荣筋通痹汤治疗腰椎间盘突出所致肝肾虚损型坐骨神经痛的临床观察

Clinical Observation on Rongjin Tongbi Decoction in Treating Sciatica Caused by Lumbar Intervertebral Disc Herniation with Liver and Kidney Deficiency Type

目的:基于随机对照研究,评价荣筋通痹汤对腰椎间盘突出所致坐骨神经痛患者(肝肾虚损型)的疗效及安全性。方法:选取2019年1月至2022年7月北京积水潭医院中医科收治的符合入组标准的患者90例,按随机数字表法分为两组,各45例。研究过程中脱落19例,最终观察组41例、对照组30例,观察组予荣筋通痹汤口服,对照组予洛索洛芬钠片口服,治疗28 d。观察治疗前后两组的视觉模拟评分(VAS)评分、日本骨科协会下腰痛评价量表评分(JOA)评分、日常生活能力量表(ADL)量表评估,中医临床症状、主观症状及临床体征评分的差异;并检测肝肾功能及胃肠道不良反应,进行安全性评估。结果:治疗前观察组与对照组的分值差异无统计学意义;治疗后观察组VAS及ADL评分差值绝对值高于对照组(P<0.05)。两组JOA评分差值绝对值差异无统计学意义,观察组中医临床症状评分差值绝对值高于对照组(P<0.01);两组主观症状及临床体征评分差值绝对值差异无统计学意义。试验前后两组肝肾功能指标水平均正常,胃肠道反应差异无统计学意义。结论:荣筋通痹汤对腰椎间盘突出引起的坐骨神经痛肝肾虚损型患者的症状有明显改善作用,治疗后患者在疼痛、活动等方面均改善明显,且安全性可靠,有利于身体功能恢复。

Objective:To evaluate the efficacy and safety of Rongjin Tongbi decoction on sciatica caused by lumbar intervertebral disc herniation with liver and kidney deficiency type based on a randomized controlled study.Method:From January 2019 to July 2022,90 patients in the department of Traditional Chinese medicine(TCM)of Beijing Jishuitan Hospital who met the inclusion criteria were selected and divided into two groups according to the random number table,with 45 patients in each group.During the study,19 cases dropped out,with 41 cases included in the final observation group and 30 cases in the control group.The observation group was given Rongjin Tongbi decoction orally,and the control group was given Loxoprofen Sodium Tablets orally for 28 days.The differences in the visual analog scale(VAS)scores,the Japanese Orthopaedic Association(JOA)scores,activities of daily living(ADL)assessments,TCM clinical symptoms,subjective symptoms,and clinical signs scores between two groups before and after treatment were observed.Liver and kidney functions and gastrointestinal adverse reactions were detected for safety evaluation.Result:Before treatment,there was no statistically significant difference in scores between the observation group and the control group.After treatment,the absolute values of the differences in VAS and ADL scores in the observation group were higher than those in the control group(P<0.05).There was no statistically significant difference in the absolute value of the difference in JOA scores between two groups.The absolute value of the difference in TCM clinical symptom scores in the observation group was higher than that in the control group(P<0.01).There was no statistically significant difference in the absolute values of the differences in subjective symptom and clinical sign scores between two groups.The levels of liver and kidney function indicators in both groups before and after the experiment were normal,and there was no significant difference in gastrointestinal reactions.Conclusion:Rongjin Tongbi decoction can significantly improve the symptoms of sciatica patients caused by lumbar intervertebral disc herniation with liver and kidney deficiency type.After treatment,the patients exhibited significant improvements in pain,activity and other aspects,and it is proven to be safe and reliable,which is conducive to the recovery of physical function.