止痛颗粒治疗;对照组口服塞来昔布胶囊、甲钴胺片和盐酸乙哌立松片治疗。以4周为1个疗程。治疗前、治疗1个疗程后、1个疗程结束后1个月分别进行随访,记录每组患者的疼痛视觉模拟(visual analogue scale,VAS)评分、日本骨科协会(Japanese Orthopaedic Association,JOA)评估治疗评分和SF-36健康调查量表(36-item Short Form Health Survey,SF-36)评分。对3组患者的数据进行对照分析,明确和营止痛颗粒治疗LIDH的临床疗效。[结果]各组患者在性别组成、年龄构成、体质量指数(body mass index,BMI)、病程长短、影像学检查突出节段以及治疗前的VAS评分、JOA评分、SF-36评分等方面差异无统计学意义(P>0.05),提示各组患者基线一致,具有可比性。治疗1个疗程后,与治疗前比较,3组患者的VAS评分均降低(P<0.001),JOA评分均升高(P<0.001),SF-36评分均上升(P<0.001)。对照组VAS评分低于观察组,治疗组低于对照组和观察组(P<0.001);对照组JOA评分高于观察组,治疗组高于对照组和观察组(P<0.001);对照组的SF-36评分高于观察组,治疗组高于对照组和观察组(P<0.001)。1个疗程治疗结束后1个月,与治疗前比较,三组患者的VAS评分均降低(P<0.001),JOA评分均升高(P<0.001),SF-36评分均上升(P<0.001)。对照组VAS评分低于观察组,治疗组低于对照组和观察组(P<0.001);对照组JOA评分高于观察组,治疗组高于对照组和观察组(P<0.001);对照组SF-36评分高于观察组,治疗组高于对照组和观察组(P<0.001)。[结论]和营止痛颗粒能有效缓解LIDH患者的临床症状,改善活动能力和功能,提高生活质量,与西药联用时,能提高西药的临床疗效,是临床治疗LIDH的良好中药制剂。

[Objective]To investigate whether Heying Zhitong Granule can alleviate the clinical symptoms of lumbar intervertebral disc herniation(LIDH),improve the activity and function and the life quality of patient.[Methods]A total of 120 patients with LIDH who met the inclusion criteria were recruited in the First Affiliated Hospital of Zhejiang Chinese Medical University.The patients were randomly divided into observation group,control group and treatment group,with 40 cases in each group.Patients in observation group were treated with Heying Zhitong Granule.The patients in treatment group were treated with Celecoxib capsule,Mecobalamin tablet and Eperisone hydrochloride tablet,combined with Heying Zhitong Granule.The patients in control group were treated with Celecoxib capsule,Mecobalamin tablet and Eperisone hydrochloride tablet.The three groups were treated for 4 weeks as a course of treatment.The patients were followed-up before treatment,after one course of treatment,and one month after the end of treatment,and the visual analogue scale(VAS)score,Japanese Orthopaedic Association(JOA)scores,and 36-item Short Form Health Survey(SF-36)score were recorded.The clinical efficacy of Heying Zhitong Granule in treating LIDH was determined by comparative analysis of the data of 3groups.[Results]There were no statistically significant differences in gender composition,age composition,body mass index(BMI),disease duration,prominent segments of imaging examination,VAS score,JOA score and SF-36 score before treatment among all groups(P>0.05),suggesting that all groups had the same baseline and were comparable.After treatment,compared with before treatment,VAS score was decreased(P<0.001),but JOA score and SF-36 score were increased(P<0.001)among all groups.The VAS score of control group was lower than that of observation group,and the VAS score of treatment group was lower than that of control group and observation group(P<0.001).The JOA score in control group was higher than that in observation group,and the JOA score in treatment group was higher than that in control group and observation group(P<0.001).The SF-36 score in control group was higher than that in observation group,and the SF-36 score in treatment group was higher than that in control group and observation group(P<0.001).One month after the end of treatment,compared with before treatment,VAS score was decreased(P<0.001),but JOA score and SF-36 score were increased(P<0.001).The VAS score of control group was lower than that of observation group,and the VAS score of treatment group was lower than that of control group and observation group(P<0.001).The JOA score in control group was higher than that in observation group,and the JOA score in treatment group was higher than that in control group and observation group(P<0.001).The SF-36score in control group was higher than that in observation group,and the SF-36 score in treatment group was higher than that in control group and observation group(P<0.001).[Conclusion]Heying Zhitong Granule can effectively relieve the clinical symptoms of LIDH,reduce pain and complications,improve the quality of life,and have good safety.When combined with western medicine,it can improve the clinical efficacy of western medicine and is a good traditional Chinese medicine preparation for clinical treatment of LIDH.