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三亚市中医院,海南 三亚 572220
* 范荣,硕士,副主任医师,从事中西医结合骨科疾病诊治工作,E-mail: hnfanr@163.com
收稿日期:2021-03-22,
网络出版日期:2021-04-22,
纸质出版日期:2021-08-20
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范荣,刘玉金,白曼莫.身痛逐瘀汤加减治疗急性期椎间盘源性腰痛风寒瘀阻证的临床观察[J].中国实验方剂学杂志,2021,27(16):111-115.
FAN Rong,LIU Yu-jin,BAI Man-mo.Clinical Efficacy of Modified Shentong Zhuyutang in Treatment of Acute Discogenic Low Back Pain Due to Wind-Cold and Stasis Obstruction Syndrome[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(16):111-115.
范荣,刘玉金,白曼莫.身痛逐瘀汤加减治疗急性期椎间盘源性腰痛风寒瘀阻证的临床观察[J].中国实验方剂学杂志,2021,27(16):111-115. DOI: 10.13422/j.cnki.syfjx.20210832.
FAN Rong,LIU Yu-jin,BAI Man-mo.Clinical Efficacy of Modified Shentong Zhuyutang in Treatment of Acute Discogenic Low Back Pain Due to Wind-Cold and Stasis Obstruction Syndrome[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(16):111-115. DOI: 10.13422/j.cnki.syfjx.20210832.
目的
2
评价身痛逐瘀汤加减联合塞来昔布胶囊治疗急性期椎间盘源性腰痛(DLBP)风寒瘀阻证的疗效及抗炎、镇痛作用。
方法
2
将140例符合要求的患者按随机数字表法分为对照组和观察组各70例。两组患者均口服塞来昔布胶囊,200 mg/次,1次/d;对照组口服通络活血胶囊,6粒/次,3次/d;观察组口服身痛逐瘀汤加减,1剂/d;两组疗程均为3周。进行治疗前后简化McGill疼痛量表(SF-MPQ),SF-MPQ含疼痛分级指数(PRI),现时疼痛强度(PPI)和视觉模拟量表(VAS)3个因子;评价Oswestry功能障碍指数(ODI),风寒瘀阻证、日常生活能力(ADL)评分和Schober试验;检测治疗前后肿瘤坏死因子-
α
(TNF-
α
),白细胞介素-1
β
(IL-1
β
),IL-6,血栓素B
2
(TXB
2
)和6-酮-前列腺素F
1
α
(6-keto-PGF
1
α
)水平;进行安全性评价。
结果
2
治疗后,观察组SF-MPQ量表各维度(PRI,VAS和PPI)评分均低于对照组(
P
<
0.01);观察组风寒瘀阻证和ODI评分均低于对照组(
P
<
0.01),ADL评分和Schober试验均高于对照组(
P
<
0.01);观察组TNF-
α
,IL-1
β
,IL-6和TXB
2
水平均低于对照组(
P
<
0.01);6-keto-PGF
1
α
水平高于对照组(
P
<
0.01);观察组临床的优良率为(51/63)80.95%,高于对照组的(39/63)61.90%(
χ
2
=5.601,
P
<
0.05);没有发现服用中药相关不良反应。
结论
2
身痛逐瘀汤加减联合塞来昔布胶囊治疗急性期DLBP风寒瘀阻证患者,具有抗炎、镇痛作用,能有效缓解腰痛程度,改善腰椎活动功能,提高了日常生活活动能力,临床优良率较高,且使用安全。
Objective
2
To evaluate of modified Shentong Zhuyutang combined with celecoxib capsules in the treatment of acute discogenic low back pain due to wind-cold and stasis obstruction sydrome.
Method
2
One hundred and forty eligible patients were randomly divided into control group (70 cases) and observation group (70 cases). Patients in both groups took the celecoxib capsules orally, 200 mg/time. On this basis, patients in the control group were further treated with Tongluo Huoxue capsule orally, 6 capsules/time, 3 times/day, while those in the observation group received the modified Shentong Zhuyutang, 1 bag/day, for three weeks. The short-form McGillpain questionnaire (SF-MPQ), including pain rating index (PRI), present pain intensity (PPI), and visual analog scale (VAS), Oswestry disability index (ODI), wind-cold obstruction and stasis syndrome, and abilities of daily living (ADL) scoring and the Schober's test were conducted before and after treatment. The tumor necrosis factor-
α
(TNF-
α
), interleukin-1
β
(IL-1
β
), IL-6, thromboxane B
2
(TXB
2
), and 6-keto prostaglandin F
1
α
(6-keto-PGF
1
α
) levels before and after treatment were measured, followed by the safety evaluation.
Result
2
The PRI, VAS, and PPI scores in SF-MPQ of the observation group were reduced in contrast to those in the control group (
P
<
0.01). The wind-cold and stasis obstruction syndrome and ODI scores in the observation group also declined as compared with those of the control group (
P
<
0.01), while the ADL and Schober's test scores were elevated (
P
<
0.01). The TNF-
α
, IL-1
β
, IL-6, and TXB
2
levels in the observation group were lower than those in the control group (
P
<
0.01), whereas the 6-keto-PGF
1
α
was higher (
P
<
0.01). The excellent and good rate of the observation group was (51/63) 80.95%, significantly better than (39/63) 61.90% of the control group (
χ
2
=5.601,
P
<
0.05). No adverse reactions occurred after the intake of Chinese medicinal prescriptions.
Conclusion
2
The modified Shentong Zhuyutang combined with celecoxib capsules is efficient and safe in inhibiting inflammation, easing back pain, enhancing lumbar spine mobility, and improving the ADL of patients with acute DLBP of wind-cold obstruction syndrome.
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