活血镇痛汤治疗腰椎间盘突出症经皮椎间孔镜下髓核摘除术后残留腰痛的临床效果

Clinical effect of Huoxue Zhentong Decoction on residual lumbago after percutaneous foraminal endoscopic removal of nucleus pulposus for lumbar disc herniation

目的 探讨活血镇痛汤治疗腰椎间盘突出症(LDH)患者经皮椎间孔镜下髓核摘除术后残留腰痛的临床效果。方法 选择2021年1月至2022年12月安徽省六安市中医院骨伤三科收治的86例LDH患者,按照随机数字表法将其分成两组,各43例。对照组行温针灸治疗,观察组在对照组基础上行活血镇痛汤治疗。治疗4周比较治疗效果,记录治疗前后中医证候积分、视觉模拟评分法(VAS)、Osweatry腰椎功能障碍指数(ODI)及血清P物质(SP)、5-羟色胺(5-HT)、前列腺素E_(2)(PEG_(2))水平变化。结果 观察组临床疗效优于对照组,差异有统计学意义(P<0.05)。与治疗前比较,治疗后两组腰痛、麻木、僵硬证候评分均降低,且观察组低于对照组,差异有统计学意义(P<0.05)。与治疗前比较,治疗后两组VAS、ODI均降低,且观察组低于对照组,差异有统计学意义(P<0.05)。与治疗前比较,治疗后两组SP、PEG_(2)均降低,且观察组低于对照组,差异有统计学意义(P<0.05);与治疗前比较,治疗后两组5-HT升高,且观察组高于对照组,差异有统计学意义(P<0.05)。结论 活血镇痛汤治疗LDH患者经皮椎间孔镜下髓核摘除术后可有效缓解临床症状,减轻局部疼痛,促进腰椎功能恢复,效果理想,可在临床推广运用。

Objective To investigate the clinical effect of Huoxue Zhentong Decoction on residual lumbago in patients with lumbar disc herniation(LDH) after percutaneous foraminal endoscopic removal of nucleus pulposus.Methods A total of 86LDH patients admitted to the Third Department of Orthopedics and Traumatology,Lu'an Hospital of Traditional Chinese Medicine in Anhui Province from January 2021 to December 2022 were selected and they were divided into two groups according to random number table method,with 43 cases in each group.The control group was treated with warming needle moxibustion,and the observation group was treated with Huoxue Zhentong Decoction on the basis of the control group.After four weeks of treatment,the therapeutic effect was compared,and the changes of traditional Chinese medicine syndrome score,visual analogue score(VAS),Osweatry lumbar dysfunction index(ODI),serum substance P(SP),5-hydroxytryptamin(5-HT) and prostaglandin E_2(PEG_2) levels before and after treatment were recorded.Results The clinical efficacy of the observation group was better than that of the control group,the difference was statistically significant(P<0.05).Compared with before treatment,the syndrome scores of lumbago,numbness and stiffness in both groups were decreased after treatment,and those in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Compared with before treatment,VAS and ODI of both groups were decreased after treatment,and those in the observation group were lower than those in control group,the differences were statistically significant(P<0.05).Compared with before treatment,SP and PEG_(2) of both groups were decreased after treatment,and those in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Compared with before treatment,5-HT was increased in both groups after treatment,and that in the observation group was higher than that in the control group,the difference was statistically significant(P <0.05).Conclusion Huoxue Zhentong Decoction can effectively relieve clinical symptoms,relieve local pain and promote the recovery of lumbar function after percutaneous foraminal endoscopic removal of nucleus pulposus of LDH patients,and can be widely used in clinical practice.