蛇蝎散加味治療腰椎間盤突出癥神經(jīng)痛（寒濕型）臨床療效觀察
發(fā)布時(shí)間：2019-02-11 10:39
【摘要】：目的:通過觀察口服中藥蛇蝎散加味在治療腰椎間盤突出癥神經(jīng)痛(寒濕型)中的臨床療效,探討其治療腰椎間盤突出癥神經(jīng)痛的作用機(jī)制及臨床運(yùn)用價(jià)值。方法:選擇前來安徽省中醫(yī)院骨科門診就診的腰椎間盤突出癥患者,通過嚴(yán)格篩選,納入符合觀察標(biāo)準(zhǔn)的患者60例,隨機(jī)分成治療組30例,對(duì)照組30例。對(duì)性別、年齡、病程、治療前VAS、JOA評(píng)分進(jìn)行統(tǒng)計(jì)學(xué)分析,排除差異性,治療組給予口服蛇蝎散加味治療,每日一劑(全蝎3g,蜈蚣3g,烏梢蛇10g,制附片10g,干姜10g,炙甘草15g,茯苓10g,白術(shù)10g,桂枝10g)溫水沖服,早晚分服,連續(xù)服藥14天;對(duì)照組采用腰痛寧膠囊治療,每次3粒,每日3次,連續(xù)服藥14天。對(duì)兩組患者椎間盤突出導(dǎo)致的神經(jīng)癥狀及對(duì)生活的影響情況進(jìn)行記錄、評(píng)分,對(duì)比觀察兩組藥物總有效率、治療前后VAS疼痛評(píng)分及JOA評(píng)分變化,對(duì)所記錄數(shù)據(jù)進(jìn)行整理,并作統(tǒng)計(jì)學(xué)分析。結(jié)果:在納入臨床觀察的兩組患者中,性別、年齡、病程、治療前VAS疼痛評(píng)分及JOA下腰痛評(píng)分經(jīng)統(tǒng)計(jì)學(xué)分析無差異,具有可比性。兩組治療前后組內(nèi)VAS疼痛評(píng)分經(jīng)統(tǒng)計(jì)學(xué)分析,P均小于0.01,說明兩組治療均有效;治療后兩組組間VAS評(píng)分統(tǒng)計(jì)學(xué)分析,P0.01,說明治療后兩組疼痛評(píng)分有差異;兩組患者治療前后VAS評(píng)分差值經(jīng)統(tǒng)計(jì)學(xué)分析,顯示P0.05,有統(tǒng)計(jì)學(xué)差異,提示了兩組患者治療后疼痛改善程度不同,治療組疼痛減輕程度較對(duì)照組好;治療前后兩組組內(nèi)JOA評(píng)分經(jīng)統(tǒng)計(jì)學(xué)分析,P均小于0.01,說明兩組治療前后臨床癥狀均有改善;治療后兩組組間JOA評(píng)分經(jīng)統(tǒng)計(jì)學(xué)檢驗(yàn),P0.05,說明治療后兩組患者相關(guān)功能狀態(tài)評(píng)分有差異;對(duì)兩組患者治療前后JOA評(píng)分的差值進(jìn)行統(tǒng)計(jì)學(xué)分析,P0.01,差異有統(tǒng)計(jì)學(xué)意義,說明兩組患者治療后JOA評(píng)分有差異,兩組患者臨床改善程度不同,治療組功能改善較對(duì)照組明顯。口服蛇蝎散加味組患者中,治愈10人,顯效12人,有效6人,總有效率為93.33%。口服腰痛寧膠囊的患者中,治愈6人,顯效10人,有效9人,總有效率為83.33%。經(jīng)秩和檢驗(yàn)分析,Z=-3.17,P=0.020.05,統(tǒng)計(jì)學(xué)有差異,治療組較對(duì)照組療效顯著。綜合分析得出治療組及對(duì)照組均取得明顯的臨床療效,治療效果均較滿意,但治療組療效較于對(duì)照組更為理想。結(jié)論:經(jīng)過臨床療效觀察和統(tǒng)計(jì)學(xué)分析后,可以得出結(jié)論:蛇蝎散加味與腰痛寧膠囊均可在一定程度上減輕或消除寒濕型腰椎間盤突出癥患者腰痛、下肢放射痛、麻木等神經(jīng)癥狀,可明顯改善患者生活質(zhì)量,減輕患者痛苦,但蛇蝎散加味臨床療效更為顯著,治療后疼痛評(píng)分明顯下降、JOA評(píng)分增加,治療有效率高于腰痛寧組。通過后期觀察隨訪,病人對(duì)治療效果的滿意度較高,日常生活工作基本不受影響。所以,我們可以說蛇蝎散加味在寒濕型腰椎間盤突出癥患者的治療中臨床療效較好,值得作為基礎(chǔ)藥物運(yùn)用于適合保守的患者。
[Abstract]:Objective: to observe the clinical effect of snake and scorpion powder on the treatment of neuralgia of lumbar disc herniation (cold and wet type), and to explore the mechanism and clinical application value of the treatment of neuralgia of lumbar intervertebral disc herniation. Methods: 60 patients with lumbar disc herniation were selected from orthopedic outpatient department of Anhui traditional Chinese Medicine Hospital. 60 patients who met the observation criteria were selected and randomly divided into treatment group (n = 30) and control group (n = 30). Sex, age, course of disease, and VAS,JOA score before treatment were statistically analyzed, and the difference was excluded. The treatment group was treated with oral snake and scorpion powder, once a day (Scorpio 3g, centipede 3g, Wutiao snake 10g, appended tablet 10g, dried ginger 10g). Roasted liquorice 15g, Poria cocos 10g, Atractylodes macrocephala 10g, Guizhi 10g) warm water, morning and evening were taken separately and continuously for 14 days; The control group was treated with Yutongning capsule, 3 capsules per time, 3 times a day for 14 days. The neurological symptoms caused by intervertebral disc herniation and their influence on life were recorded and scored. The total effective rate, VAS pain score and JOA score before and after treatment were compared between the two groups, and the recorded data were sorted out. Statistical