汪宝军+王竹风+李爱君

[摘要] 目的 观察经验方熏洗1号熏蒸治疗腰椎间盘突出症的临床效果。 方法 收集2017年1～8月中国中医科学院广安门医院南区收治的诊腰椎间盘突出症患者60例，按随机数字表法分为两组，每组各30例。熏蒸组采用熏洗1号熏蒸，每日1次，每日1剂，每次30 min；寒痛乐组采用寒痛乐熨剂外用，每日1次，每日1贴。两组患者均持续治疗2周。比较两组不良反应、VAS疼痛评分、JOA评分和疗效。 结果 熏蒸组未见明显不良反应发生，寒痛乐组有1例出现烫伤。熏蒸组疗效优于寒痛乐组（P < 0.01）。治疗后，两组VAS评分均显著下降，JOA评分均显著升高，且熏蒸组改善更加显著（P < 0.01）。 结论 熏洗1号熏蒸治疗腰椎间盘突出症能显著减轻腰腿痛症状，明显改善腰椎功能，有较好的临床效果。

[关键词] 中药熏蒸；腰椎间盘突出症；临床疗效；VAS评分；JOA评分

[中图分类号] R274 [文献标识码] A [文章编号] 1673-7210（2017）12（b）-0172-04

[Abstract] Objective To observe clinical effect of Xunxi NO.1 empirical formula of Chinese medicine fumigation on the patients with lumbar disc herniation （LDH）. Methods Sixty patients with LDH treated in South Campus of Guang′anmen Hospital， China Academy of Chinese Medical Sciences， from January to August in 2017 were selected as the study subjects， and they were divided into two groups by random number table， with 30 cases in each group. The fumigation group was treated with Xunxi NO.1 Chinese medicine fumigation， 1 time per day， one dose a day， 30 minutes each time. The Hantongle group was treated with Hantongle Compression Formula， 1 times per day， one stick a day for 2 weeks. The adverse reaction， VAS score， JOA score and clinical effective of the two groups were compared. Results No obvious adverse reaction occurred in treatment group， 1 case appeared ambustion in the Hantongle group. The clinical effect of the fumigation group was better than that of the Hantongle group （P < 0.01）. After treatment， in the two groups， the VAS scores were decreased， and the JOA scores were increased， and the improvement of the fumigation group was markedly better than that of the Hantongle group （P < 0.01）. Conclusion Xunxi NO.1 of Chinese medicine fumigation can effectively relieve the lumbago and leg pains of patients with LDH， improve the lumbar function， and has significantly therapeutic effect to LDH.

[Key words] Lumbar disc herniation； Chinese medicine fumigation； Clinical effect； VAS score； JOA score

腰椎間盘突出症的发病机制主要为腰椎间盘的退行性改变，加上外力或不良姿势等的作用，椎间盘髓核组织突破纤维环从而压迫毗邻神经根产生的一系列的症状，在骨科临床上非常常见，发病率高，影响患者的生活和工作，甚至丧失劳动能力[1-2]。最常见的病变部位是L4～5和L5～S1突出，5%的患者会有大小便的功能障碍。腰椎间盘突出症属中医“腰痛”“痹症”范畴。腰椎间盘突出症的治疗有保守治疗和手术治疗，首选保守治疗。中频脉冲电疗、腰椎牵引、超短波等物理因子以及中药熏蒸等保守治疗方法被广泛用于腰椎间盘突出症的临床治疗中[3]。中药熏蒸属于中医外治法，外治法具有疗效好、见效快、患者易接受、不良反应少等优点[4]。中药熏蒸疗法主要是采用药物加热后，药物治疗因子经人体内的皮肤进入体内，达到一定的治疗作用[5]。……