畲药地稔水煎液联合艾瑞昔布片对神经根型颈椎病的效果评估

Effect assessment of She medicine-melastoma dodecandrum water extract fumigation combined with imrecoxib table in cervical spondylotic radiculopathy

目的评价畲药地稔水煎液(MDWE)联合艾瑞昔布片(IT)对神经根型颈椎病(CSR)疼痛程度及生活质量的影响。方法回顾性选取2021年12月至2023年7月浙江中医药大学附属丽水市中医院收治的CSR患者为研究对象。根据CSR患者治疗方案分为对照组(IT,0.1 g,po,bid,共4周)和联合组(IT,0.1 g,po,bid,共4周;畲药MDWE,熏蒸,40 g,每周6次,共4周)。比较两组CSR患者干预4周后疗效;治疗前和治疗2周后、4周后的视觉模拟疼痛评分(VAS),治疗前和治疗4周后的中医证候积分、血液流变学指标,治疗前和治疗3个月后的生活质量以及治疗期间的不良反应发生率。结果研究共纳入100例CSR患者,联合组52例,对照组48例。治疗4周后,联合组的治疗总有效率显著高于对照组(P<0.05)。治疗前,两组患者的VAS评分、颈部疼痛评分、运动障碍评分、肢体麻木评分、头晕评分、腰膝酸软评分、全血高切粘度、全血低切粘度、血浆粘度差异无统计学意义(P>0.05)。治疗2周后,两组CSR患者VAS评分较治疗前显著下降(P<0.05),且联合组患者VAS评分显著低于对照组(P<0.05)。治疗4周后,两组CSR患者上述评分和血液粘度均较治疗前显著下降(P<0.05),且联合组患者上述评分和血液粘度显著低于对照组(P<0.05)。治疗前,两组CSR患者生理职能、躯体疼痛、社会功能、精神健康、健康变化、生活质量总分差异无统计学意义(P>0.05);治疗3个月后,两组CSR患者上述评分均显著升高,且联合组上述评分高于对照组(P<0.05)。安全性方面,两组CSR患者治疗期间不良反应发生率差异无统计学意义(P>0.05)。结论与单一IT治疗比较,畲药MDWE联合IT治疗CSR患者可提高临床疗效、改善中医证候积分、降低血液粘度、改善生活质量,且不良反应小,值得临床推广应用。

Objective To evaluate the effect of She medicine-melastoma dodecandrum water extract(MDWE)combined with imrecoxib tablet(IT)on the pain level and quality of life in patients with cervical spondylotic radiculopathy(CSR).Methods CSR patients admitted to Lishui Hospital of Traditional Chinese Medicine affiliated to Zhejiang TCM University from December 2021 to July 2023 were selected as study subjects.According to the treatment protocol of CSR patients,they were divided into the control group(IT,0.1 g,po,bid,a total of 4 weeks)and combination group(IT,0.1 g,po,bid,4 weeks;She medicine MDWE,fumigation,40 g,6 times a week for 4 weeks).The treatment efficacy of CSR patients after 4 weeks of intervention,visual analog pain score(VAS)before and after 2 and 4 weeks of treatment,TCM syndrome score and hemorheological indicators before and after 4 weeks of treatment,quality of life before and after 3 months of treatment,and the incidence of adverse reactions during treatment were compared.Results A total of 100 CSR patients were included in the study,52 in the combined group and 48 in the control group.After 4 weeks of treatment,the total effective rate of treatment in the combined group was significantly higher than that in the control group(P<0.05).Before treatment,the differences in VAS score,neck pain score,dyskinesia score,limb numbness score,dizziness score,back and knee weakness score,whole blood high cut viscosity,whole blood low cut viscosity,and plasma viscosity between the two groups were not statistically significant(P>0.05).After 2 weeks of treatment,the VAS scores of CSR patients in both groups decreased significantly compared with those before treatment(P<0.05),and the VAS scores of patients in the combined group were significantly lower than those in the control group(P<0.05).After 4 weeks of treatment,the above scores and blood viscosity of CSR patients in both groups were significantly lower than before treatment(P<0.05),and the above scores and blood viscosity of patients in the combined group were significantly lower than those in the control group(P<0.05).Before treatment,there was no statistically significant difference in the total scores of physiological function,somatic pain,social function,mental health,health changes,and quality of life between the two groups of CSR patients(P>0.05);After 3 months of treatment,the above scores of the two groups of CSR patients were significantly higher and the above scores of the combined group were higher than those of the control group(P<0.05).On the safety,there was no statistically significant difference in the incidence of adverse reactions during treatment between the two groups of CSR patients(P>0.05).Conclusion Compared with single IT treatment,She medicine MDWE combined with IT can improve the efficacy,improve the TCM syndrome score,reduce blood viscosity,improve the quality of life,and has small adverse reactions,which is worthy of clinical promotion and application.