analysis was made. Results: there was no significant difference in sex, age, course of disease, VAS pain score and JOA low back pain score between the two groups. The VAS pain scores of the two groups before and after treatment were statistically analyzed (P < 0.01), which indicated that the two groups were effective, and the VAS scores of the two groups were statistically analyzed after treatment (P 0.01), which indicated that there were differences in the pain scores between the two groups after treatment. The difference of VAS score between the two groups before and after treatment showed a statistical difference (P0.05), which indicated that the pain improvement degree of the two groups was different after treatment, the pain relief degree of the treatment group was better than that of the control group. Before and after treatment, the JOA scores in the two groups were statistically analyzed, P < 0.01, indicating that the clinical symptoms of the two groups were improved before and after treatment. After treatment, the JOA scores of the two groups were statistically tested, P0.05, indicating that there were differences in the scores of the related functional status between the two groups after treatment. The difference of JOA score between the two groups before and after treatment was statistically analyzed, P0.01, the difference was statistically significant, which indicated that there were differences in JOA score between the two groups after treatment, and the clinical improvement degree of the two groups was different. The function improvement of the treatment group was more obvious than that of the control group. In the treated group, 10 patients were cured, 12 were effective and 6 were effective. The total effective rate was 93.33. Among the patients with Yutongning capsule, 6 were cured, 10 were markedly effective and 9 were effective. The total effective rate was 83.33. The results of rank sum test showed that the treatment group was more effective than the control group. Comprehensive analysis showed that both the treatment group and the control group had obvious clinical effect, and the therapeutic effect was satisfactory, but the curative effect of the treatment group was better than that of the control group. Conclusion: after clinical observation and statistical analysis, it can be concluded that both Shexiu Powder and Yutongning capsule can alleviate or eliminate low back pain and lower limb radiodynia in patients with cold and wet lumbar disc herniation to a certain extent. Numbness and other neurological symptoms can significantly improve the quality of life of patients and alleviate the pain of patients, but the clinical efficacy of Scorpio Powder is more significant. After treatment, the pain score decreased significantly, the JOA score increased, and the effective rate of treatment was higher than that of Yutongning group. Through later observation and follow-up, the patients' satisfaction with the therapeutic effect was higher, and their daily life and work were not affected. Therefore, we can say that snake and scorpion powder in the treatment of cold and wet lumbar disc herniation patients clinical efficacy is better, it is worthy of being used as a basic drug for conservative patients.
