基于“三焦气化”理论运用己椒苈黄汤治疗腰椎间盘突出症41例

Ji-Jiao-Li-Huang Decoction was Used to Treat 41 Cases of Prolapse of Lumbar Intervertebral Disc Based on the Theory of“Sanjiao Qi Movement”

目的:观察经方己椒苈黄汤治疗腰椎间盘突出症(气机不利、瘀水互结证)的临床疗效。方法:采用前瞻性单臂临床研究方法,观察符合条件的38例腰椎间盘突出症患者,采用己椒苈黄汤内服治疗2周,分别于治疗前、治疗1周后、治疗2周后、疗程结束2周后随访,记录患者腰腿疼痛视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)评分、中医证候评分、起效时间及治疗前后的腰椎活动度,来评价临床疗效及安全性。结果:VAS评分、ODI评分及中医证候评分在治疗1周后、治疗2周后、治疗结束2周后与治疗前比较,差异均有统计学意义(P<0.05);治疗2周后及治疗结束2周后与治疗1周后相比差异有统计学意义(P<0.05);治疗结束后2周随访与治疗2周后相比,VAS评分和ODI评分差异无统计学意义(P>0.05),中医证候评分差异有统计学意义(P<0.05);治疗2周后,腰椎前屈、后伸活动度对比治疗前,差异有统计学意义(P<0.05);治疗结束时,ODI评分有效率为80.5%。结论:己椒苈黄汤能显著改善腰椎间盘突出症(气机不利、瘀水互结证)患者腰腿疼痛、腰椎活动受限等症状,改善中医证候,起效时间快,不良反应少。

To observe the clinical efficacy of Ji-Jiao-Li-Huang decoction in the treatment of lumbar disc herniation with the syndrome of Qi stagnation and stagnation of blood and water.Methods:A prospective single-arm clinical study was conducted on 38 eligible patients with lumbar disc herniation.The patients were treated with Ji-Jiao-Li-Huang decoction taken orally for 2weeks.The patients'lumbar and leg pain visual analogue scale(VAS)scores,Oswestry disability index(ODI)scores,TCM syndrome scores,onset time,and lumbar mobility before and after treatment were recorded and followed up at 1week,2weeks,and 2weeks after the treatment course to evaluate clinical efficacy and safety.Results:The VAS scores,ODI scores,and TCM syndrome scores showed statistically significant differences after 1week,2weeks,and 2weeks post-treatment compared to before treatment(P<0.05).There were statistically significant differences in these scores at 2weeks and 2weeks post-treatment compared to 1week(P<0.05).No statistically significant difference was observed in VAS and ODI scores between 2weeks post-treatment and 2 weeks after the end of treatment(P>0.05),but there was a statistically significant difference in TCM syndrome scores(P<0.05).After 2weeks of treatment,the lumbar flexion and extension mobility showed statistically significant differences compared to before treatment(P<0.05).At the end of the treatment,the effective rate of the ODI scores was 80.5%.Conclusion:Ji-Jiao-Li-Huang decoction can significantly improve the symptoms of lumbar and leg pain and limited lumbar mobility in patients with lumbar disc herniation with the syndrome of Qi stagnation and stagnation of blood and water.It also improves TCM syndrome,has a rapid onset time,and has few adverse reactions.