化瘀消肿散对改善腰椎间盘突出症患者血清PGE2、PGF2α水平及疗效的临床研究
|
摘要
目的:观察腰椎间盘突出症患者配合外敷化瘀消肿散治疗的临床疗效,探讨化瘀消肿散对改善患者VAS、JOA评分及血清PGE2及PGF2α水平的影响。方法:将240例符合纳入标准的病例随机分为治疗组和对照组各120例,两组在采用常规脱水及营养神经治疗的基础上,治疗组加用外敷化瘀消肿散治疗,对照组加用外擦扶他林治疗,分别观察两组患者治疗总疗效,VAS评分、JOA评分、PGE2值、PGF2α值及各指标治疗前后差值情况。结果:治疗组总有效率(82.50%)与对照组总有效率(65.83%)比较,差异有统计学意义(P<0.05);两组患者治疗前VAS评分、JOA评分、PGE2值、PGF2α值比较,差异无统计学意义(P>0.05);两组患者治疗后VAS评分、JOA评分、PGE2值比较,差异有统计学意义(P<0.05),PGF2α值比较,差异无统计学意义(P>0.05)。结论:两组治疗均能有效改善患者VAS评分、JOA评分及PGE2值,但在改善患者PGF2α值上均无效;治疗组总疗效优于对照组,且在改善患者VAS评分、JOA评分及血清PGE2值水平上优于对照组。
Objective:To observe the clinical effect of Huayu Xiaozhong Powder(化瘀消肿散) on the serum PGE2 and PGF2αlevels of patients with lumbar disc and to explore its effect on VAS,JOA score and serum PGE2 and PGF2α levels.Methods:240 cases were randomly divided into the treatment group and the control group,with 120 cases in each group.On the basis of routine dehydration and nutritional neurotherapy,the treatment group was treated with external application of Huayu Xiaozhong Powder;and the control group was treated with external application of voltaren.The total curative effect of the two groups was observed.Results:The total efficiency of the treatment group(82.50%) was higher than 65.83% in the control group;the difference was statistically significant(P<0.05).There was no significant difference in VAS score,JOA score,PGE2 level and PGF2α level between two groups before treatment(P>0.05).There were significant differences in VAS score,JOA score and PGE2 level between two groups after treatment(P<0.05).There was no significant difference in PGF2α level after treatment(P>0.05).Conclusion:Both groups of treatment were effective in improving VAS score,JOA score and PGE2 level,but both were ineffective in improving PGF2α level.The total curative effect in the treatment group was better than that in the control group,and the improvement of VAS score,JOA score and serum PGE2 was better.
Objective:To observe the clinical effect of Huayu Xiaozhong Powder(化瘀消肿散) on the serum PGE2 and PGF2αlevels of patients with lumbar disc and to explore its effect on VAS,JOA score and serum PGE2 and PGF2α levels.Methods:240 cases were randomly divided into the treatment group and the control group,with 120 cases in each group.On the basis of routine dehydration and nutritional neurotherapy,the treatment group was treated with external application of Huayu Xiaozhong Powder;and the control group was treated with external application of voltaren.The total curative effect of the two groups was observed.Results:The total efficiency of the treatment group(82.50%) was higher than 65.83% in the control group;the difference was statistically significant(P<0.05).There was no significant difference in VAS score,JOA score,PGE2 level and PGF2α level between two groups before treatment(P>0.05).There were significant differences in VAS score,JOA score and PGE2 level between two groups after treatment(P<0.05).There was no significant difference in PGF2α level after treatment(P>0.05).Conclusion:Both groups of treatment were effective in improving VAS score,JOA score and PGE2 level,but both were ineffective in improving PGF2α level.The total curative effect in the treatment group was better than that in the control group,and the improvement of VAS score,JOA score and serum PGE2 was better.
引文
[1]中国医师协会康复医师分会骨骼肌肉专业委员会.“腰椎间盘突出症的康复治疗”中国专家共识[J].中国康复医学杂志,2017,32(2):129-135.
[2]贾小格.踩跷法治疗腰椎间盘突出症的临床观察[J].北京中医药,2008,03:199-200.
[3]李万林,黄靖宇.踩跷治疗腰椎间盘突出症100例[J].中国中医药现代远程教育,2010,04:39-40.
[4]谢艳艳.腰椎间盘突出症发病机理探讨[J].中医学报,2 0 1 3,28(184):1388-1389.
[5]李智斌.腰椎间盘突出症病机研究进展[J].现代中医药,2007,27(6):72-73.
[6]张威,郭伟,赵平.多种炎性因子在椎间盘突出的炎性机制中的作用研究进展[J].医学综述,2013,19(20):3685-3688.
[7]姜志钊,李毅中.环氧合酶-2、前列腺素E2在突出腰椎间盘中的表达及其意义[J].临床骨科杂志,2014,17(6):730-733.
[8]田伟.实用骨科学[M].北京:人民卫生出版社,2008:560-561.
[9]张小定,朱剑平,张周虎.骨愈芳联合推拿治疗急性期腰椎间盘突出症的疗效观察及其对血清炎症因子的影响[J].中国中医药科技,2017,24(4):412-434.
[10]黄冰晴,王兵丽.前列腺素E2及其受体对炎性痛调制的研究进展[J].闽南师范大学学报,2017(2):65-70.
