骨痛灵酊对“血瘀型”腰椎间盘突出症的短期干预效果及对其相关炎性介质的影响

Short-term intervention effect of Gutongling Tincture on lumbar disc herniation caused by blood stasis and reducing effect of related inflammatory mediators

目的:探究骨痛灵酊对“血瘀型”腰椎间盘突出症(LDH)的干预效果及对其相关炎性介质的影响。方法:选取2022年2月—2023年4月昆明市中医医院(云南中医药大学第三附属医院)骨伤科和曲靖市中医医院骨伤科收治“血瘀型”腰椎间盘突出症患者217例,按照治疗方法进行分组,分为对照组108例,治疗组109例,对照组均予以基础治疗和塞来昔布口服,治疗组予以基础治疗和骨痛灵酊外用。比较两组患者治疗前后白介素-6(IL-6),肿瘤坏死因子α(TNF-α),以及治疗前、治疗后2 h、6 d疼痛视觉模拟量表(VAS)、日本骨科协会评估(JOA)评分,同时记录并比较两组并发症情况。结果:两组患者治疗后VAS评分、JOA评分与本组治疗前比较均明显下降(P<0.05),差异具有统计学意义;两组患者VAS评分、JOA评分在治疗前、治疗后6 d比较,差异无统计学意义(P>0.05),但在治疗后2 h,两组患者VAS评分、JOA评分比较,治疗组明显优于对照组(P<0.05),差异具有统计学意义。两组患者炎症指标IL-6、TNF-α与本组治疗前比较均明显下降(P<0.05),差异具有统计学意义;治疗前、治疗结束后两组患者炎症指标IL-6水平比较差异无统计学意义(P>0.05),但TNF-α水平比较,差异有统计学意义(P<0.05)。两组患者在治疗期间均未出现不良反应事件。结论:骨痛灵酊对“血瘀型”腰椎间盘突出症在短期内有着明显的疼痛缓解、功能改善等效果。

Objective:To investigate the intervention effect of Gutongling Tincture on lumbar disc herniation(LDH)caused by blood stasis and the reducing effect of related inflammatory mediators.Methods:217 patients with LDH caused by blood stasis admitted to the Department of Orthopaedics and Traumatology of Kunming Hospital of Traditional Chinese Medicine(the Third Affiliated Hospital of Yunnan University of Chinese Medicine)and the Department of Orthopaedics and Traumatology of Qujing Hospital of Traditional Chinese Medicine from February 2022 to April 2023 were selected and divided into control group(108 cases)and treatment group(109 cases)according to treatment methods.The control group was given basic treatment and oral celecoxib and the treatment group was given basic treatment and Gutongling Tincture for external use.Interleukin-6(IL-6)and TNF-α(tumor necrosis factor-α)were compared between the two groups before and after treatment.The Visual Analogue Scale(VAS)and Japanese Orthopaedic Association Scores(JOA)scores were recorded and compared between the two groups before treatment,2h and 6 days after treatment,and the complications of the two groups were recorded and compared.Results:VAS score and JOA score of patients in each group after treatment were significantly decreased compared with before treatment,and the difference was statistically significant(P<0.05).In addition,VAS score and JOA score showed no statistically significant difference between the two groups before treatment and 6 days after treatment(P>0.05);however,two hours after treatment,VAS score and JOA score of the two groups were significantly better than those of the control group,and the difference was statistically significant(P<0.05).In terms of inflammation indicators(IL-6 and TNF-α),there was a significant decrease in each group compared with before treatment,and the difference was statistically significant(P<0.05).There was no significant difference in inflammatory indexes IL-6 between the two groups before and after treatment(P>0.05),but the difference was statistically significant in inflammatory indexes TNF-α(P<0.05).There were no adverse events in the two groups during the treatment.Conclusion:Gutongling Tincture for LDH caused by blood stasis has obvious pain relief,functional improvement and other effects in the short term.In addition,due to its safe administration mode,it is worthy of priority recommendation in clinical work.