[1]孙凯 朱立国△ 魏戌△ 银河 杨克新高景华杨博文 齐保玉 唐彬 陈琳 秦晓宽 谭贵红.壮腰通络方治疗腰椎间盘突出症45例[J].中国中医骨伤科杂志,2021,29(01):19-23.
　SUN Kai ZHU Liguo WEI Xu YIN He YANG Kexin GAO JinghuaYANG Bowen QI Baoyu TANG Bin CHEN Lin QIN Xiaokuan TAN Guihong.Clinical Observation on Zhuangyao Tongluo Decoction in theTreatment of 45 Patients with Lumbar Disc Herniation[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2021,29(01):19-23.
点击复制

壮腰通络方治疗腰椎间盘突出症45例()
分享到：

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

卷:
第29卷
期数:
2021年01期
页码:
19-23
栏目:
临床研究
出版日期:
2021-01-15

文章信息/Info

Title:
Clinical Observation on Zhuangyao Tongluo Decoction in theTreatment of 45 Patients with Lumbar Disc Herniation
文章编号:
1005-0205(2021)01-0019-05
作者:
孙凯1 朱立国1; 2△ 魏戌1△ 银河1 杨克新1高景华1杨博文1 齐保玉1 唐彬1 陈琳1; 3 秦晓宽1 谭贵红1
Author(s):
SUN Kai1 ZHU Liguo1; 2△ WEI Xu1△ YIN He1 YANG Kexin1 GAO Jinghua1YANG Bowen1 QI Baoyu1 TANG Bin1 CHEN Lin1; 3 QIN Xiaokuan1 TAN Guihong1
1Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China; 2Beijing Key Laboratory of Orthopedics of Traditional Chinese Medicine,Beijing 100007,China; 3Beijing University of Traditional Chinese Medicine,Beijing 100029,China.
关键词:
腰椎间盘突出症;  壮腰通络方;  临床观察
Keywords:
lumbar disc herniation;  Zhuangyao Tongluo decoction;  clinical observation
分类号:
R681.5
文献标志码:
A
摘要:
目的:探讨壮腰通络方治疗腰椎间盘突出症(肝肾亏虚、瘀血阻络证)的临床疗效和安全性。方法:采用壮腰通络方内服治疗45例(肝肾亏虚、瘀血阻络证)腰椎间盘突出症患者,疗程4周,分别于治疗前、治疗2周后、治疗4周后及治疗结束后2周随访时记录患者JOA评分、腰痛VAS评分及中医证候积分,并观察用药安全性。结果:患者的JOA评分、VAS评分及中医证候积分在治疗2周后、治疗4周后及治疗结束后2周随访与治疗前比较,差异均有统计学意义(P<0.05); 治疗4周后及治疗结束后2周随访与治疗2周后比较,差异有统计学意义(P<0.05)。在JOA评分中,主观症状评分及日常活动受限程度评分在治疗2周后、治疗4周后及治疗结束后2周随访与治疗前比较,差异均有统计学意义(P<0.05); 治疗4周后及治疗结束后2周随访与治疗2周后比较,差异有统计学意义(P<0.05); 而临床体征评分仅在治疗4周后及治疗结束后2周随访与治疗前比较,差异均有统计学意义(P<0.05)。经过治疗2周及治疗4周后,JOA疗效评价有效率分别为77.78%和82.22%; 在治疗结束后2周随访时,有效率为80%。在观察期内未发现因服用本药而引起的不良事件。结论:壮腰通络方能改善腰椎间盘突出症(肝肾亏虚、瘀血阻络证)患者腰膝酸软等中医证候积分及主观症状、日常活动受限程度等腰椎功能评分,具有较稳定的临床疗效和安全性。
Abstract:
To explore the clinical efficacy and safety of Zhuangyao Tongluo decoction in the treatment of lumbar disc herniation(LDH)of liver-kidney deficiency,blood stasis syndrome.Methods:45 patients with LDH were treated with Zhuangyao Tongluo decoction for 4 weeks.JOA scores,VAS scores,traditional Chinese medicine(TCM)syndrome scores and drug safety were recorded before treatment,2 weeks,4 weeks after treatment and 2 weeks’ follow-up.Results:Compared with those before treatment,JOA scores,VAS scores and TCM syndrome scores were respectively significantly changed at 2 weeks,4 weeks after treatment and 2 weeks’ follow-up(P<0.05).Compared with those of 2 weeks after treatment,there were significant differences after 4 weeks treatment and 2 weeks of follow-up(P<0.05).In terms of clinical sign scores,compared with that before treatment,there was significant difference after 4 weeks of treatment and 2 weeks of follow-up(P<0.05).After 2 weeks and 4 weeks treatment,the effective rates of JOA efficacy evaluation were 77.78% and 82.22% respectively.The effective rate was 80% after 2 weeks’ follow-up.During the observation period,there was no side-effects caused by medication.Conclusion:Zhuangyao Tongluo decoction can effectively improve the scores of TCM syndromes such as sore waist and knees of patients with LDH of liver-kidney deficiency,blood stasis syndrome,and can also improve the scores of lumbar function such as subjective symptoms and limits of daily activities,which has stable clinical efficacy and safety.

