| 徐政.身痛逐瘀汤对盘源性腰痛气滞血瘀证血清炎症因子和疼痛介质释放的影响分析[J].浙江中西医结合杂志,2025,35(1): |
| 身痛逐瘀汤对盘源性腰痛气滞血瘀证血清炎症因子和疼痛介质释放的影响分析 |
| Analysis of the effect of Shentong Zhuyutang on the release of inflammatory factors and pain mediators in Discogenic Low Back Pain Due to Qi-stagnation and blood stasis syndr-ome |
| 投稿时间：2024-01-17 修订日期：2024-12-19 |
| DOI： |
| 中文关键词: 身痛逐瘀汤 盘源性腰痛 气滞血瘀证 血清炎症因子 痛介质释 疗效分析 |
| 英文关键词:Shentong Zhuyutang Discogenic low back pain Qi-stagnation and blood st-asis syndrome Serum inflammatory factors Pain mediators release Curative effect analysis |
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| 中文摘要: |
| 【】 目的:探讨身痛逐瘀汤对盘源性腰痛(discogenic low back pain, DLBP)气滞血瘀证血清炎症因子和疼痛介质释放的影响。方法:回顾性选取2022年3月-2023年7月收治的DLBP气滞血瘀证患者136例为研究对象,分为常规组(n=67)和联合组(n=69)。常规组患者予塞来昔布胶囊口服治疗,联合组在常规组用药方案的基础上联合身痛逐瘀汤内服治疗。2组患者均完成为期3周的治疗后,收集治疗前后2组患者中医证候积分、气滞血瘀证评分、Oswestry功能障碍指数(Oswestry disability Index, ODI)、日常生活自理能力(activities of daily living, ADL)评分、血清炎症因子[肿瘤坏死因子-α(tumor necrosis factor-α, TNF-α)、白细胞介素-6(Interleukin-6, IL-6)、C反应蛋白(C-reactive protein, CRP)]水平、疼痛介质[血清β-内啡肽(beta-endorphin, β-EP)、5-羟色胺(5-Hydroxytryptamine, 5-HT)、前列腺素E2(prostaglandin E2, PGE2)]水平,并对治疗后组间临床疗效、不良反应发生情况及上述指标进行统计学分析。结果:治疗后,2组患者的中医证候积分、气滞血瘀证评分、ODI、TNF-α、IL-6、CRP、β-EP、5-HT、PGE2均显著降低,ADL评分均显著提高,差异均具有统计学意义(均P<0.05)。行组间治疗后数据比较结果提示,联合组中医证候积分、气滞血瘀证评分、ODI均显著低于常规组,ADL评分显著高于常规组；各血清炎症因子水平与各疼痛介质水平均显著低于常规组；联合组治疗优良率94.20%(65/69),显著高于常规组治疗优良率76.12%(51/67),差异均具有统计学意义(均P<0.05)。联合组不良反应发生率2.90%(2/69),较之常规组不良反应发生率4.48%(3/67)无统计学差异(P>0.05)。结论:身痛逐瘀汤可在常规西药治疗的基础上显著增强对患者机体血清炎症因子水平与疼痛介质释放的调节,有效缓解患者疼痛症状,提高对DLBP气滞血瘀证的临床疗效。 |
| 英文摘要: |
| 【】 Objective: To investigate the effects of Shentong Zhuyu Decoction on the release of serum inflammatory factors and pain mediators in discogenic low back pain (DLBP) syndrome of qi stagnation and blood stasis. Methods: 136 patients with DLBP qi stagnation and blood stasis syndrome admitted from March 2022 to July 2023 were retrospectively selected as the study objects, and were divided into conventional group (n=67) and combined group (n=69). The conventional group was treated with celecoxib capsules orally, and the combined group was treated with fitted Tongzhuyu decoction on the basis of the routine medication regimen. After completing the 3-week treatment in both groups, TCM syndrome score, Qi-stagnation and blood-stasis score, Oswestry disability Index (ODI), activities of daily living, and self-care ability were collected before and after treatment. ADL score, serum inflammatory factors [tumor necrosis factor-α (TNF-α), Interleukin-6 (IL-6), C-reactive protein, CRP)] levels, pain mediators [serum beta-endorphin (beta-EP), 5-Hydroxytryptamine (5-HT), prostaglandin E2 (PGE2)] levels, After treatment, the clinical efficacy, the occurrence of adverse reactions and the above indexes were statistically analyzed. Results: After treatment, TCM syndrome score, Qi-stagnation and blood-stasis score, ODI, TNF-α, IL-6, CRP, β-EP, 5-HT and PGE2 were significantly decreased in 2 groups, and ADL score was significantly increased, with statistical significance (all P<0.05). The results of data comparison after treatment showed that TCM syndrome scores, Qi-stagnation and blood-stasis scores and ODI scores in the combined group were significantly lower than those in the conventional group, and ADL scores were significantly higher than those in the conventional group. The levels of serum inflammatory factors and pain mediators were significantly lower than those of conventional group. The superior and excellent rate of the combined group was 94.20% (65/69), which was significantly higher than that of the conventional group (76.12% (51/67), and the differences were statistically significant (all P<0.05). The incidence of adverse reactions in combination group was 2.90% (2/69), which had no statistical difference compared with that in conventional group (4.48% (3/67)) (P>0.05). Conclusion: Shentong Zhuyu Decoction can significantly enhance the regulation of serum inflammatory factors and pain mediators release of patients on the basis of conventional western medicine treatment, effectively relieve the pain symptoms of patients, and improve the clinical efficacy of DLBP syndrome of qi stagnation and blood stasis. |
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