恒古骨伤愈合剂治疗腰椎间盘突出症气滞血瘀证的疗效及对血清代谢物的影响

Effect of Osteoking on Serum Metabolites in the Treatment of Lumbar Intervertebral Disc Herniation of Qi Stagnation and Blood Stasis Syndrome and Clinical Efficacy Evaluation

目的:观察恒古骨伤愈合剂治疗腰椎间盘突出症(LDH)气滞血瘀证的临床疗效及对血清代谢物的影响。方法:运用随机数字表法,将82例LDH气滞血瘀证患者随机分为治疗组和对照组,每组41例。对照组患者口服塞来昔布胶囊,治疗组患者口服恒古骨伤愈合剂。12 d为1个疗程,2组均连续治疗2个疗程。观察患者的临床疗效及治疗前后的疼痛视觉模拟评分法(VAS)评分和日本骨科协会评估治疗分数(JOA);治疗前后取血清进行代谢组学检测,进行多元化统计分析,鉴定并筛选血清代谢物的变化,对比并通过MetaboAnalyst 5.0富集相关信号通路。结果:治疗组总有效率为87.80%(36/41),对照组总有效率为68.29%(28/41),治疗组总有效率高于对照组(P<0.05)。两组患者治疗后VAS评分均较治疗前降低(P<0.05),且治疗组患者治疗后VAS评分低于对照组(P<0.05);两组患者治疗后JOA评分均较治疗前升高(P<0.05),且治疗组患者治疗后JOA评分高于对照组(P<0.05)。代谢组学分析共筛选出42种差异代谢物,将差异代谢物与人类代谢组学数据库(HMDB)进行比对,通过所得到的差异代谢物,富集出11条代谢通路。结论:恒古骨伤愈合剂治疗腰椎间盘突出症气滞血瘀证疗效明确,能有效缓解患者疼痛症状,改善功能障碍,且恒古骨伤愈合剂可能通过血清代谢物调控患者氨基酸代谢、脂代谢、糖代谢产生抗氧化、抗炎等作用。

Objective:To observe the clinical efficacy of Osteoking in the treatment of lumbar disc herniation of qi stagnation and blood stasis syndrome and its effect on serum metabolites.Methods:Totally 82 patients with lumbar disc herniation of qi stagnation and blood stasis syndrome were selected and divided into a control group and an treatment group of 4l patients in each using the random number table method.The patients in the control group were given oral celecoxib capsules,while the patients in the treatment group were given Osteoking.2 consecutive courses of treatment were given to both groups,each course of treatment lasting 12 days.The clinical efficacy,visual analogue scale(VAS)score,and Japanese Orthopaedic Association Assessment of Treatment(JOA)score were observed.Take serum samples before and after treatment for metabolic group testing,subjected to a diverse statistical analysis,identified and screened for changes in serum metabolites,and compared and enriched for relevant signalling pathways by MetaboAnalyst 5.0.Results:The total effective rate of the treatment group is 87.80%(36/41)and the total effective rate of the control group is 68.29%(28/41).The total efficiency of the treatment group is higher than the control group(P<0.05).The VAS scores of patients in both groups were lower than before treatment,and the treatment group was lower than the control group(P<0.05).The JOA scores of patients in both groups were significantly higher than before treatment,and the treatment group was higher than the control group(P<0.05).After metabolomic analysis,a total of 42 differential metabolites were screened.The differential metabolites were compared to the human metabolomicsdatabase(HMDB).11 metabolic pathways were enriched by the obtained differential metabolite HMDB numbers.Conclusion:Osteoking can effectively relieve patients'pain symptoms and improve functional impairment in the conservative treatment of lumbar disc herniation qi stagnation and blood stasis syndrome,and it may be related to the mechanism of action through serum metabolites regulating patients'amino acid metabolism,lipid metabolism,glucose metabolism,antioxidant and anti-inflammatory.