止痛壮骨丸治疗肝肾亏虚型腰椎间盘突出症临床研究及对血清炎症因子水平的影响

Clinical efficacy of Zhitong Zhuanggu Pills on lumbar disc herniation of liver and kidney deficiency type and its influence on serum inflammatory factor

目的观察止痛壮骨丸治疗肝肾亏虚型腰椎间盘突出症的临床疗效及对血清炎症因子水平的影响。方法将80例肝肾亏虚型腰椎间盘突出症患者按照随机数字表法分为2组,治疗组40例采用止痛壮骨丸治疗,对照组40例采用塞来昔布胶囊治疗。2组均治疗4周。比较2组治疗前后日本骨科协会(JOA)腰椎功能评分、腰椎Oswestry功能障碍指数(ODI)评分、疼痛视觉模拟评分(VAS)、血清白细胞介素1β(IL-1β)、肿瘤坏死因子α(TNF-α)、前列腺素E_(2)(PGE_(2))、基质金属蛋白酶-1(MMP-1)、基质金属蛋白酶-3(MMP-3)水平变化。结果2组治疗后ODI评分均较本组治疗前降低(P<0.05),JOA腰椎功能评分均升高(P<0.05),2组治疗后ODI、JOA腰椎功能评分比较差异均无统计学意义(P>0.05)。2组治疗后疼痛VAS均较本组治疗前降低(P<0.05),2组治疗后比较差异均无统计学意义(P>0.05)。2组治疗后血清IL-1β、TNF-α、PGE_(2)、MMP-1、MMP-3水平均较本组治疗前降低(P<0.05),2组治疗后比较差异无统计学意义(P>0.05)。结论止痛壮骨丸可抑制炎症因子及致痛介质表达,改善肝肾亏虚型腰椎间盘突出症患者椎间盘退变情况。

Objective To observe the clinical efficacy of Zhitong Zhuanggu Pills on lumbar disc herniation(LDH)of liver and kidney deficiency type and its influence on serum inflammatory factor.Methods A total of 80 LDH patients(liver and kidney deficiency type)were randomly assigned into the treatment group(n=40)and the control group(n=40),in which they were treated with Zhitong Zhuanggu Pills and celecoxib capsules,respectively.Treated for 4 weeks,the aim was to compare Japanese Orthopaedic Association(JOA),Oswestry Disability Index(ODI),visual analogue scale(VAS)for pain,serum interleukin 1β(IL-1β),tumor necrosis factor-α(TNF-α),prostaglandin E_(2)(PGE_(2)),matrix metalloproteinase-1(MMP-1),matrix metalloproteinase-3(MMP-3).Results After treatment,significantly decreased ODI scores and significantly increased JOA scores were detected in the both groups than those before treatment(all P<0.05),but the difference was not statistically significant between groups(P>0.05).VAS scores decreased significantly in the both groups(P<0.05),and there was no statistically significant differencebetween groups(P>0.05).The serum levels of IL-1β,TNF-α,PGE_(2),MMP-1,MMP-3 reduced significantly in the two groups than those before treatment(all P<0.05),but the different was not significant between groups for the above indexes(all P>0.05).Conclusion For LDH patients(liver and kidney deficiency type),Zhitong Zhuanggu Pills can inhibit the expression of inflammatory factors and pain mediators,improve intervertebral disc degeneration,and worthy of promotion.