| 摘要: |
| 目的：观察麻桂温经汤加味联合五籽散热奄包治疗张家界地区寒湿型腰椎间盘突出症（LDH）的临床疗效，探索其作用机制。方法：将张家界市中医医院骨伤科收治的寒湿型LDH患者64例，按照随机数字表法将其分为2组，每组各32例。治疗组予麻桂温经汤加味口服联合五籽散热奄包热敷治疗，对照组予口服萘普生缓释胶囊治疗，2组均连续治疗 14 d。比较2组治疗前、治疗7 d、治疗14 d的Oswestry残损指数 (ODI) 评分、中医证候评分及肿瘤坏死因子-α（TNF-α） 、白细胞介素-6（IL-6） 、白细胞介素- 1β（IL-1β）的变化情况，评价其综合疗效。结果：对照组脱落 1例。综合疗效总有效率治疗组为 93.75%（30/32）， 高于对照组的 80.65% （25/31），差异有统计学意义 （P＜0.05）。2组ODI评分、中医证候评分、TNF-α、IL-6、IL-1β治疗前后组内比较及治疗后同时间节点组间比较，差异均有统计学意义（P＜0.05）。结论：麻桂温经汤加味联合五籽散热奄包热敷治疗张家界地区寒湿型LDH，可有效缓解患者临床症状，促进腰椎功能恢复，其治疗机制可能是降低 TNF-α、IL-6 和 IL-1β水平，减少机体炎症反应，从而抑制疼痛因子生成。 |
| 关键词: 腰椎间盘突出症 寒湿型 “温法”理论 麻桂温经汤加味 五籽散热奄包 张家界地区 |
| DOI： |
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| Clinical effect of Jiawei Magui Wenjing decoction combined with hot compress therapy with five-seed powder in treatment of lumbar disc herniation with cold dampness in Zhangjiajie，China：An analysis of 32 cases |
| XIANG Jianfeng,XIANG Xu,GENG Yongzhi |
| (Zhangjiajie Municipal Hospital of Traditional Chinese Medicine，Zhangjiajie 427200，Hunan，China) |
| Abstract: |
| Objective：To investigate the clinical effect and mechanism of action of Jiawei Magui Wenjing decoction combined with hot compress therapy with five-seed powder in the treatment of lumbar disc herniation (LDH) with cold dampness in Zhangjiajie，China.Methods：A total of 64 patients with cold-dampness LDH who were admitted to Department of Orthopedics and Traumatology，Zhangjiajie Municipal Hospital of Traditional Chinese Medicine，were enrolled and divided into treatment group and control group using a random number table，with 32 patients in each group.The patients in the treatment group were given oral administration of Jiawei Magui Wenjing decoction combined with hot compress therapy with five-seed powder，while those in the control group were given oral administration of Naproxen sustained release capsules，and the course of treatment was 14 days for both groups.The two groups were compared in terms of Oswestry Disability Index (ODI)，traditional Chinese medicine (TCM) syndrome score，tumor necrosis factor-α (TNF-α)，interleukin-6 (IL-6)，and interleukin-1β (IL-1β) before treatment and on days 7 and 14 of treatment，and overall response was assessed.Results：One patient was lost to follow-up in the control group.The treatment group had a significantly higher overall response rate than the control group ［93.75% (30/32) vs 80.65% (25/31)，P＜0.05］.Both groups had significant changes in ODI score，TCM syndrome score，TNF-α，IL-6，and IL-1β after treatment，and there were significant differences in these indicators between the two groups at each time point after treatment (P＜0.05).Conclusion：In the treatment of patients with cold-dampness LDH in Zhangjiajie，Jiawei Magui Wenjing decoction combined with hot compress therapy with five-seed powder can effectively alleviate clinical symptoms and promote the functional recovery of lumbar vertebra，possibly by reducing the levels of TNF-α，IL-6，and IL-1β，alleviating inflammatory response in the body，and inhibiting the production of pain factors. |
| Key words: lumbar disc herniation cold-dampness “warming method” theory Jiawei Magui Wenjing decoction hot compress therapy with five-seed powder Zhangjiajie |
