[1]钟传棋sup>△ 杨功旭 吴斌 霍雄涛 金军.通督活血汤治疗肾虚血瘀型腰椎间盘突出症的临床研究[J].中国中医骨伤科杂志,2020,28(10):13-16.
　ZHONG Chuanqisup> YANG Gongxu WU Bin HUO Xiongtao JIN Jun.Clinical Study on Tongdu Huoxue Decoction in Treating Prolapse of Lumbar Intervertebral Disc with Kidney Deficiency and Blood Stasis[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2020,28(10):13-16.
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通督活血汤治疗肾虚血瘀型腰椎间盘突出症的临床研究()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第28卷
期数:
2020年10期
页码:
13-16
栏目:
临床研究
出版日期:
2020-10-10

文章信息/Info

Title:
Clinical Study on Tongdu Huoxue Decoction in Treating Prolapse of Lumbar Intervertebral Disc with Kidney Deficiency and Blood Stasis
文章编号:
1005-0205(2020)10-0013-04
作者:
钟传棋<sup>1; 2△ 杨功旭1; 2 吴斌1; 2 霍雄涛1; 2 金军1; 2
Author(s):
ZHONG Chuanqi<sup>1; 2△ YANG Gongxu1; 2 WU Bin1; 2 HUO Xiongtao1; 2 JIN Jun1; 2
1Hubei Provincial Hospital of Traditional Chinese Medicine,Wuhan 430061,China; 2Hubei Province Academy of Traditional Chinese Medicine,Wuhan 430074,China.
关键词:
腰椎间盘突出症;  通督活血汤;  炎症因子;  ODI指数;  JOA 评分
Keywords:
lumbar disc herniation;  Tongdu Huoxue decoction;  inflammatory factors;  ODI index;  JOA score
分类号:
R681.5
文献标志码:
A
摘要:
目的:观察通督活血汤治疗肾虚血瘀型腰椎间盘突出症的疗效及对患者外周血清中白细胞介素-1β(IL-1β)和肿瘤坏死因子-α(TNF-α)的影响。方法:选择2017年7月至2018年7月在湖北省中医院骨伤科治疗的肾虚血瘀型腰椎间盘突出症患者80例,随机分为治疗组和对照组,每组各40例,对照组采用推拿治疗,治疗组采用口服通督活血汤结合推拿治疗,4周为1个疗程,比较两组治疗前后视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、日本骨科医师协会神经功能评分(JOA)变化,采用酶联免疫法(ELISA)测定治疗前后患者血清中IL-1β,TNF-α的变化。结果:治疗组总有效率为 92.5%,对照组为70.0%,治疗组患者总有效率高于对照组,差异有统计学意义(P<0.05); 治疗后两组 VAS 评分、ODI指数均低于治疗前,JOA 评分高于治疗前,差异有统计学意义(P<0.05),且治疗后治疗组患者 ODI指数低于对照组,JOA 评分高于对照组,差异有统计学意义(P<0.05); 治疗后两组患者血清中IL-1β,TNF-α水平均下调,差异有统计学意义(P<0.05)。结论:通督活血汤治疗腰椎间盘突出症具有较好疗效,能降低外周血清IL-1β,TNF-α水平。
Abstract:
To observe the effect of Tongdu Huoxue decoction on lumbar disc herniation with kidney deficiency and blood stasis and its effect on the levels of interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)in the peripheral serum of patients.Methods:80 lumbar disc herniation patients with kidney deficiency and blood stasis were treated in the Department of Orthopedics,Hubei Provincial Hospital of Traditional Chinese Medicine from July 2017 to July 2018,randomly divided into treatment group and control group,each group 40 cases,the control group was treated with massage therapy,the treatment group was treated with oral Tongdu Huoxue decoction combined with massage therapy,4 weeks as a course of treatment.The changes of visual analog score(VAS),Oswestry dysfunction index(ODI)and Japanese orthopaedic association neurofunction score(JOA)were compared before and after treatment.The serum levels of IL-1β and TNF-α were measured by enzyme-linked immunoassay(ELISA)before and after treatment.Results:The total effective rate of the treatment group was 92.5%,and that of the control group was 70.0%.The total effective rate of patients in the treatment group was higher than that of the control group(P<0.05).After treatment,the scores of VAS and ODI in the two groups were lower than before treatment,and the JOA were higher than before treatment,the difference was statistically significant(P<0.05).The levels of IL-1β and TNF-α in serum were down-regulated(P<0.05),and the treatment group was better than the control group(P<0.05).Conclusion:Tongdu Huoxue decoction has a good curative effect on the treatment of lumbar disc herniation,and can reduce the level of peripheral serum IL-1β and TNF-α.

