[1]李玉冰,齐翰林,蔡迎峰△,等.八段锦联合椎间盘方治疗肝肾亏虚型腰椎间盘突出症疗效观察[J].中国中医骨伤科杂志,2022,30(01):45-49.
　LI Yubing,QI Hanlin,CAI Yingfeng,et al.Clinical Observation of Eight-Section Brocade Exercise Combined with Disc Decoction on the Treatment of Lumbar Intervertebral Disc Herniation with Liver and Kidney Deficiency[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2022,30(01):45-49.
点击复制

八段锦联合椎间盘方治疗肝肾亏虚型腰椎间盘突出症疗效观察()
分享到：

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

卷:
第30卷
期数:
2022年01期
页码:
45-49
栏目:
临床研究
出版日期:
2022-01-15

文章信息/Info

Title:
Clinical Observation of Eight-Section Brocade Exercise Combined with Disc Decoction on the Treatment of Lumbar Intervertebral Disc Herniation with Liver and Kidney Deficiency
文章编号:
1005-0205(2022)01-0045-05
作者:
李玉冰1; 2; 齐翰林1; 2; 蔡迎峰1△; 梁浩东1; 杜鹏2; 3; 田天照1
1广州医科大学(广州,511400) 2广州医科大学附属中医医院 3广州中医药大学
Author(s):
LI Yubing1; 2; QI Hanlin1; 2; CAI Yingfeng1△; LIANG Haodong1; DU Peng2; 3; TIAN Tianzhao1
1Guangzhou Medical University,Guangzhou 511400,China; 2The Affiliated TCM Hospital of Guangzhou Medical University,Guangzhou 510145,China; 3Guangzhou University of Chinese Medicine,Guangzhou 510006,China.
关键词:
腰椎间盘突出症;  运动疗法;  八段锦;  椎间盘方;  临床疗效
Keywords:
lumbar disc herniation;  exercise therapy;  Eight-Section Brocade Exercise;  disc decoction;  clinical trial
分类号:
R681.5
文献标志码:
A
摘要:
目的:观察八段锦功能锻炼联合椎间盘方治疗肝肾亏虚型腰椎间盘突出症的临床疗效。方法:将符合要求的66例腰椎间盘突出症患者随机分为两组,每组各33例。治疗组采用八段锦功能锻炼联合椎间盘方治疗,对照组采用五点支撑功能锻炼联合椎间盘方治疗,均治疗4周。比较治疗前、治疗2周后及4周后的日本骨科协会评估治疗腰椎评分(JOA)、视觉模拟评分法评分(VAS),并记录临床疗效和不良反应事件的差异,作为临床疗效观察有效值。结果:治疗组1例患者和对照组4例患者未能坚持完成治疗,予以剔除,两组患者治疗期间均未出现并发症。就临床疗效而言,经治疗后,治疗组治愈率为12.50%,显效率为62.50%,总有效率为93.75%; 对照组治愈率为10.34%,显效率为48.29%,总有效率为89.66%。经Mann-Whitney U秩和检验,u=330.00,P=0.035,提示治疗组在治疗效果上优于对照组。经治疗后,两组患者不同时间点腰椎JOA评分、VAS评分较治疗前差异有统计学意义,即存在时间效应(F=108.565,P<0.001; F=157.456,P<0.001)。其中就JOA评分而言,治疗组优于对照组(P<0.05); 且治疗4周后,治疗组明显优于对照组,差异有统计学意义(P<0.01)。就VAS评分而言,虽然治疗组评分低于对照组,但是两组差异无统计学意义(P>0.05)。结论:八段锦功能锻炼联合椎间盘方可缓解肝肾亏虚型腰椎间盘突出症患者症状,就功能评分而言其效果明显优于五点支撑功能锻炼联合椎间盘方组,更有利于腰椎肌肉功能性恢复与协调,且长期疗效更明显。但就止痛效果而言,二者无明显差异。
Abstract:
Objective:To observe the clinical efficacy of Eight-Section Brocade Exercise combined with disc decoction on the treatment of lumbar disc herniation(LDH)with liver and kidney deficiency and provide basis for clinical practice.Methods:66 cases with lumbar disc herniation were randomly divided into 2 groups,with 33 cases in each group.The treatment group was treated with