摘要
目的评价石氏牛蒡子汤加减配合强筋健腰功法治疗腰椎间盘突出症(LDH)临床疗效。方法随机对照试验设计。将符合入选标准的2020年9月-2021年9月北京中医医院平谷医院60例LDH患者,采用随机数字表法分为2组,每组30例。2组患者均予常规基础治疗(强筋健腰功法+三位六步手法),在此基础上,治疗组服用石氏牛蒡子汤加减治疗,对照组服用洛芬待因缓释片。2组均治疗4周。采用日本骨科协会评估治疗(JOA评分)评估腰椎功能,Oswestry功能障碍指数(ODI)评估腰椎功能障碍程度,VAS量表评估腰腿疼痛及下肢麻木情况,评价临床疗效。结果治疗组总有效率为93.3%(28/30)、对照组为73.3%(22/30),2组比较差异有统计学意义(χ^(2)=4.32,P=0.038)。治疗组治疗后主观症状、临床体征、日常活动受限程度评分高于对照组(t值分别为3.86、2.71、2.21,P<0.05);腰痛[(2.12±0.21)分比(3.02±0.32)分,t=12.88]、腿痛[(2.04±0.64)分比(2.64±0.66)分,t=3.58]、下肢麻木[(1.75±0.24)分比(2.41±0.70)分,t=4.89]评分低于对照组(P<0.01);治疗组治疗后1周、1个月ODI评分低于对照组(t值分别为10.22、5.59,P<0.01)。结论石氏牛蒡子汤加减配合强筋健腰功法可有效改善LDH患者腰部疼痛症状,恢复腰部活动能力,提高疗效。
Objective To observe the clinical effect of modified Shishi Niubangzi Decoction combined with strengthening muscle-waist exercise on lumbar disc herniation(LDH).Methods Randomized controlled trial.A total of 60 patients with LDH admitted to the Pinggu Hospital,Beijing Traditional Chinese Medicine Hospital,were enrolled as the research objects between September 2020 and September 2021.According to the random number table,they were randomly divided into the treatment group and control group,30 in each group.Both groups were given routine basic treatments(strengthening tendons-waist exercise and three-position six-step manipulation).On this basis,the treatment group was treated with modified Shishi Niubangzi Decoction,while the control group was treated with non-steroidal anti-inflammatory drugs (ibuprofen codeine sustained-release tablets). Both groups were treated for 4 weeks. The responsiverates, back pain intensity, leg pain and numbness by Visual Analogue Scale (VAS) and lumbarfunction by Oswestry Disability Index (ODI), and Japanese Orthopaedic Association (JOA) werecompared between the two groups. Results The response rate of treatment group was significantlyhigher than that of control group (93.3% vs. 73.3%;χ^(2)=4.32, P=0.038). After treatment, scores of JOA(subjective symptoms, signs, activities of daily living) in the treatment group were significantlyhigher than those in the control group (t=3.86, 2.71, 2.21, P<0.05). After treatment, scores of backpain (2.12±0.21 vs. 3.02±0.32, t=12.88), leg pain (2.04±0.64 vs. 2.64±0.66, t=3.58), lower limbnumbness (1.75±0.24 vs. 2.41±0.70, t=4.89) in the treatment group were significantly lower thanthose in the control group (P<0.01). At 1 week and 1 month after treatment, ODI scores in treatmentgroup were significantly lower than those in control group (t=10.22, 5.59;P<0.05).Conclusion The modified Shishi Niubangzi Decoction combined with strengthening tendons-waistexercise can improve responsive rates, improve lumbar pain and function in LDH patients.
作者
白金山
谢志勇
陆雪松
张振
李娜
任希斌
见国繁
詹红生
Bai Jinshan;Xie Zhiyong;Lu Xuesong;Zhang Zhen;Li Na;Ren Xibin;Jian Guofan;Zhan Hongsheng(Department of Massage,Pinggu Hospital,Beijing Traditional Chinese Medicine Hospital,Beijing 101200,China;Department of Orthopedics and Traumatology,Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)
出处
《国际中医中药杂志》
2023年第4期421-425,共5页
International Journal of Traditional Chinese Medicine
基金
全国中医临床特色技术传承骨干人才培养项目(〔2019〕36号)
北京市区域特色重点专科项目资助(〔2018〕29号)
北京市平谷区卫生健康委科研项目(pgwjw2020-01)。
关键词
椎间盘移位
腰椎
石氏牛蒡子汤
强筋健腰功法
腰椎功能
Intervertebral disc displacement
Lumbar vertebrae
Shishi Niubangzi Decoction
Strengthening tendons-waist exercise
Lumbar function
