身痛逐瘀汤联合理筋整复推拿对腰椎间盘突出症效果观察

Observation on the effect of Shentong Zhuyu decoction combined with Lijin rectiffcation massage on lumbar disc herniation

目的 探讨身痛逐瘀汤联合理筋整复推拿对腰椎间盘突出症(lumbar disc herniation,LDH)疾病转归的影响。方法 纳入LDH患者80例,按随机数表法分为对照组及研究组,每组40例。两组均予消炎、止痛、理筋整复推拿,研究组加用身痛逐瘀汤,两组均治疗1个月。比较两组治疗有效率,以及治疗前后炎症因子[白介素(interleukin,IL)-1β、IL-6、肿瘤坏死因子(tumor necrosis factor,TNF)-α]、血液流变学指标[全血高切黏度、血浆黏度(plasma viscosity,PV)、红细胞比容(hematokrit,HCT)、红细胞聚集指数(red blood cell aggregation index,AI)]、血流动力学指标[血管阻力指数(resistance index,RI)、血管搏动指数(pulse index,PI)、收缩期速度峰值(peak systolic velocity,PSV)、舒张末期血流速度(end diastolic velocity,EDV)]、视觉模拟疼痛评分(visual analog pain score,VAS)及腰椎Oswestry功能障碍指数(Oswestry disability index,ODI)变化,并记录治疗期间不良反应发生情况。结果 治疗后,研究组治疗有效率高于对照组(95.00% vs 65.00%,P<0.05);研究组IL-1β、IL-6、TNF-α、全血高切黏度、PV、HCT、AI、RI水平以及VAS和ODI均低于对照组(P<0.05),PI、PSV、EDV水平均高于对照组(P<0.05)。两组在治疗过程中均未发生严重不良反应。结论 身痛逐瘀汤联合理筋整复推拿可降低LDH患者血液黏度,调节血液循环,降低炎症反应表达水平,改善病情。

Objective To investigate the effect of Shentong Zhuyu decoction combined with Lijin rectification massage on the outcome of lumbar disc herniation(LDH).Methods A total of 80 patients with LDH were included and divided into control group and study group according to random number table,with 40 cases in each group.Both groups were treated with anti-inflammatory,analgesic symptomatic treatment and Lijin rectification massage,and the study group was additionally treated with Shentong Zhuyu decoction,both groups were treated for 1 month.The effective rate,inffammatory factors[interleukin(IL)-1β,IL-6,tumor necrosis factor(TNF)-α],hemorheological indexes[whole blood high shear viscosity,plasma viscosity(PV),hematocrit(HCT),red blood cell aggregation index(AI)],hemodynamic index[resistance index(RI),pulse index(PI),peak systolic velocity(PSV),end diastolic velocity(EDV)],visual analog pain score(VAS), Oswestry disability index(ODI) before and after treatment were compared between the two groups. The occurrence of adverse reactions during treatment were recorded. Results After treatment, the clinical effective rate of the study group was higher than that of the control group(95.00% vs 65.00%, P<0.05). After treatment, the levels of IL-1β, IL-6, TNF-α, whole blood high shear viscosity, PV, HCT, AI, RI, VAS and ODI in the study group were lower than those in the control group(P<0.05), and the levels of PI, PSV and EDV were higher than those in the control group(P<0.05). No serious adverse reactions occurred in both groups during treatment. Conclusion Shentong Zhuyu decoction combined with Lijin rectiffcation massage can reduce the blood viscosity, regulate the blood circulation, reduce the expression level of inffammatory response and improve the condition of LDH patients.