基于浊毒理论针刺结合通滞苏润江胶囊治疗腰椎间盘突出症临床研究

Clinical Study on Treating Lumbar Disc Herniation with Needling and Tongzhi Surunjiang Capsules Based on Turbid-toxin Theory

目的:探究浊毒理论针刺结合通滞苏润江胶囊治疗腰椎间盘突出症(lumbar disc herniation,LDH)的临床效果。方法:将湿浊瘀阻型LDH患者120例按照随机数字表法分为针药结合组、针刺组、中药组各40例。3组患者均接受常规康复护理训练,在此基础上,针刺组给予《神应经》腰痛十二穴针刺治疗;中药组给予通滞苏润江胶囊;针药结合组给予通滞苏润江胶囊+《神应经》腰痛十二穴针刺,均连续治疗4周。比较3组治疗前后疼痛视觉模拟评分(visual analogue scale,VAS)、日本骨科学会评估治疗评分(Japanese orthopaedic association scores,JOA)、Oswestry功能障碍指数(oswestry disability index,ODI)、临床症状及椎间盘退变等级改善率和安全性。结果:针药结合组临床症状改善率为97.50%(39/40),高于针刺组的80.00%(32/40)及中药组的82.50%(33/40)(P<0.05);针药结合组椎间盘退变等级改善率为92.50%(37/40),高于针刺组的75.00%(30/40)及中药组的70.00%(28/40)(P<0.05);治疗后,3组患者VAS、JOA、ODI评分与治疗前比较差异具有统计学意义(P<0.05),针药结合组VAS、ODI评分低于针刺组及中药组(P<0.05),JOA评分高于针刺组及中药组(P<0.05);3组不良反应发生率较低。结论:将基于浊毒理论的针药结合治疗应用于LDH,可有效缓解疼痛,提高患者生活质量及腰椎功能恢复率,改善椎间盘退变程度,且安全性较高。

Objective:To explore therapeutic effects of needling and Tongzhi Surunjiang capsules in the treatment of lumbar disc herniation(LDH)based on the turbid-toxin theory.Methods:A total of 120 patients of LDH of damp-turbid stagnation and obstruction pattern were divided into the groups of needling-medicine combination,needling,and Chinese medicine,with 40 cases in each.The patients in three groups accepted routine nursing training of rehabilitation,the needling group was treated by needling at 12 acupoints for lumbago from Shenyingjing;and Chinese medicine group took Tongzhi Surunjiang capsules orally,needling-medicine combination group received the combination therapy of Tongzhi Surunjiang capsules and needling at 12 acupoints for lumbago from Shenyingjing,they were treated for four weeks consecutively.To compare VAS scores,JOA scores,ODI,the improvement rate of clinical symptoms and disc degeneration grade and the safety before and after the treatment between three groups.Results:The improvement rate of clinical symptoms was 97.50%(39/40)in the needle-medicine combination group,higher than 80.00%(32/40)of the needling group and 82.50%(33/40)of Chinese medicine group(P<0.05);the improvement rate of disc degeneration grade was 92.50%(37/40)in the needle-medicine combination group,higher than 75.00%(30/40)of the needling group and 70.00%(28/40)of Chinese medicine group(P<0.05);after the treatment,the statistical difference existed in VAS,JOA,ODI scales between three groups when compared with before the treatment(P<0.05),the VAS and ODI scores of the needle-medicine combination group were lower than these of the needling group and Chinese medicine group(P<0.05),JOA scores were higher than these of the needling group and Chinese medicine group(P<0.05);the incidence of adverse reaction was lower in three groups.Conclusion:On the foundation of turbid-toxin theory,needling-medicine combination could gain noticeable clinical effects in the application of LDH,it could effectively relieve pain,improve the patients'quality of life,the improvement rate of lumbar function and the degree of disc degeneration grade with higher safety,and it is worthy of clinical dissemination.