自拟舒筋活血方熬制黑膏药贴敷治疗气滞血瘀型腰椎间盘突出症的临床研究
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摘要
目的研究自拟舒筋活血方熬制黑膏药贴敷治疗气滞血瘀型腰椎间盘突出症的临床效果。方法参照气滞血瘀型腰椎间盘突出症诊断标准,选取2016年4月～2018年4月河北省廊坊市中医医院门诊收治的腰椎间盘突出症患者100例,按随机数字表法将其分为治疗组和对照组,每组50例。治疗组采用自拟舒筋活血方治疗,对照组采用奇正消痛贴治疗,2 d一换,10 d为1个疗程,治疗2个疗程。观察两组临床疗效和治疗前后视觉模拟评分(VAS)、改良日本骨科协会腰痛评分(M-JOA)的变化。结果治疗10、20 d后,两组VAS、M-JOA评分均较治疗前显著降低(P <0.05),且治疗组VAS、M-JOA评分显著低于对照组,差异有统计学意义(P <0.05)。治疗组临床疗效显著优于对照组,差异有统计学意义(Z=3.821,P <0.05)。结论自拟舒筋活血方熬制黑膏药贴敷治疗气滞血瘀型腰椎间盘突出症效果确切,能明显减轻患者疼痛,改善患者功能障碍。
Objective To study the clinical effect of self-made black sticking-plaster decocted by Shujin Huoxue Recipe in the treatment of lumbar disc herniation with syndrome of qi stagnation and blood stasis. Methods According to the diagnostic criteria of lumbar disc herniation with syndrome of qi stagnation and blood stasis, 100 cases of patients with lumbar disc herniation admitted to Outpatient Department of Langfang Traditional Chinese Medicine Hospital of Hebei Province from April 2016 to April 2018 were selected and divided into treatment group and control group by random number table method, with 50 cases in each group. The treatment group was treated with self-maded Shujin Huoxue Recipe, and the control group was treated with Qizheng Xiaotong Plaster, one change every 2 d, 10 d was as a course of treatment, for 2 courses. The clinical efficacy and the changes of visual analogue scale(VAS) and modified Japanese Orthopaedic Association scores(M-JOA) of the two groups before and after treatment were observed. Results After treatment for 10, 20 d, the VAS, M-JOA scores of the two groups were lower than those before treatment(P <0.05), and the VAS, M-JOA scores of treatment group were lower than those of control group, the differences were statistically significant(P < 0.05). The clinical efficacy of treatment group was better than that of control group, the difference was statistically significant(Z = 3.821, P < 0.05). Conclusion Self-made black sticking-plaster decocted by Shujin Huoxue Recipe in the treatment of lumbar disc herniation with syndrome of qi stagnation and blood stasis has a definite curative effect, which can obviously relieve pain and improve patients' dysfunction.
Objective To study the clinical effect of self-made black sticking-plaster decocted by Shujin Huoxue Recipe in the treatment of lumbar disc herniation with syndrome of qi stagnation and blood stasis. Methods According to the diagnostic criteria of lumbar disc herniation with syndrome of qi stagnation and blood stasis, 100 cases of patients with lumbar disc herniation admitted to Outpatient Department of Langfang Traditional Chinese Medicine Hospital of Hebei Province from April 2016 to April 2018 were selected and divided into treatment group and control group by random number table method, with 50 cases in each group. The treatment group was treated with self-maded Shujin Huoxue Recipe, and the control group was treated with Qizheng Xiaotong Plaster, one change every 2 d, 10 d was as a course of treatment, for 2 courses. The clinical efficacy and the changes of visual analogue scale(VAS) and modified Japanese Orthopaedic Association scores(M-JOA) of the two groups before and after treatment were observed. Results After treatment for 10, 20 d, the VAS, M-JOA scores of the two groups were lower than those before treatment(P <0.05), and the VAS, M-JOA scores of treatment group were lower than those of control group, the differences were statistically significant(P < 0.05). The clinical efficacy of treatment group was better than that of control group, the difference was statistically significant(Z = 3.821, P < 0.05). Conclusion Self-made black sticking-plaster decocted by Shujin Huoxue Recipe in the treatment of lumbar disc herniation with syndrome of qi stagnation and blood stasis has a definite curative effect, which can obviously relieve pain and improve patients' dysfunction.
引文
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[17]李振朝,郭勇.定点运穴手法配合盘根消痛方治疗气虚型腰椎间盘突出疗效观察[J].中国现代医生,2017,55(25):94-96,100.
[18]张万荣,李敏.辨证施护配合中药湿热敷在腰椎间盘突出症患者康复中的应用[J].西部中医药,2017,30(9):133-135.