【學(xué)位授予單位】：安徽中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R274.9
本文編號(hào)：2419648
[Abstract]:Objective: to observe the clinical effect of snake and scorpion powder on the treatment of neuralgia of lumbar disc herniation (cold and wet type), and to explore the mechanism and clinical application value of the treatment of neuralgia of lumbar intervertebral disc herniation. Methods: 60 patients with lumbar disc herniation were selected from orthopedic outpatient department of Anhui traditional Chinese Medicine Hospital. 60 patients who met the observation criteria were selected and randomly divided into treatment group (n = 30) and control group (n = 30). Sex, age, course of disease, and VAS,JOA score before treatment were statistically analyzed, and the difference was excluded. The treatment group was treated with oral snake and scorpion powder, once a day (Scorpio 3g, centipede 3g, Wutiao snake 10g, appended tablet 10g, dried ginger 10g). Roasted liquorice 15g, Poria cocos 10g, Atractylodes macrocephala 10g, Guizhi 10g) warm water, morning and evening were taken separately and continuously for 14 days; The control group was treated with Yutongning capsule, 3 capsules per time, 3 times a day for 14 days. The neurological symptoms caused by intervertebral disc herniation and their influence on life were recorded and scored. The total effective rate, VAS pain score and JOA score before and after treatment were compared between the two groups, and the recorded data were sorted out. Statistical analysis was made. Results: there was no significant difference in sex, age, course of disease, VAS pain score and JOA low back pain score between the two groups. The VAS pain scores of the two groups before and after treatment were statistically analyzed (P < 0.01), which indicated that the two groups were effective, and the VAS scores of the two groups were statistically analyzed after treatment (P 0.01), which indicated that there were differences in the pain scores between the two groups after treatment. The difference of VAS score between the two groups before and after treatment showed a statistical difference (P0.05), which indicated that the pain improvement degree of the two groups was different after treatment, the pain relief degree of the treatment group was better than that of the control group. Before and after treatment, the JOA scores in the two groups were statistically analyzed, P < 0.01, indicating that the clinical symptoms of the two groups were improved before and after treatment. After treatment, the JOA scores of the two groups were statistically tested, P0.05, indicating that there were differences in the scores of the related functional status between the two groups after treatment. The difference of JOA score between the two groups before and after treatment was statistically analyzed, P0.01, the difference was statistically significant, which indicated that there were differences in JOA score between the two groups after treatment, and the clinical improvement degree of the two groups was different. The function improvement of the treatment group was more obvious than that of the control group. In the treated group, 10 patients were cured, 12 were effective and 6 were effective. The total effective rate was 93.33. Among the patients with Yutongning capsule, 6 were cured, 10 were markedly effective and 9 were effective. The total effective rate was 83.33. The results of rank sum test showed that the treatment group was more effective than the control group. Comprehensive analysis showed that both the treatment group and the control group had obvious clinical effect, and the therapeutic effect was satisfactory, but the curative effect of the treatment group was better than that of the control group. Conclusion: after clinical observation and statistical analysis, it can be concluded that both Shexiu Powder and Yutongning capsule can alleviate or eliminate low back pain and lower limb radiodynia in patients with cold and wet lumbar disc herniation to a certain extent. Numbness and other neurological symptoms can significantly improve the quality of life of patients and alleviate the pain of patients, but the clinical efficacy of Scorpio Powder is more significant. After treatment, the pain score decreased significantly, the JOA score increased, and the effective rate of treatment was higher than that of Yutongning group. Through later observation and follow-up, the patients' satisfaction with the therapeutic effect was higher, and their daily life and work were not affected. Therefore, we can say that snake and scorpion powder in the treatment of cold and wet lumbar disc herniation patients clinical efficacy is better, it is worthy of being used as a basic drug for conservative patients.
【學(xué)位授予單位】：安徽中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R274.9
【相似文獻(xiàn)】
相關(guān)期刊論文 前10條
1 郭永紅;;定點(diǎn)旋轉(zhuǎn)復(fù)位結(jié)合蛇蝎散治療腰椎間盤突出癥102例臨床觀察[J];中醫(yī)藥導(dǎo)報(bào);2009年05期
2 劉艷;蛇蝎散治頸椎病60例[J];湖南中醫(yī)藥導(dǎo)報(bào);1996年05期
3 李引剛;蛇蝎散治療腰椎間盤突出癥136例[J];陜西中醫(yī)學(xué)院學(xué)報(bào);1999年05期
4 王蕾;復(fù)方蛇蝎散外敷治療帶狀皰疹[J];中醫(yī)外治雜志;2001年01期
5 昂永宏;蛇蝎散治療肩周炎52例報(bào)道[J];基層中藥雜志;2000年06期
6 劉艷;蛇蝎散治頸椎病60例[J];河南診斷與治療雜志;1996年05期
7 鐘磊;蛇蝎散治療類風(fēng)濕性關(guān)節(jié)炎臨床觀察[J];湖北中醫(yī)雜志;1995年06期
8 鐘磊，任志敏，江靜;蛇蝎散治療類風(fēng)濕性關(guān)節(jié)炎的臨床研究[J];河南中醫(yī);1995年06期
9 劉文靜,張素云,賀瑞興;蛇蝎散治療坐骨神經(jīng)痛82例[J];國(guó)醫(yī)論壇;1998年01期
10 鐘磊,易明;蛇蝎散治療類風(fēng)濕性關(guān)節(jié)炎的臨床研究[J];實(shí)用中醫(yī)藥雜志;1996年04期
相關(guān)重要報(bào)紙文章 前1條
1 薛少馳 陜西中醫(yī)學(xué)院;蛇蝎散加減治腰椎間盤突出癥[N];中國(guó)中醫(yī)藥報(bào);2014年
相關(guān)碩士學(xué)位論文 前1條
1 趙光彩;蛇蝎散加味治療腰椎間盤突出癥神經(jīng)痛（寒濕型）臨床療效觀察[D];安徽中醫(yī)藥大學(xué);2016年
，本文編號(hào)：2419648
本文鏈接：http://sikaile.net/zhongyixuelunwen/2419648.html
最近更新
教材專著
