丹鹿通督片治疗腰椎间盘突出症肾虚瘀阻证的疗效与机制

颜宾宏; 牛乾; 符致坚; 杨帆; 虞道锐; 牛坤

doi:10.13422/j.cnki.syfjx.20191634

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丹鹿通督片治疗腰椎间盘突出症肾虚瘀阻证的疗效与机制

临床 | 更新时间：2021-02-09

- 丹鹿通督片治疗腰椎间盘突出症肾虚瘀阻证的疗效与机制
- Efficacy and Mechanism of Danlu Tongdu Tablets on Lumbar Disc Herniation with Kidney Deficiency and Stasis Syndrome
- 中国实验方剂学杂志 2019年25卷第22期页码：66-71
- 作者机构：
  
  1.海南医学院　第一附属医院，海口　 570102；
  2.海南医学院　中医学院，海口　 571101；
  3.东方红草参民族医药研究院，海口　 572600；
  4.海南医学院　基础医学与生命医科学学院，海口　 571101
- 作者简介：
  
  颜宾宏，主治医师，从事中医治疗慢性疼痛的研究，E-mail：563703194@qq.com
  牛乾，硕士，副教授，从事中医临床、教学、科研工作，E-mail：gxqian127@163.com
- 基金信息：
  
  海南省自然科学基金项目(818MS061)
- DOI：10.13422/j.cnki.syfjx.20191634
  中图分类号： R68; R274; R274.9; R685
- 收稿日期：2019-03-20，
  
  网络出版日期：2019-05-10，
  
  纸质出版日期：2019-11-20
- 稿件说明：
移动端阅览
颜宾宏, 牛乾, 符致坚, 等. 丹鹿通督片治疗腰椎间盘突出症肾虚瘀阻证的疗效与机制[J]. 中国实验方剂学杂志, 2019,25(22):66-71.

Bin-hong YAN, Qian NIU, Zhi-jian FU, et al. Efficacy and Mechanism of Danlu Tongdu Tablets on Lumbar Disc Herniation with Kidney Deficiency and Stasis Syndrome[J]. Chinese journal of experimental traditional medical formulae, 2019, 25(22): 66-71.
颜宾宏, 牛乾, 符致坚, 等. 丹鹿通督片治疗腰椎间盘突出症肾虚瘀阻证的疗效与机制[J]. 中国实验方剂学杂志, 2019,25(22):66-71. DOI： 10.13422/j.cnki.syfjx.20191634.

Bin-hong YAN, Qian NIU, Zhi-jian FU, et al. Efficacy and Mechanism of Danlu Tongdu Tablets on Lumbar Disc Herniation with Kidney Deficiency and Stasis Syndrome[J]. Chinese journal of experimental traditional medical formulae, 2019, 25(22): 66-71. DOI： 10.13422/j.cnki.syfjx.20191634.

摘要

目的：

观察丹鹿通督片治疗腰椎间盘突出症(LDH)肾虚瘀阻证的近期和远期疗效，及对髓核重吸收和免疫炎症因子的影响。

方法：

将160例患者随机按数字表法分成对照组和观察组各80例。对照组采用穴位按摩＋针刺，1次/d。观察组治疗同对照组，并口服丹鹿通督片，4片/次，3次/d。两组疗程均连续治疗12周，并进行9个月的随访。采用视觉模拟(VAS)评分记录治疗前、治疗后1，2，3个月腰痛、腿痛程度；进行治疗前后日本骨科协会(JOA)评分和症状、体征评分；随访9个月，计算复发率，记录复发的时间和复发时的VAS和JOA评分；评价治疗后髓核吸收情况；检测治疗前后白细胞介素-1(IL-1)，IL-17，肿瘤坏死因子-

(TNF-

)，基质金属蛋白酶-3(MMP-3)水平。

结果：

经秩和检验，观察组临床疗效优于对照组(

＝2.125，

0.05)，观察组JOA评分疗效优于对照组(

＝1.924，

0.05)；观察组治疗后1，2，3个月腰痛、腿痛VAS评分均低于对照组(

0.01)；治疗后观察组腰痛、腿痛VAS评分下降幅度均多于对照组(

0.01)；观察组症状、体征评分均低于对照组(

0.01)，观察组JOA量表各维度评分和JOA总分均高于对照组(

0.01)；观察组髓核完全吸收率为61.11%，高于对照组42.03%(

＝5.138，

0.05)；观察组IL-1，IL-17，TNF-

和MMP-3水平均低于对照组(

0.01)；观察组复发率为23.61%，低于对照组的40.58%(

＝4.668，

0.05)；观察组平均复发时间长于对照组(

0.05)，复发时VAS评分低于对照组(

0.05)，JOA总分高于对照组(

0.05)。

结论：

在针刺与按摩治疗的基础上，加服丹鹿通督片治疗LDH(肾虚瘀阻证)近期可减轻疼痛和改善功能，提高临床疗效，远期可降低复发率，减轻复发程度，并可促进髓核重吸收和减轻神经根炎性刺激。

Abstract

Objective:

To observe short-term and long-term efficacies of Danlu Tongdu tablets on lumbar disc herniation (LDH) with kidney deficiency and stasis syndrome

and its effect on nucleus pulposus reabsorption and immunoinflammatory factors.

Method:

One hundred and sixty patients were randomly divided into control group (80 cases) and observation group by random number table. Patients in control group (80 cases) got acupoint massage and acupuncture

1 time/day. In addition to the therapy of control group

patients in observation group were also given Danlu Tongdu tablets

4 tablets/time

3 times/days. A course of treatment was 12 weeks

and a 9-month follow-up was recorded. Lumbago and leg pain were recorded by visual simulation (VAS) before treatment and at the first

second

third month after treatment. Before and after treatment

Japanese orthopaedic association (JOA)

symptoms and signs were scored. During the 9-month follow-up

relapse rate and relapse time were recorded

and VAS and JOA were scored. Absorption of nucleus pulposus was assessed

and levels of interleukin-1 (IL-1)

IL-17

tumor necrosis factor-

(TNF-

)

matrix metalloproteinases-3 (MMP-3) were detected.

Result:

By rank sum test

the clinical efficacy in observation group was better than that in control group (

=2.125

0.05)

and scores of JOA was better than that in control group (

=1.924

0.05). At the first

second and third months after treatment

VAS scores of low back pain

leg pain were lower than those in control group (

0.01)

while the decline range were more than that in control group (

0.01). And scores of symptoms and signs were lower than that in control group (

0.01)

whereas scores by dimensions of JOA scale and the total score of JOA were all higher than those in control group (

0.01). Complete absorptivity of nucleus pulposus in observation group was 61.11%

which was higher than 42.03%in observation group (

=5.138

0.05). Levels of IL-1

IL-17

TNF-

and MMP-3 were lower than that in control group (

0.01). Relapse rate in observation group was 23.61%

which was lower than 40.58%in control group (

=4.668

0.05). Average recurrence time was longer than that in control group (

0.05)

score of VAS was lower than that in control group (

0.05)

and the total score of JOA was higher than that in control group (

0.05).

Conclusion:

In addition to acupuncture and massage therapy

Danlu Tongdu tablets can also be used to relieve pain and ameliorate function

improve clinical efficacy

reduce relapse rate

promote nucleus pulposus reabsorption

and relieve inflammation of nerve root.

关键词

Keywords

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