[19]邱铕滇,郑锐坚.身痛逐瘀汤治疗血瘀气滞型腰椎间盘突出症的疗效分析[J].内蒙古中医药,2017,36(9):12-13.
[20]鄂远.身痛逐瘀汤加减治疗腰椎间盘突出症临床研究[J].亚太传统医药,2017,13(18):141-142.
[21]王小佶.推拿配合中药治疗湿热型腰椎间盘突出症的效果观察[J].中国医药科学,2017,7(17):66-68.
[22]周小芳,庄素芳.加味乌头散火龙灸对寒湿型腰椎间盘突出症患者JOA及SF-36评分影响研究[J].中国现代医生,2017,55(11):104-108.
[23]清·吴尚先.理瀹骈文[M].北京:中国中医药出版社,1995:8.
[24]郑俊民.经皮给药新剂型[M].北京:人民卫生出版社,1997:1-2.
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[2]张菁蔷,汪小冬,孟晓耘,等.腰椎间盘突出症缓解期“强筋固肾功”康复锻炼的效果研究[J].护理管理杂志,2013,13(10):736-737.
[3]韩为华.体外冲击波穴位冲击疗法在腰椎间盘突出症中的疗效观察[J].陕西中医,2015,36(11):1535-1536.
[4]金今,邱贵兴,王以朋,等.经皮穿刺木瓜凝乳蛋白酶化学溶核术治疗腰椎间盘突出症[J].中国脊柱脊髓杂志,1998,8(4):39-41.
[5]李永刚,韦继南,陆军,等.椎间盘镜下髓核摘除术和经皮椎间盘切吸术治疗单节段中央型椎间盘突出症的远期疗效比较[J].介入放射学杂志,2012,21(1):40-44.
[6]鲁玉来,鲁雯,燕好军,等.骨关节炎的药物治疗[J].中国矫形外科杂志,2002,10(14):1425-1427.
[7]胡旭东,霍保善,何仁亮,等.两种糖皮质激素硬膜外腔注入治疗腰椎间盘突出症疗效分析[J].中国医师杂志,2004,6(9):1274-1275.
[8]黄章松,黄杨勇.甲钻胺与拨尼松治疗腰椎间盘突出症临床疗效比较[J].中国现代医生,2011,49(9):3-11.
[9]刘伟志,秦阿娜,钟伯雄,等.传统膏药制备工艺研究进展[J].中央民族大学学报:自然科学版,2010,19(4):73-76.
[10]无.中药新药治疗腰椎间盘突出症的临床研究指导原则[J].中国中医骨伤科杂志,1995,3(5):52-53.
[11]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:166-167.
[12]费炳红.黑膏药熬炼工艺改进[J].中国药业,2006,15(15):61.
[13]杨景德.桃红四物汤结合PLDD治疗气滞血瘀型腰椎间盘突出症的临床疗效观察[D].福州:福建中医药大学,2013:5.
[14]苏国宏,周忠良,罗建明,等.针灸治疗气滞血瘀型腰椎间盘突出症临床观察[J].中医药临床杂志,2011,23(4):320-322.
[15]辛卓萍.五劳七损方加味治疗肝肾亏虚型腰椎间盘突出症临床疗效[J].西部中医药,2018,31(1):89-91.
[16]魏军义.身痛逐瘀汤加减治疗腰椎间盘突出症临床观察[J].中国民族民间医药,2018,27(5):97-98.
[17]李振朝,郭勇.定点运穴手法配合盘根消痛方治疗气虚型腰椎间盘突出疗效观察[J].中国现代医生,2017,55(25):94-96,100.
[18]张万荣,李敏.辨证施护配合中药湿热敷在腰椎间盘突出症患者康复中的应用[J].西部中医药,2017,30(9):133-135.
[19]邱铕滇,郑锐坚.身痛逐瘀汤治疗血瘀气滞型腰椎间盘突出症的疗效分析[J].内蒙古中医药,2017,36(9):12-13.
[20]鄂远.身痛逐瘀汤加减治疗腰椎间盘突出症临床研究[J].亚太传统医药,2017,13(18):141-142.
[21]王小佶.推拿配合中药治疗湿热型腰椎间盘突出症的效果观察[J].中国医药科学,2017,7(17):66-68.
[22]周小芳,庄素芳.加味乌头散火龙灸对寒湿型腰椎间盘突出症患者JOA及SF-36评分影响研究[J].中国现代医生,2017,55(11):104-108.
[23]清·吴尚先.理瀹骈文[M].北京:中国中医药出版社,1995:8.
[24]郑俊民.经皮给药新剂型[M].北京:人民卫生出版社,1997:1-2.
[25]张其来.张氏黑膏药治疗腰椎间盘突出症1344例[J].中医外治杂志,2003,12(6):56.