摘要
目的观察中药熏蒸联合洛芬待因缓释片治疗腰椎间盘突出症(LDH)的临床疗效。方法将200例LDH患者按照随机数字表法分为2组。均予腰椎牵引、理疗等常规治疗,对照组100例予洛芬待因缓释片治疗,治疗组100例在对照组治疗基础上加中药熏蒸治疗。比较2组疗效;比较2组治疗前后日本骨科学会(JOA)评分及疼痛视觉模拟评分法(VAS)评分变化,腰椎关节活动度变化,血清炎症因子白细胞介素1β(IL-1β)、肿瘤坏死因子α(TNF-α)变化,免疫指标免疫球蛋白(Ig) G、Ig M及Ig A变化。结果治疗组总有效率88. 00%,对照组总有效率76. 00%,治疗组疗效优于对照组(P <0. 05)。2组治疗后JOA评分均较本组治疗前升高(P <0. 05),疼痛VAS评分降低(P <0. 05),且治疗组JOA评分高于对照组(P <0. 05),VAS评分低于对照组(P <0. 05)。2组治疗后腰椎关节活动度均较本组治疗前增加(P <0. 05),且治疗组增加更明显(P <0. 05)。2组治疗后IL-1β、TNF-α均较本组治疗前降低(P <0. 05),且治疗组降低更明显(P <0. 05)。2组治疗后Ig G、Ig M均较本组治疗前降低(P <0. 05),且治疗组降低更明显(P <0. 05)。结论中药熏蒸联合洛芬待因缓释片治疗LDH疗效显著,可明显改善患者腰腿痛症状,扩大关节活动范围,同时减轻腰椎局部免疫炎症反应,减轻神经根炎症和局部水肿。
Objective To observe the clinical effects of lumbar disc herniation with combination of traditional Chinese medicine fumigation and lofen-codeine sustained release tablets on the treatment of lumbar disc herniation (LDH).Methods 200 patients with LDH were divided into two groups according to the random number table method,and all were treated by lumber traction,physiotherapy and other routine treatment.100 cases in control group were treated by lofen-codeine sustained release tablets.100 cases in treatment group were treated by traditional Chinese medicine fumigation on the basis of the control group.The efficacy of the two groups was compared.The changes of Japanese Orthopedics Associati (JOA) score and pain visual analogue scale (VAS) score,lumbar joint activity,serum inflammatory factor interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),immunoglobulin (Ig) G,IgM and IgA were compared before and after treatment.Results The total effective rate was 88.00 % in treatment group and 76.00% in control group.The clinical curative effect of the treatment group was better than that of the control group (P<0.05).After treatment,the JOA score of the two groups were higher than those in the group before treatment (P<0.05),and the VAS scores were decreased (P<0.05).After treatment,the JOA score of the treatment group was higher than that of the control group (P<0.05),and the VAS score was lower than that of the control group(P<0.05).After treatment,the lumbar joint activity of the two groups were increased than those in the group before treatment (P< 0.05 ),and the treatment group increased more significantly (P<0.05).After treatment,the IL-1β and TNF-α of the two groups were decreased than those in the group before treatment (P<0.05),and the treatment group decreased more significantly (P<0.05).After treatment,the IgG and IgM of the two groups were decreased than those in the group before treatment (P<0.05),and the treatment group decreased more significantly (P<0.05).Conclusion Traditional Chinese medicine fumigation combined with lofen-codeine sustained release tablets have significant curative effect on LDH,which can significantly improve the symptoms of lumbar and leg pain,expand the range of joint activity,reduce the local immune inflammatory response of the lumbar vertebrae,and alleviate nerve root inflammation and local edema.
作者
张圣宏
张峻峰
李石胜
吴耀持
ZHANG Shenghong;ZHANG Junfeng;LI Shisheng(Department of Acupuncture and Injury,The Sixth People's Hospital Affiliated to Shanghai Jiaotong University,Shanghai 200233)
出处
《河北中医》
2018年第12期1807-1811,共5页
Hebei Journal of Traditional Chinese Medicine
基金
上海市科学技术委员会科研计划项目(编号:16401933900)
关键词
腰椎
椎间盘移位
中西医结合疗法
Lumbar vertebrae
Intervertebral disc displacement
Integrated Chinese and western medicine therapy
作者简介
张圣宏(1979-),男,主治医师,硕士。从事针灸推拿临床工作;通讯作者:吴耀持,上海交通大学附属第六人民医院针推伤科,上海200233
