附子汤合芍药甘草汤加味离子导入治疗寒湿瘀阻证非特异性下腰痛

发布时间：2018-05-21 08:42

本文选题：非特异性下腰痛 + 寒湿瘀阻证　；参考：《中国实验方剂学杂志》2017年20期

【摘要】：目的:评价附子汤合芍药甘草汤加味离子导入治疗非特异性下腰痛(NLBP)寒湿瘀阻证的临床疗效及对白细胞介素-1β(IL-1β),血栓素2(TXB2),6-酮前列腺素F_(lα)(6-Keto-PGF_(lα)),降钙素基因相关肽(CGRP),血管活性肠肽(VIP)的影响。方法:将176例患者以入诊先后顺序随机按数字表法分为对照组和观察组。对照组采用腰腿痛丸+电针治疗,观察组采用附子汤合芍药甘草汤离子导入+电针。两组疗程均为治疗4周。进行治疗前后简化McG ill疼痛量表(SF-MPQ),压痛情况评分,并进行压痛和痛阈值的测量;功能情况采用日本骨科协会(JOA)法评估;进行寒湿瘀阻证和总体感觉(PGIC)评价;检测治疗前后IL-1β,TXB2,6-Keto-PGF_(lα),CGRP和VIP水平;进行安全性评价。结果:观察组JOA总改善率为95.18%,高于对照组的83.95%(χ~2=5.564,P0.05);观察组疼痛感觉评分、疼痛情绪评分、疼痛总分、目测类比疼痛评分和现在疼痛状况评分均低于对照组(P0.01);观察组硬度值低于对照组,压痛和中医证候评分均低于对照组,痛阈值高于对照组(P0.05,P0.01);观察组JOA量表主观症状、临床体征、日常活动受限度及总分均高于对照组(P0.01);观察组PGIC"明显好转"的患者为68.67%,多于对照组的50.62%(χ~2=5.558,P0.05);观察组IL-1β,TXB2,CGRP和VIP水平均低于对照组,6-KetoPGF_(lα)高于对照组(P0.01)。结论:采用附子汤合芍药甘草汤加味离子导入治疗NLBP寒湿瘀阻证患者,能改善血液循环,促进腰部功能的恢复,减轻疼痛,提高患者活动能力。
[Abstract]:Objective: to evaluate the clinical efficacy of Fuzi decoction combined with Paeoniflorin Glycyrrhiza decoction plus modified ion-introduction in the treatment of non-specific low back pain (NLBP-) syndrome of cold dampness and stasis and its effect on interleukin-1 尾 and thromboxane 2TXB2O6-Keto-PGFl 伪, calcitonin gene-related peptide CGRPU, vascularization. The effect of VIPs. Methods: 176 patients were randomly divided into control group and observation group. The control group was treated with Yaoshutong Pill and the observation group was treated with Fuzi decoction and Paeoniao Licorice decoction. The course of treatment in both groups was 4 weeks. Before and after treatment, simplified McG ill pain scale (SF-MPQN), tenderness score, tenderness and pain threshold were measured, the functional status was evaluated by JOAA method, cold and wet stasis syndrome and total sensory pain were evaluated. Before and after treatment, the levels of IL-1 尾 -TXB _ 2 and 6-Keto-PGF- 伪 -CGRP and VIP were measured, and the safety was evaluated. Results: the total improvement rate of JOA in the observation group was 95.18%, which was higher than that in the control group (83.95%). The scores of visual analogue pain and current pain status were lower than those of the control group, the hardness of the observation group was lower than that of the control group, the scores of tenderness and TCM syndromes were lower than that of the control group, and the pain threshold was higher than that of the control group. The subjective symptoms and clinical signs of the JOA scale in the observation group were higher than those in the control group. The limit degree and total score of daily activity in the observation group were higher than those in the control group (P 0.01), the patients in the observation group who had "obvious improvement" in PGIC were 68.67, more than 50.62 in the control group (蠂 ~ 2, P = 5.558), and the levels of IL-1 尾 -TXB _ 2C _ RP and VIP in the observation group were lower than those in the control group (P _ (0.01), and the levels of IL-1 尾 -TXB _ (2 +) CGRP and VIP in the observation group were higher than those in the control group (P _ (0.01). Conclusion: the treatment of NLBP patients with cold and dampness stasis syndrome with modified ion introduction of Fuzi decoction and Shaoyao Licorice decoction can improve blood circulation, promote the recovery of waist function, relieve pain and improve the activity ability of patients.
【作者单位】：河南中医药大学第三附属医院;
【基金】：河南省教育厅科学技术研究重点项目(13B360099)
【分类号】：R274.9

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