Eight-Section Brocade Exercise combined with disc decoction,while the control group was treated with Five-Point Supporting Function Exercise combined with disc decoction.The Japanese Orthopaedic Association evaluation lumbar spine score(JOA)and visual analogue scale(VAS)were compared before treatment,after treatment for 2 weeks and 4 weeks,and the differences in clinical efficacy and adverse events were recorded as effective values for clinical efficacy observation.Results:1 patient in the treatment group and 4 patients in the control group failed to complete the treatment and were excluded,and no complications occurred during the treatment in both groups.In terms of clinical efficacy,the cure rate of the treatment group was 12.50%,the significant efficiency was 62.50% and the total effective rate was 93.75% after treatment.In the control group,the cure rate was 10.34%,the effective rate was 48.29%,and the total effective rate was 89.66%.Mann-Whitney U rank-sum test showed that the treatment group was better than the control group in treatment efficacy(U=330.00,P=0.035).In conclusion,the therapeutic efficacy of the treatment group was better than that of the control group.After treatment,lumbar JOA score and VAS score were significantly improved at different time points in 2 groups,and it has statistical significance,that is,there was time effect(F=108.565,P<0.001; F=157.456,P<0.001).In terms of JOA score,the treatment group was better than that of the control group(P<0.05).After 4 weeks of treatment,the treatment group was significantly better than that of the control group,and the difference was statistically significant(P<0.01).In terms of VAS score,although the score of the treatment group was lower than that of the control group,and there was no statistical significance between the two groups(P>0.05).Conclusion:Eight-Section Brocade Exercise combined with disc decoction can effectively relieve lumbar back pain in patients with lumbar disc herniation with liver and kidney deficiency.In terms of functional score,its efficacy is significantly better than that of Five-Point Supporting Function Exercise combined with intervertebral disc prescription group,which is more beneficial to the recovery and coordination of lumbar muscle function,and the long-term efficacy is more obvious.But in terms of analgesic efficacy,there was no significant difference between them.