[11]赖晓文,何晓升,钟晓春,等.增生型瘢痕组织中PGE2和PGF2a的表达及其意义[J].广东医学,2016(37):41-42.
[12]Sharmn A.Pilgram T,Wippold FJ 2 nd.Association between annular tears and disk degeneration:a longitudinal study[J].Am J Neuroradiol,2009,30(3):500-506.
[13]Alfranca A.Genis L,Salvado D,et a1.PGE2 induces angiogenesis via MT1-MMP-mediated activation of the TGFβ/Alk5 signaling pathway Blood,2008,112:1120-1128.
[14]Dingfelder.treatment with prostaglandin inhibiters:a review[J].Am J Obstet Gynecol,1981,140(8):874.
[15]华永庆,洪敏.原发性痛经研究进展[J].南京中医药大学学报,2003,19(1):62.
[16]张旭桥,姜升平,王晓晖,等.活血健腰汤对腰椎间盘突出症射频消融术后临床疗效的影响[J].中医临床研究,2014,6(2):17-20.
[17]嵆辉,陈其义,杨增敏,等.中医定向透药疗法治疗气滞血瘀型腰椎间盘突出症临床疗效观察[J].中医临床研究,2017,9(29):86-87.
[18]高学敏.中药学[M].北京:中国中医药出版社,2007:260-261.
[19]易善勇,官丽莉,杨晶,等.红花药理作用及其开发与应用研究进展[J].北方园艺,2015(05):191-195.
[20]刘医辉,杨世英,马伟林,等.当归药理作用的研究进展[J].中国当代医药,2014,21(22):192-196.
[21]蒋丽丽,张彦龙,王春杰,等.牡丹皮中有效成分丹皮酚的药理活性研究进展[J].现代诊断与治疗,2016,27(22):4223-4224.
[22]王立娜,王颖,朱明珠,等.土鳖虫的活性成分及药理研究进展[J].化工时刊,2017,31(6):34-36.
[23]何恩惠.续断的药理分析与中药配伍[J].世界最新医学信息文摘,2015,15(66):251.
[2]贾小格.踩跷法治疗腰椎间盘突出症的临床观察[J].北京中医药,2008,03:199-200.
[3]李万林,黄靖宇.踩跷治疗腰椎间盘突出症100例[J].中国中医药现代远程教育,2010,04:39-40.
[4]谢艳艳.腰椎间盘突出症发病机理探讨[J].中医学报,2 0 1 3,28(184):1388-1389.
[5]李智斌.腰椎间盘突出症病机研究进展[J].现代中医药,2007,27(6):72-73.
[6]张威,郭伟,赵平.多种炎性因子在椎间盘突出的炎性机制中的作用研究进展[J].医学综述,2013,19(20):3685-3688.
[7]姜志钊,李毅中.环氧合酶-2、前列腺素E2在突出腰椎间盘中的表达及其意义[J].临床骨科杂志,2014,17(6):730-733.
[8]田伟.实用骨科学[M].北京:人民卫生出版社,2008:560-561.
[9]张小定,朱剑平,张周虎.骨愈芳联合推拿治疗急性期腰椎间盘突出症的疗效观察及其对血清炎症因子的影响[J].中国中医药科技,2017,24(4):412-434.
[10]黄冰晴,王兵丽.前列腺素E2及其受体对炎性痛调制的研究进展[J].闽南师范大学学报,2017(2):65-70.
[11]赖晓文,何晓升,钟晓春,等.增生型瘢痕组织中PGE2和PGF2a的表达及其意义[J].广东医学,2016(37):41-42.
[12]Sharmn A.Pilgram T,Wippold FJ 2 nd.Association between annular tears and disk degeneration:a longitudinal study[J].Am J Neuroradiol,2009,30(3):500-506.
[13]Alfranca A.Genis L,Salvado D,et a1.PGE2 induces angiogenesis via MT1-MMP-mediated activation of the TGFβ/Alk5 signaling pathway Blood,2008,112:1120-1128.
[14]Dingfelder.treatment with prostaglandin inhibiters:a review[J].Am J Obstet Gynecol,1981,140(8):874.
[15]华永庆,洪敏.原发性痛经研究进展[J].南京中医药大学学报,2003,19(1):62.
[16]张旭桥,姜升平,王晓晖,等.活血健腰汤对腰椎间盘突出症射频消融术后临床疗效的影响[J].中医临床研究,2014,6(2):17-20.
[17]嵆辉,陈其义,杨增敏,等.中医定向透药疗法治疗气滞血瘀型腰椎间盘突出症临床疗效观察[J].中医临床研究,2017,9(29):86-87.
[18]高学敏.中药学[M].北京:中国中医药出版社,2007:260-261.
[19]易善勇,官丽莉,杨晶,等.红花药理作用及其开发与应用研究进展[J].北方园艺,2015(05):191-195.
[20]刘医辉,杨世英,马伟林,等.当归药理作用的研究进展[J].中国当代医药,2014,21(22):192-196.
[21]蒋丽丽,张彦龙,王春杰,等.牡丹皮中有效成分丹皮酚的药理活性研究进展[J].现代诊断与治疗,2016,27(22):4223-4224.
[22]王立娜,王颖,朱明珠,等.土鳖虫的活性成分及药理研究进展[J].化工时刊,2017,31(6):34-36.
[23]何恩惠.续断的药理分析与中药配伍[J].世界最新医学信息文摘,2015,15(66):251.