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附子湯合芍藥甘草湯加味離子導(dǎo)入治療寒濕瘀阻證非特異性下腰痛

發(fā)布時間:2018-05-21 08:42

  本文選題:非特異性下腰痛 + 寒濕瘀阻證; 參考:《中國實驗方劑學(xué)雜志》2017年20期


【摘要】:目的:評價附子湯合芍藥甘草湯加味離子導(dǎo)入治療非特異性下腰痛(NLBP)寒濕瘀阻證的臨床療效及對白細胞介素-1β(IL-1β),血栓素2(TXB2),6-酮前列腺素F_(lα)(6-Keto-PGF_(lα)),降鈣素基因相關(guān)肽(CGRP),血管活性腸肽(VIP)的影響。方法:將176例患者以入診先后順序隨機按數(shù)字表法分為對照組和觀察組。對照組采用腰腿痛丸+電針治療,觀察組采用附子湯合芍藥甘草湯離子導(dǎo)入+電針。兩組療程均為治療4周。進行治療前后簡化McG ill疼痛量表(SF-MPQ),壓痛情況評分,并進行壓痛和痛閾值的測量;功能情況采用日本骨科協(xié)會(JOA)法評估;進行寒濕瘀阻證和總體感覺(PGIC)評價;檢測治療前后IL-1β,TXB2,6-Keto-PGF_(lα),CGRP和VIP水平;進行安全性評價。結(jié)果:觀察組JOA總改善率為95.18%,高于對照組的83.95%(χ~2=5.564,P0.05);觀察組疼痛感覺評分、疼痛情緒評分、疼痛總分、目測類比疼痛評分和現(xiàn)在疼痛狀況評分均低于對照組(P0.01);觀察組硬度值低于對照組,壓痛和中醫(yī)證候評分均低于對照組,痛閾值高于對照組(P0.05,P0.01);觀察組JOA量表主觀癥狀、臨床體征、日;顒邮芟薅燃翱偡志哂趯φ战M(P0.01);觀察組PGIC"明顯好轉(zhuǎn)"的患者為68.67%,多于對照組的50.62%(χ~2=5.558,P0.05);觀察組IL-1β,TXB2,CGRP和VIP水平均低于對照組,6-KetoPGF_(lα)高于對照組(P0.01)。結(jié)論:采用附子湯合芍藥甘草湯加味離子導(dǎo)入治療NLBP寒濕瘀阻證患者,能改善血液循環(huán),促進腰部功能的恢復(fù),減輕疼痛,提高患者活動能力。
[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 偽, 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- 偽 -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.
【作者單位】: 河南中醫(yī)藥大學(xué)第三附屬醫(yī)院;
【基金】:河南省教育廳科學(xué)技術(shù)研究重點項目(13B360099)
【分類號】:R274.9

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