骨愈方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

摘要

目的:探讨自拟骨愈方联合推拿治疗腰椎间盘突出(LDH)急性期的临床疗效及对血清炎症因子白介素-1β(IL-1β)、白介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平的影响.方法:102例急性期LDH患者,随机分为对照组和观察组.对照组通过牵引及非甾体抗炎药物治疗,观察组采用自拟骨愈方联合推拿治疗,疗程为1个月.观察患者的疼痛(VAS)评分和JOA腰椎功能评分,采用酶联免疫吸附法检测治疗前后血清IL-Iβ、IL-6、TNF-α水平.结果:观察组总有效率为98.0％,明显高于对照组的84.3％(P＜0.05);2组患者治疗后VAS评分均明显降低(P＜0.05),与对照组比较观察组降低更显著(P＜0.05);2组患者治疗后JOA评分显著提高,与对照组比较观察组JOA评分升高显著(P＜0.05);2组患者治疗后炎症因子水平均明显下降,观察组显著低于对照组(P＜0.05).结论:自拟骨愈方联合推拿治疗急性期LDH具有明显的优效性,可有效降低患者的VAS评分,提高JOA评分,显著降低患者血清炎症因子IL-1β、IL-6、TNF-α的水平.%Objective:To observe the curative effect of Guyu Fang combining with Massage on acute limbar disc herniation and influences on changes of serum inflammatory factors containing IL-1β,IL-6 and TNF-α.Methods:102 Cases with limbar disc herniation at acute stage were divided into control and observation groups at random,control group was given traction therapy and non-steroidal anti-inflammatory drugs,observation was given Chinese medicine decoction-guyu Fang and Massage,treatment course was one month.VAS and JOA score were evaluated before and after treatment,serum IL-1β,IL-6 and TNF-α contents were determined byELISA.Results:The total effective rate of observation group was 98.0％,that was better than that of control group,that was 84.3％ (P ＜0.05).VAS score was reduced in the two groups after treatment,JOA score was raised,the effects of observation group were more significant than those in control group,the difference were statistical significance (P ＜ 0.05).The serum IL-1β,IL-6 and TNF-α levels were decreased in the two groups after treatment,the levels in the observation group were lower to compare with control group,the differences were statistical significance (P ＜ 0.05).Conclusion:Guyu Fang drated by writer can effectively treat limbar disc herniation at acute stage,reducing VAS score and raise JOA score,decreasing serum IL-1β,IL-6 and TNF-α levels.