参考文献/References:

[1] KREINER D S,HWANG S W,EASA J E,et al.An evidence-based clinical guideline for the diagnosis and treatment of lumbar disc herniation with radiculopathy[J].Spine J,2014,14(1):180-191.
[2] KIM J H,VAN RIJN R M,VAN TULDER M W,et al.Diagnostic accuracy of diagnostic imaging for lumbar disc herniation in adults with low back pain or sciatica is unknown:a systematic review[J].Chiropr Man Therap,2018,26(1):37.
[3] 中华医学会骨科学分会.腰椎间盘突出症诊疗指南[J].中华骨科杂志,2020,40(8):477-487.
[4] LEE J H,CHOI K H,KANG S,et al.Nonsurgical treatments for patients with radicular pain from lumbosacral disc herniation[J].Spine J,2019,19(1):1478-1489.
[5] 王人彦,张杰,赵睿晞,等.骨伤名师张玉柱治疗腰椎间盘突出症的临床经验[J].中国中医骨伤科杂志,2020,28(2):80-81.
[6] 马志红,白玉,马富强.白玉教授治疗腰椎间盘突出症94例临床报道[J].中国中医骨伤科杂志,2020,28(5):67-69.
[7] 王行利.中西医治疗腰椎间盘突出症研究进展[J].临床医学研究与实践,2020,5(4):194-195.
[8] 朱立国,孙凯,魏戌,等.《外台秘要》腰痛方证治特点及用药规律探析[J].世界中西医结合杂志,2019,14(9):1188-1190.
[9] 中华医学会.临床诊疗指南—骨科分册[S].北京:人民卫生出版社,2009:108-109.
[10] KREINER D S,SHAFFER W O,BAISDEN J L,et al.An evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spinal stenosis(update)[J].Spine J,2013,13(7):734-743.
[11] 国家中医药管理局.中医病证诊断疗效标准[M].南京: 南京大学出版社,1994: 24.
[12] 李灿东.中医诊断学[M].北京:中国中医药出版社,2016:107.
[13] 戚麟,王馨,陈瑞奇,等.评分量表在脊柱疾病评价中的应用进展[J].实用骨科杂志,2019,25(12):1098-1102.
[14] 陈锋,吴晓飞,闫乾,等.腰椎间盘突出症中医证候学研究[J].辽宁中医药大学学报,2019,21(12):13-16.
[15] 杨少锋,郭彦涛,罗振华,等.长沙市腰椎间盘突出症中医证候研究[J].中医正骨,2016,28(2):33-35.

备注/Memo

备注/Memo:
基金项目:中国中医药循证能力提升建设项目(ZZ13-024-7)中国中医科学院“十三五”重点领域科研项目(ZZ10-022)中国中医科学院优秀青年科技人才(创新类)培养专项计划(ZZ13-YQ-039)
1中国中医科学院望京医院脊柱二科(北京,100102)
2中医正骨技术北京市重点实验室
3北京中医药大学
△通信作者 E-mail:zhlg95@aliyun.com(朱立国)weixu.007@163.com(魏戌)
更新日期/Last Update: 2021-01-15