参考文献/References:

[1] WEINSTEIN J N,TOSTESON T D,LURIE J D,et al.Surgical vs nonoperative treatment for lumbar disk herniation:the Spine Patient Outcomes Research Trial(SPORT):a randomized trial[J].JAMA,2006,296(20):2441-2450.
[2] ALBAYRAK S,OZTURK S,AYDEN O,et al.Dural tear:a feared complication of lumbar discectomy[J].Turk Neurosurg,2016,26(6):918-921.
[3] 王海瑞,刘斌,张连生,等.腰椎间盘突出症术后手术部位感染并发脑积水1例报道[J].中国脊柱脊髓杂志,2020,30(10):957-960.
[4] ZHONG M,LIU J T,JIANG H,et al.Incidence of spontaneous resorption of lumbar disc herniation:a meta-analysis[J].Pain Physician,2017,20(1):E45-E52.
[5] 刘锦涛,俞鹏飞,马智佳,等.巨大破裂型腰椎间盘突出症重吸收55例分析[J].中国中医骨伤科杂志,2021,29(9):27-31.
[6] DAI F,DAI Y X,JIANG H,et al.Non-surgical treatment with XSHHD for ruptured lumbar disc herniation:a 3-year prospective observational study[J].BMC Musculoskelet Disord,2020,21(1):690.
[7] 张金晶,张迎春,姚艳红.扶阳罐循经熨推法改善寒湿型腰椎间盘突出症护理研究[J].新中医,2021,53(4):175-178.
[8] 张仲博,史栋梁,杜旭召,等.加减肾附丸治疗腰椎间盘突出症肾虚寒凝证的疗效观察[J].中国实验方剂学杂志,2021,27(9):100-105.
[9] 姚弘毅,任亚丽,韦卓,等.基于子午流注取穴的一指禅推法治疗腰椎间盘突出症的临床疗效[J].中国中医骨伤科杂志,2021,29(2):53-55.
[10] 王新,朱群邦,方凡夫,等.健身气功八段锦辅助治疗老年男性慢性腰痛患者的临床观察[J].中华中医药杂志,2017,32(10):4753-4755.
[11] 周剑鹏,蔡迎峰,田天照,等.椎间盘方对腰椎间盘突出症行Mis-TLIF术后早期临床疗效及炎性因子的影响[J].贵州医药,2020,44(3):419-420.
[12] 施敏,蔡迎峰,刘保新.经皮椎间孔镜微创手术合“椎间盘方”治疗腰椎间盘突出症的疗效观察[J].实用中西医结合临床,2020,20(7):22-23.
[13] 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.
[14] 国家中医药管理局.中医病证诊断疗效标准[J].中医药管理杂志,1994(6):2.
[15] BANSAL D,ASRAR M M,GHAI B,et al.Prevalence and impact of low back pain in a community-based population in northern india[J].Pain Physician,2020,23(4):E389-E398.
[16] 冯宪煊,徐义明,蔡赟,等.非手术脊柱减压系统与常规牵引器治疗腰椎间盘突出症:表面肌电图分析的比较[J].中国组织工程研究,2018,22(7):1032-1037.
[17] WAN Q,LIN C,LI X,et al.MRI assessment of paraspinal muscles in patients with acute and chronic unilateral low back pain[J].Br J Radiol,2015,88(1053):20140546.
[18] SUN D,LIU P,CHENG J,et al.Correlation between intervertebral disc degeneration,paraspinal muscle atrophy,and lumbar facet joints degeneration in patients with lumbar disc herniation[J].BMC Musculoskelet Disord,2017,18(1):167.
[19] 王辉昊,詹红生,石印玉.八段锦导引功法防治骨伤科常见疾病研究进展[J].中国中医骨伤科杂志,2017,25(10):78-82.
[20] CHOU R,ATLAS S J,STANOS S P,et al.Nonsurgical interventional therapies for low back pain:a review of the evidence for an American Pain Society clinical practice guideline[J].Spine(Phila Pa 1976),2009,34(10):1078-1093.
[21] 朱顺昌,周红海,黄伟恩,等.传统运动疗法防治脊柱病的研究进展[J].中国中医骨伤科杂志,2019,27(3):86-88.
[22] 蔡迎峰,张胜.仲景“利小便法”治疗急性腰椎间盘突出症的临床疗效观察[J].中国医药科学,2013,3(13):93-94.
[23] WANG J Y,YUAN Y,CHEN X J,et al.Extract from Eucommia ulmoides Oliv.ameliorates arthritis via regulation of inflammation,synoviocyte proliferation and osteoclastogenesis in vitro and in vivo[J].J Ethnopharmacol,2016,194:609-616.
[24] INDRAN I R,LIANG R L,MIN T E,et al.Preclinical studies and clinical evaluation of compounds from the genus Epimedium for osteoporosis and bone health[J].Pharmacol Ther,2016,162:188-205.
[25] XI H R,MA H P,YANG F F,et al.Total flavonoid extract of Epimedium herb increases the peak bone mass of young rats involving enhanced activation of the AC10/cAMP/PKA/CREB pathway[J].J Ethnopharmacol,2018,223:76-87.

备注/Memo

备注/Memo:
基金项目:广东省中医药局科研项目(20201262)
广州市中医药局科研项目(20202A011003)
△通信作者 E-mail:1377055255@qq.com
更新日期/Last Update: 2022-01-18