舒经活络方外敷治疗气滞血瘀型腰椎间盘突出症临床研究

Curative effect of external application of self-made Shujing Huoluo Prescription on lumbar disc herniation of Qi stagnation and blood stasis type

目的观察舒经活络方外敷治疗气滞血瘀型腰椎间盘突出症的临床疗效。方法选取2021年7月至2022年7月收治的气滞血瘀型腰椎间盘突出症患者100例为研究对象,按照随机数字表法分为2组,对照组50例予西医常规治疗,治疗组50例在对照组的基础上联合舒经活络方外敷治疗。2组均治疗2周为1个疗程,治疗2个疗程后统计疗效,比较2组治疗前及治疗第7、14天疼痛症状[分别采用疼痛视觉模拟评分法(VAS)及日本骨科协会(JOA)评估治疗分数下腰痛评价量表进行评价]及炎症因子[包括白细胞介素4(IL-4)、IL-6、IL-12及肿瘤坏死因子α(TNF-α)]水平变化情况,比较2组治疗前及治疗2个疗程后中医症状(包括腰痛、下肢痛或麻木及下肢乏力)评分及Oswestry功能障碍指数问卷表(ODI)(包括睡眠、坐立、提物、负重、站立、行走、疼痛、生活自理、社会生活及夫妻生活)评分变化情况。结果治疗组总有效率94.00%(47/50),对照组总有效率78.00%(39/50),治疗组总有效率高于对照组(P<0.05)。与本组治疗前比较,2组治疗7、14天疼痛VAS评分均降低(P<0.05),JOA下腰痛评分均升高(P<0.05),且治疗组治疗7、14天疼痛VAS评分低于对照组治疗同期(P<0.05),JOA下腰痛评分高于对照组治疗同期(P<0.05)。与本组治疗前比较,2组治疗7、14天炎症因子IL-4、IL-6、IL-12及TNF-α水平均降低(P<0.05),且治疗组治疗7、14天IL-4、IL-6、IL-12及TNF-α水平均低于对照组治疗同期(P<0.05)。与本组治疗前比较,2组治疗2个疗程后中医症状腰痛、下肢痛或麻木及下肢乏力评分均降低(P<0.05),且治疗组治疗2个疗程后中医症状腰痛、下肢痛或麻木及下肢乏力评分均低于对照组(P<0.05)。与本组治疗前比较,2组治疗2个疗程后ODI睡眠、坐立、提物、负重、站立、行走、疼痛、生活自理、社会生活、夫妻生活评分及总分均降低(P<0.05),且治疗组治疗2个疗程后ODI各项评分及总分均低于对照组(P<0.05)。结论舒经活络方外敷治疗气滞血瘀型腰椎间盘突出症临床疗效确切,可有效缓解患者疼痛症状,改善腰椎功能,减低炎症因子水平,减轻炎症反应,改善中医症状,提高生活质量。

Objective The curative effect of external application of self-made Shujing Huoluo Prescription in the treatment of lumbar disc herniation(LDH)of Qi stagnation and blood stasis type.Methods A total of 100 LDH patients(Qi stagnation and blood stasis type)admitted to our hospital from July 2021 to July 2022 were randomly assigned into treatment group(n=50)and control group(n=50).All patients received conventional Western medicine,those in the treatment group additionally received external application of the self-made Shujing Huoluo Prescription for external application,and the therapeutic effects were compared after 2 courses of treatment(2 weeks as a course of treatment).On day 0 and days 7 and 14 of treatment,the changes in the pain symptoms scores(including pain visual analogue scale[VAS]and Japanese orthopaedic association back pain evaluation questionnaire[JOABPEQ]),and the levels of inflammatory factors(including interleukin 4[IL-4],IL-6,IL-12 and tumor necrosis factorα[TNF-α]),traditional Chinese medicine(TCM)symptoms(including low back pain,lower limb pain or numbness and lower limb fatigue)scores,and the Oswestry disability index questionnaire(ODI)(including sleep,sitting,lifting,loading weight,standing,walking,pain,self-care,social life and husband-wife life)scores were assessed.Results The total effective rate of the treatment group was significantly higher than that of the control group(94.00[47/50]vs 78.00%[39/50],P<0.05).Compared with before treatment,the respective 7-day and 14-day VAS scores were significantly lower and JOABPEQ scores were significantly higher(P<0.05).The respective 7-day and14-day levels of IL-4,IL-6,IL-12 and TNF-αwere significantly lower(P<0.05),and the respective 7-day and14-day TCM symptoms scores were significantly lower(P<0.05),the respective 7-day and14-day each dimension and total scores of ODI were significantly lower(P<0.05).The improvements were more pronounced in the treatment group than those of the control group(all P<0.05).Conclusion The external application of the self-made Shujing Huoluo Prescription has a significant effect in treating LDH(Qi stagnation and blood stasis type).It can not only relieve pain performance but also improve lumbar function in the human body,at the same time,it is capable of improving their quality of life by remission of inflammatory response and TCM symptoms.