[1]温海宝,高景华△,朱立国,等.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[J].中国中医骨伤科杂志,2024,32(08):80-84.[doi:10.20085/j.cnki.issn1005-0205.240816 ]
 WEN Haibao,GAO Jinghua,ZHU Liguo,et al.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”[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2024,32(08):80-84.[doi:10.20085/j.cnki.issn1005-0205.240816 ]
点击复制

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()
分享到:

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第32卷
期数:
2024年08期
页码:
80-84
栏目:
临床报道
出版日期:
2024-08-15

文章信息/Info

Title:
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”
文章编号:
1005-0205(2024)08-0080-05
作者:
温海宝1高景华12△朱立国12冯敏山12高春雨1杨克新1李建国1李路广1
1中国中医科学院望京医院(北京,100102);2北京市中医正骨技术重点实验室
Author(s):
WEN Haibao1GAO Jinghua12△ZHU Liguo12FENG Minshan12GAO Chunyu1YANG Kexin1LI Jianguo1LI Luguang1
1Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China; 2Beijing Key Laboratory of Orthopedic Technology in Traditional Chinese Medicine,Beijing 100102,China.
关键词:
己椒苈黄汤 腰椎间盘突出症 三焦气化 气机不利 瘀水互结
Keywords:
Ji-Jiao-Li-Huang decoction lumbar disc herniation Sanjiao Qi movement Qi stagnation stagnation of blood and water
分类号:
R681.5
DOI:
10.20085/j.cnki.issn1005-0205.240816
文献标志码:
B
摘要:
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。
Abstract:
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 2 weeks.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 1 week,2 weeks,and 2 weeks 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 1 week,2 weeks,and 2 weeks post-treatment compared to before treatment(P<0.05).There were statistically significant differences in these scores at 2 weeks and 2 weeks post-treatment compared to 1 week(P<0.05).No statistically significant difference was observed in VAS and ODI scores between 2 weeks 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 2 weeks 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.

参考文献/References:

[1] 中华医学会疼痛学分会脊柱源性疼痛学组.腰椎间盘突出症诊疗中国疼痛专家共识[J].中国疼痛医学杂志,2020,26(1):2-6.
[2] AMIN RAJ M,ANDRADE NICHOLAS S,NEUMAN BRIAN J.Lumbar disc herniation[J].Current Reviews in Musculoskeletal Medicine,2017,10(4):507-516.
[3] 中华医学会骨科学分会脊柱外科学组,中华医学会骨科学分会骨科康复学组.腰椎间盘突出症诊疗指南[J].中华骨科杂志,2020,40(8):477-487.
[4] 国家食品药品监督管理局.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:356-359.
[5] 国家中医药管理局.中医病证诊断疗效标准[M].北京:中国医药科技出版社,2012:214-215.
[6] 万丽,赵晴,陈军,等.疼痛评估量表应用的中国专家共识(2020版)[J].中华疼痛学杂志,2020,16(3):177-187.
[7] FAIRBANK J.The Oswestry disability index[J].Spine(Phila Pa 1976),2000,25(22):2940-2953.
[8] 程继伟,王振林,刘伟,等,周跃.Oswestry 功能障碍指数的改良及信度和效度检验[J].中国脊柱脊髓杂志,2017,27(3):235-241.
[9] 董国菊.基于“三焦气化”理论谈中医药分期防治射血分数保留心衰的思路[J].中华中医药学刊,2023,41(4):1-3.
[10] 张天星,贺娟.三焦探源[J].北京中医药大学学报,2015,38(11):725-728.
[11] BENIAS P C,WELLS R G,SACKEY-ABOAGYE B,et al.Structure and distribution of an unrecognized interstitium in human tissues[J].Science Reports,2018,8(1):4947.
[12] FENG J T,LI H Y,HAN D,et al.A ‘green pathway' different from simple diffusion in soft matter:fast molecular transport within micro/nanoscale multiphase porous systems[J].Nano Research,2014,7(3):434-442.
[13] 孙旭云,赖永健,魏峰明,等.从“三焦气化失司”理论探讨慢性功能性便秘的治疗[J].山西中医药大学学报,2022,23(5):465-468.
[14] 王桂彬,荆琳,潘丽,等.中医治疗腰痛经验[J].中医学报,2021,36(10):2059-2062.
[15] BLUMENFELD H.临床神经解剖学:病例解析[M].李云庆,赵钢,汪昕,等译.2版.天津:天津科技翻译出版有限公司,2020:276-279.
[16] 罗思进.腰椎间盘突出症疼痛发生机制的研究进展[J].世界最新医学信息文摘,2019,19(58):38-39.
[17] DI MARTINO A,MERLINI L,FALDINI C.Autoimmunity in intervertebral disc herniation:from bench to bedside[J].Expert Opin Ther Targets,2013,17(12):1461-1470.
[18] 周岩著,邹运国点校.本草思辨录[M].北京:人民军医出版社,2015:58-59.
[19] 邹澍撰.本经疏证[M].北京:中国中医药出版社,2015:373-375.
[20] RASMUSSEN-BARR E,HELD U,GROOTEN W J,et al.Non-steroidal anti-inflammatory drugs for sciatica[J].Cochrane Database Syst Rev,2016,10(10):CD012382.
[21] ABDEL SHAHEED C,MAHER C G,BUCHBINDER R,et al.Efficacy and harms of orally,intramuscularly or intravenously administered glucocorticoids for sciatica:a systematic review and meta-analysis[J].Eur J Pain,2020,24(3):518-535.

备注/Memo

备注/Memo:
基金项目:国家中医药传承创新团队项目(ZYYCXTD-C-202003) 中国中医科学院科技创新工程项目(C12021A02015) 通信作者 E-mail:gaojinghua64@sina.com
更新日期/Last Update: 2024-08-05