参考文献/References:

[1] 张云亮,徐蕴杰,李鞠,等.身痛逐瘀汤改良制备黑膏药治疗气滞血瘀型腰椎间盘突出症疗效分析[J].陕西中医,2020,41(4):481-483.
[2] 张亚洲,唐纯志.腹针配合神阙灸治疗腰椎间盘突出症疗效观察[J].辽宁中医药大学学报,2017,19(9):114-116.
[3] 李洪涛,魏心然,孙晓伟,等.脊痛消胶囊对腰椎间盘突出症的疗效及对IL-1β、IL-6、TNF-α因子的影响[J].中医药信息,2020,37(2):95-99.
[4] 王永胜,陈有,倪文璐,等.保守治疗对腰椎间盘突出症患者坐骨神经直径及下肢痛的影响[J].颈腰痛杂志,2020,41(2):216-218.
[5] 国家中医药管理局.中医病证诊断疗效标准[S].北京:中国医药科技出版社,2012:214-215.
[6] 杨杰科,王嘉伟,周科望,等.独活寄生汤结合推拿对腰椎间盘突出疗效及 TXB2、TNF-α、IL-1β变化研究[J].中华中医药学刊,2020,38(2):44-46.
[7] 谭响,谢继勇,谢金岑,等.PELD联合硬膜外注射糖皮质激素治疗腰椎间盘突出症的临床疗效观察[J].重庆医学,2020,49(6):918-921.
[8] MINAMIDE A,YOSHIDA M,IWAHASHI H,et al.Minimally invasive decompre-ssion surgery for lumbar spinal stenosis with degenerative scoliosis:predictive factors of radiographic and clinical outcomes[J].Journal of Orthopaedic Science,2017,22(3):377-383.
[9] 廖军,周荣斌,朱君军,等.四子散中药封包治疗腰椎间盘突出症的临床研究[J].重庆医学,2020,49(6):959-962.
[10] 朱峻松,沈玉杰,王宇,等.射频靶点热凝治疗腰椎间盘突出症对外周血中TNF-α和IL-1β的影响[J].中国医药导报,2016,13(30):87-90.
[11] 史珊怡,关睿骞,于志国.五段拔伸推拿法联合中药热敷治疗腰椎间盘突出症[J].贵州医科大学学报,2020,45(2):228-232.
[12] 唐军玲.腰椎间盘突出患者行中医护理联合针灸推拿的临床疗效观察[J].中医临床研究,2018,10(27):120-121.
[13] 何伟,李博宁.李同生名老中医治疗腰椎管狭窄症经验总结[J].中国中医骨伤科杂志,2015,23(11):67-69.
[14] 梁平,周绍稳.通督活血汤治疗退行性腰椎管狭窄症112例[J].中国中医骨伤科杂志,2014,22(8):55-56.
[15] SHOKRI E,KAMALI F,SINAEI E,et al.Spinal manipulation in the treatment of patients with MRI-confirmed lumbar disc herniation and sacroiliac joint hypomobility:a quasi-experimental study[J].Chiropractic & Manual Therapies,2018,26(1):16.
[16] 牛浩,赵永泽,苏振川,等.综合手术联合中医辨证治疗腰椎间盘突出疗效及对血清TNF-α和IL-1β水平的影响[J].现代中西医结合杂志,2017,26(16):1752-1754.
[17] 刘艳,刘莹,张绍昆,等.腰椎间盘突出症微创术后功能锻炼对老年患者血清 MMP-3、TNF-α及IL-1β水平的影响[J].中国老年学杂志,2018,38(19):4675-4678.
[18] OHTORI S,INOUE G,EGUCHI Y,et al.Tumor necrosis factor-α-immunoreactive cells in nucleus pulposus in adolescentpatients with lumbar disc herniation[J].Spine(Phila Pa1976),2013,38(6):459-462.
[19] 吴萍,邓小兰,赵红,等.普通针法、动气针法与瞬间强电针法治疗腰椎间盘突出症疗效比较及对TNF-α、IL-6的影响[J].针灸临床杂志,2019,35(6):19-23.
[20] 孙灰灰,吴小涛.TNF-α与椎间盘退变关系的研究进展[J].东南大学学报:医学版,2015,34(3):448-452.

备注/Memo

备注/Memo:
(收稿日期:2020-03-05)基金项目:中央级公益性科研院所基本科研业务费专项资金 资助(YZ-1752) 1湖北省中医院(武汉,430061) 2湖北省中医药研究院 △通信作者 E-mail:18664905115@163.com
更新日期/Last Update: 2020-10-10