腰痛六合散熨疗联合针刺治疗血瘀型腰椎间盘突出症

温泽发; 牛淑芳; 曾令友; 潘广华

doi:10.13422/j.cnki.syfjx.20180730

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腰痛六合散熨疗联合针刺治疗血瘀型腰椎间盘突出症

临床 | 更新时间：2024-01-04

- 腰痛六合散熨疗联合针刺治疗血瘀型腰椎间盘突出症
- Yaotong Liuhesan Combined with Acupuncture in Treating Lumbar Disc Herniation with Syndrome of Blood Stasis
- 中国实验方剂学杂志 2018年24卷第7期页码：217-222
- 作者机构：
- 作者简介：
- 基金信息：
  
  海南省卫生计生行业科研项目（15A200061）
- DOI：10.13422/j.cnki.syfjx.20180730
  中图分类号： R274.9
- 纸质出版日期：2018
- 稿件说明：
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温泽发, 牛淑芳, 曾令友, 等. 腰痛六合散熨疗联合针刺治疗血瘀型腰椎间盘突出症[J]. 中国实验方剂学杂志, 2018,24(7):217-222.

WEN Ze-fa, NIU Shu-fang, ZENG Ling-you, et al. Yaotong Liuhesan Combined with Acupuncture in Treating Lumbar Disc Herniation with Syndrome of Blood Stasis[J]. Chinese journal of experimental traditional medical formulae, 2018, 24(7): 217-222.
温泽发, 牛淑芳, 曾令友, 等. 腰痛六合散熨疗联合针刺治疗血瘀型腰椎间盘突出症[J]. 中国实验方剂学杂志, 2018,24(7):217-222. DOI： 10.13422/j.cnki.syfjx.20180730.

WEN Ze-fa, NIU Shu-fang, ZENG Ling-you, et al. Yaotong Liuhesan Combined with Acupuncture in Treating Lumbar Disc Herniation with Syndrome of Blood Stasis[J]. Chinese journal of experimental traditional medical formulae, 2018, 24(7): 217-222. DOI： 10.13422/j.cnki.syfjx.20180730.

摘要

目的：观察探讨腰痛六合散熨疗联合针刺治疗腰椎间盘突出症（LDH）血瘀证的疗效，并探讨其可能作用机制。方法：筛选120例收治的血瘀型LDH患者，按数字表法随机分为对照组和治疗组各60例。对照组采用电动牵引床牵引，30 min/次，1次/d；和口服依托考昔片，1片/次，1次/d。治疗组在对照组治疗的基础上给予腰痛六合散熨疗联合针刺疗法。两组疗程均为连续治疗4周。比较两组患者中医血瘀证症状评分，LDH功能障碍，改良日本骨科学会下腰痛评分法（M-JOA）及功能障碍指数问卷表（Oswestry）评分及临床疗效。检测两组患者外周血中Th17水平及血清中白细胞介素（IL）-17，IL-6，肿瘤坏死因子（TNF）-α，IL-1β，血管内皮细胞生长因子（VEGF）水平。检测两组治疗前后血液流变学水平。结果：治疗后，治疗组血瘀证症状积分，M-JOA及Oswestry评分与对照组比较，下降均为明显（P<0.01）。治疗组临床总有效率为95%，显著高于对照组80%（P<0.05）。治疗组治疗后2周和4周，与对照组比较，外周血Th17下降明显（P<0.01）。治疗组治疗后，患者血清中IL-17，IL-6，IL-1β，TNF-α，VEGF水平均下降明显（P<0.01）。与对照组相比较，治疗组血液流变学指标水平降低更明显（P<0.01）。结论：在常规西医治疗的基础上加用腰痛六合散熨疗联合针刺疗法，血瘀型LDH临床疗效优于单纯西医干预，调节体内Th17，从而减少相关细胞因子水平，改善血液局部血液循环，促进患者康复。

Abstract

Objective: To observe the efficacy of iron therapy of Yaotong Liuhesan combined with acupuncture in treating lumbar disc herniation (LDH) with syndrome of blood stasis

and investigate the mechanism. Method: Totally 120 cases were selected and randomly divided into treatment group and control group

with 60 cases in each group. Control group received the traction therapy by electric traction bed 1 time/day

30 min/time and etoricoxib tablets 1 tablet/time

qd. In addition to control group

treatment group was given Yaotong Liuhesan combined with acupuncture. Both groups were observed for 4 weeks. Scores of traditional Chinese medicine (TCM) syndrome of blood stasis and scores of LDH function obstacle and M-JOA

and the efficacy were compared between both groups. Th17 level in peripheral blood and serum interleukin (IL) -17

IL-6

tumor necrosis factor (TNF) -α

IL-1β and vascular endothelial cell growth factor (VEGF) were detected. Hemorheology index levels in both groups were measured before and after treatment. Result: After treatment

scores of TCM syndrome of blood stasis and LDH function obstacle

and M-JOA of treatment group were remarkably decreased when compared with control group (P<0.01). The efficacy rate of treatment group was 95%

which was superior to 80% of control group (P<0.05). In the 2nd and 4th weeks after treatment

Th17 in peripheral blood of treatment group was evidently lower than that of control group (P<0.01). After treatment

compared with control group

serum IL-17

IL-6

IL-1β

TNF-α and VEGF of treatment group were evidently decreased (P<0.01). Compared with control group

hemorheology index level of treatment group was obviously decreased (P<0.01). Conclusion: In addition to the conventional western medicine

iron therapy of Yaotong Liuhesan combined with acupuncture was also added to treat LDH with syndrome of blood stasis

and showed a better efficacy than the intervention with simple conventional western medicine. It could regulate the Th17

decrease cytokines levels

improve local blood circulation

and promote recovery.

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