针刺联合益肾活血汤治疗肾虚血瘀型腰椎间盘突出症临床研究

Clinical Study of Acupuncture Combined with Yishen Huoxue Tang for Lumbar Disc Herniation with Kidney Deficiency and Blood Stasis Type

目的:观察针刺联合益肾活血汤治疗肾虚血瘀型腰椎间盘突出症的临床疗效。方法:选取120例肾虚血瘀型腰椎间盘突出症患者为研究对象,按随机数字表法分为观察组和对照组,每组60例。对照组采用益肾活血汤治疗,观察组在此基础上增加针刺疗法。治疗后对比2组临床疗效,观察2组疼痛症状及腰椎功能的改善情况,记录2组治疗前后免疫功能指标水平和不良反应发生情况。结果:观察组总有效率88.33%,高于对照组的73.33%,差异有统计学意义(P <0.05)。治疗后,2组视觉模拟评分法(VAS)及Oswestry功能障碍指数问卷表(ODI)评分均较治疗前降低(P <0.05),日本骨科协会(JOA)腰椎功能评分均较治疗前升高(P <0.05);观察组VAS及ODI评分均低于对照组(P <0.05),JOA腰椎功能评分高于对照组(P <0.05)。治疗后,2组CD3^+、CD4^+及CD4^+/CD8^+值均较治疗前升高(P <0.05),CD8^+值均较治疗前降低(P <0.05);观察组CD3^+、CD4^+及CD4^+/CD8^+值高于对照组(P <0.05),CD8^+值低于对照组(P <0.05)。观察组不良反应发生率16.67%,对照组不良反应发生率11.67%,2组比较,差异无统计学意义(P> 0.05)。结论:针刺联合益肾活血汤治疗肾虚血瘀型腰椎间盘突出症疗效显著,能有效改善患者的疼痛程度和腰椎功能,提高免疫力,治疗安全性好,值得临床推广应用。

Objective: To observe the clinical effect of acupuncture combined with Yishen Huoxue tang for lumbar disc herniation with kidney deficiency and blood stasis type. Methods: Selected 120 cases of patients with lumbar disc herniation with kidney deficiency and blood stasis type as study subjects and divided them into the observation group and the control group according to random number table, 60 cases in each group. The control group was treated with Yishen Huoxue tang,and the observation group was additionally treated with acupuncture therapy. After treatment, compared the clinical effects in the two groups,observed the pain symptoms and the improvement of lumbar function in the two groups,and recorded the levels of immune function indexes and incidence of adverse reactions in the two groups before and after treatment. Results:The total effective rate was 88.33% in the observation group, being higher than that of 73.33% in the control group,difference being significant(P < 0.05). After treatment, the scores of visual analogue scale(VAS) and Oswestry dysfunction index questionnaire(ODI) in the two groups were lower than those before treatment(P< 0.05),and the scores of Japanese Orthopaedic Association(JOA) lumbar function were higher than those before treatment(P < 0.05);the VAS and ODI scores in the observation group were lower than those in the control group(P < 0.05), and the JOA lumbar function score was higher than that in the control group(P< 0.05). After treatment, the values of CD3^+, CD4^+ and CD4^+/CD8^+ in the two groups were higher than those before treatment(P < 0.05), and the values of CD8^+ were lower than those before treatment(P < 0.05). The values of CD3^+, CD4^+ and CD4^+/CD8^+ in the observation group were higher than those in the control group(P < 0.05), and the CD8^+ value was lower that in the control group(P < 0.05). The incidence of adverse reactions was 16.67% in the observation group and 11.67% in the control group, no significant difference being found in the comparison between the two groups(P>0.05). Conclusion: The application of acupuncture combined with Yishen Huoxue tang has obvious curative effect in treating lumbar disc herniation with kidney deficiency and blood stasis type. It can effectively improve the pain level and lumbar function of patients and enhance their immunity. With good safety, the treatment is worthy of clinical promotion and application.