自拟痹痛汤对寒湿痹阻型腰椎间盘突出症的临床疗效

Clinical efficacy of self-made Bitong decoction in lumbar disc herniation patients with cold-dampness syndrome

目的分析自拟痹痛汤(SBD)联合依托考昔片(ET)治疗寒湿痹阻型(CDS)腰椎间盘突出症(LDH)的临床疗效。方法回顾性分析2023年1月至2024年1月浙江中医药大学附属丽水市中医院就诊的LDH患者临床资料,根据治疗方案分为ET组和ET+SBD组。本研究主要观察指标为干预4周后LDH患者的生活质量[Oswestry功能障碍指数(ODI)]、疼痛程度[视觉模拟量表(VAS)]、功能状态[改良日本骨科协会量表(M-JOA)]、治疗有效率、中医证候积分和炎症因子[白细胞介素(IL)-1β、肿瘤坏死因子(TNF)-α和IL-6]。记录两组患者用药期间不良反应发生情况以评估安全性。结果研究共纳入患者86例,ET组40例,ET+SBD组46例。治疗后,ET+SBD组ODI评分、VAS评分、M-JOA评分、中医证候积分、IL-1β、TNF-α和IL-6水平均显著低于ET组,且治疗有效率高于ET组(P<0.05)。此外,ET+SBD组不良事件发生率与ET组差异无统计学意义(P>0.05)。结论SBD联合ET可显著改善LDH患者生活质量、疼痛程度和功能状态,提升治疗效果,其与SBD抗炎镇痛作用密切相关。

Objective To analyze the clinical efficacy of self-made Bitong decoction(SBD)combined with etoricoxib tablets(ET)in lumbar disc herniation(LDH)patients with colddampness syndrome(CDS).Methods The clinical data of LDH patients attending Lishui Hospital of Traditional Chinese Medicine affiliated to Zhejiang University of Traditional Chinese Medicine from January 2023 to January 2024 were retrospectively analyzed and divided into the ET group and the ET+SBD group according to the treatment plans.The main observed indicators of this study were quality of life[Oswestry Dysfunction Index(ODI)]and pain level[Visual Analog Scale(VAS)],functional status[Modified Japanese Orthopedic Association,(M-JOA)scale],treatment response rate,TCM syndrome score and inflammatory factors(IL-1β,TNF-α,and IL-6)after 4 weeks of treatment.The occurrence of adverse reactions during the medication period was recorded to evaluate the safty.Results A total of 86 patients were included in the study,40 in the ET group and 46 in the ET+SBD group.After treatment,the ODI score,VAS score,M-JOA score,TCM syndrome score,IL-1β,TNF-αand IL-6 levels were significantly lower in the ET+SBD group than those in the ET group,and the treatment efficiency was higher than that in the ET group(P<0.05).In addition,there was no statistically significant difference between the incidence of adverse events in the ET+SBD group and the ET group(P>0.05).Conclusion SBD combined with ET can significantly improve the quality of life,pain degree and functional status of LDH patients,and improve the treatment effect,which is closely related to the anti-inflammatory and analgesic effect of SBD.