复元止痛方辅助腰背肌功能训练对腰椎术后慢性腰痛患者疼痛缓解和腰椎功能康复的影响

Effects of Fuyuan Zhitong Formula assisting a functional training of lumbar back muscles on the pain relief and lumbar function rehabilitation in patients with chronic lumbar pain after lumbar surgery

目的探讨复元止痛方辅助腰背肌功能训练对腰椎术后慢性腰痛患者疼痛缓解和腰椎功能康复的影响。方法选取2021年1月-2023年1月收治的腰椎术后慢性腰痛患者86例,分为对照组和观察组,各43例。对照组患者采用塞来昔布胶囊口服+腰背肌功能训练治疗,观察组患者在对照组治疗基础上联合复元止痛方治疗,连续治疗4周。观察2组患者治疗前后中医症状积分、VAS和ODI评分、血清炎性因子[肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白介素-6(interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)]水平改善情况,并比较2组治疗后总有效率及治疗方案的安全性。结果治疗后,2组腰痛如针刺、疼痛拒按、腰椎活动受限、舌质紫黯积分,VAS评分,ODI评分均明显降低(P<0.05),且观察组治疗后中医症状积分及量表评分均低于对照组(P<0.05);2组TNF-α、IL-6、CRP均显著下降(P<0.05),观察组低于对照组(P<0.05);观察组总有效率93.02%明显高于对照组76.74%(P<0.05);观察组药物不良反应总发生率4.65%明显低于对照组23.26%(P<0.05)。结论采用复元止痛方配合腰背肌功能训练治疗腰椎术后慢性腰痛,能够有效减轻疼痛程度,降低炎性因子水平,促进腰椎功能恢复和临床症状缓解,且治疗安全性较高。

Objective To explore the effects of Fuyuan Zhitong Formula assisting a functional training of lumbar back muscles on the pain relief and lumbar function rehabilitation in the treatment of patients with chronic low back pain after lumbar surgery.Methods A total of 86 patients with chronic low back pain after lumbar spine surgery admitted to our hospital from January 2021 to January 2023 were selected and divided into a control group and an observation group,with 43 cases in each group.The patients in the control group were treated with celecoxib capsules orally and a functional training of lumbar and dorsal muscles,while the patients in the observation group were treated with Fuyuan Zhitong Formula on the basis of the treatment in the control group,both for 4 consecutive weeks.The improvement of TCM syndrome scores,pain scores of the Visual Analog Scale(VAS),Oswestry Disability Index(ODI),and serum inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)C-reactive protein(CRP)]was observed in the two groups before and after treatment,and the total effective rate and safety of the treatment plan were compared between the two groups.Results After treatment,the scores of low back pain,pain refusal to press,lumbar activity limitation,tongue purple darkness,VAS and ODI were all significantly decreased in the two groups(P<0.05),and the above scores were much lower in the observation group than those in the control group(P<0.05).The levels of TNF-α,IL-6,and CRP were all significantly decreased in both groups(P<0.05),with the observation group being lower than the control group(P<0.05).The total effective rate was 93.02%(40/43)in the observation group,which was significantly higher than that of the control group(76.74%,33/43)(P<0.05).The total incidence of adverse drug reactions was 4.65%(2/43)in the observation group,which was significantly lower than that in the control group(23.26%,10/43)(P<0.05).Conclusion The treatment of chronic low back pain after lumbar surgery with Fuyuan Zhitong Formula and the functional training of lumbar and dorsal muscles can effectively reduce the degree of pain,lower the levels of inflammatory factors,promote the recovery of lumbar function and relieve clinical symptoms,with a higher safety.