补肾通络方对腰椎间盘突出症患者疗效及外周血免疫细胞平衡的影响

Therapeutic Effect of Bushen Tongluo Formula for Patients with Lumbar Disc Herniation and Its Effect on the Balance of Peripheral Blood Immune Cells

【目的】探究补肾通络方对腰椎间盘突出症(LDH)肾虚血瘀证患者的疗效及外周血免疫细胞平衡的影响。【方法】将72例LDH肾虚血瘀证患者随机分为观察组和对照组,每组各36例。对照组给予腰椎牵引治疗,观察组在对照组的基础上加用补肾通络方治疗,疗程为4周。观察2组患者治疗前后疼痛视觉模拟量表(VAS)评分、日本骨科协会(JOA)腰椎功能评分、外周血炎症相关因子及T淋巴细胞亚群的变化情况,并评价2组患者的临床疗效。【结果】(1)治疗4周后,观察组的总有效率为88.89%(32/36),对照组为66.67%(24/36),组间比较,观察组的疗效明显优于对照组(P<0.05)。(2)治疗后,2组患者的JOA评分均较治疗前明显升高(P<0.05),VAS评分均较治疗前明显降低(P<0.05),且观察组对JOA评分的升高作用和对VAS评分的降低作用均明显优于对照组(P<0.05)。(3)治疗后,2组患者外周血肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)水平均较治疗前明显降低(P<0.05),白细胞介素10(IL-10)水平均较治疗前明显升高(P<0.05),且观察组对TNF-α、IL-6水平的降低作用和对IL-10水平的升高作用均明显优于对照组(P<0.05)。(4)治疗后,2组患者外周血T淋巴细胞亚群CD4^(+)、CD4^(+)/CD8^(+)水平均较治疗前明显下降(P<0.05),CD8^(+)水平均较治疗前略有升高,但差异均无统计学意义(P>0.05);治疗后组间比较,观察组对外周血T淋巴细胞亚群CD4^(+)、CD4^(+)/CD8^(+)水平的下降作用均明显优于对照组(P<0.05)。【结论】补肾通络方对LDH肾虚血瘀证患者疗效显著,可有效促进机体免疫平衡,降低患者机体炎症反应,提高患者机体免疫力。

Objective To investigate the therapeutic effect of Bushen Tongluo Formula for the treatment of patients with lumbar disc herniation(LDH)of kidney deficiency and blood stasis syndrome type,and to observe its effect on the balance of peripheral blood immune cells of the patients.Methods Seventy-two patients with LDH of kidney deficiency and blood stasis syndrome type were randomly divided into observation group and control group,with36 cases in each group.The control group was treated with lumbar traction,while the observation group was treated with Bushen Tongluo Formula orally on the basis of treatment for the control group.The course of treatment lasted for 4 weeks.The changes in pain visual analogue scale(VAS)scores,lumbar function evaluated with Japanese Orthopedic Association(JOA)scores,and the levels of peripheral blood inflammatory factors and T lymphocyte subsets in the two groups were observed before and after treatment.After treatment,the clinical efficacy of the two groups was evaluated.Results(1)After 4 weeks of treatment,the overall effective rate of the observation group was 88.89%(32/36)and that of the control group was 66.67%(24/36).The intergroup comparison showed that the efficacy of the observation group was significantly superior to that of the control group(P<0.05).(2)After treatment,the JOA scores in both groups were significantly increased and the VAS scores were significantly decreased compared with those before treatment(P<0.05).The effects on increasing JOA scores and on decreasing VAS scores of the observation group were significantly superior to those of the control group(P<0.05).(3)After treatment,the peripheral blood tumor necrosis factorα(TNF-α)and interleukin 6(IL-6)levels in both groups were significantly decreased and the interleukin 10(IL-10)level was significantly increased compared with those before treatment(P<0.05).The effects on lowering the TNF-αand IL-6 levels and on increasing the IL-10 level of the observation group were significantly superior to those of the control group(P<0.05).(4)After treatment,the levels of CD4^(+)and CD4^(+)/CD8^(+)of peripheral blood T-lymphocyte subsets in both groups were significantly decreased compared with those before treatment(P<0.05),while the CD8^(+)level was slightly increased compared with that before treatment,and the difference was not statistically significant(P>0.05).The intergroup comparison showed that the effect on decreasing the CD4^(+)and CD4^(+)/CD8^(+)levels of the observation group after treatment was significantly superior to that of the control group(P<0.05).Conclusion Bushen Tongluo Formula exerts significant effect in treating patients with LDH of kidney deficiency and blood stasis syndrome type by effectively promoting the immune balance of the body,reducing the inflammatory response and improving the immunity of the patients.