苏海明 林廷章

[摘要] 目的 研究溫经药酒外敷配合中药穴位注射用于腰椎间盘突出症的价值。方法 随机选择该院2015年9月—2018年9月收治的60例腰椎间盘突出症患者作为研究对象，抽签分为观察组和对照组，每组30例，对照组在常规治疗基础上行中药穴位注射治疗，而观察组在对照组的基础上外敷温经药酒，对比两组临床疗效，对比两组治疗前后视觉模拟评分（VAS）、现实疼痛强度评分（PPI）、情感项总分（A-PRI）、疼痛评级总分（T-PRI）、肿瘤坏死因子（TNF-α）、血浆P物质（SP）、白细胞介素-1（IL-1）差异，另外对比两组不良反应发生情况。结果 观察组临床疗效总有效率（90.00%）明显高于对照组（66.67%），差异有统计学意义（χ2=4.812，P<0.05）。观察组治疗后VAS、PPI、TPRI、APRI均明显低于治疗前及对照组治疗后，差异有统计学意义（P<0.05）。观察组治疗后TNF-α、SP、IL-1水平均明显低于治疗前及对照组治疗后，差异有统计学意义（P<0.05）。观察组不良反应发生率6.67%与对照组16.67%对比差异无统计学意义（χ2=0.647，P>0.05）。 结论 外敷温经药酒配合中药穴位注射治疗腰间盘突出症有较好的疗效，且安全性良好。

[关键词] 温经药酒;穴位推注;腰椎间盘突出症

[Abstract] Objective To study the value of external application of Wenjing medicinal wine combined with acupoint injection of traditional Chinese medicine for lumbar disc herniation. Methods Sixty patients with lumbar disc herniation who were treated in the hospital from September 2015 to September 2018 were randomly selected as the research objects. The lottery was divided into observation group and control group， 30 cases in each group. The control group received traditional Chinese medicine acupoint injection on the basis of conventional treatment， while the observation group applied warm medicinal liquor on the basis of the control group， compared the clinical efficacy of the two groups， compared the visual analogue score （VAS）， realistic pain intensity score （PPI）， and total emotional score （A- PRI）， total pain rating （T-PRI）， tumor necrosis factor （TNF-α）， plasma substance P （SP）， and interleukin-1 （IL-1） were different， and the adverse reactions of the two groups were compared. Results The total effective rate of clinical efficacy in the observation group （90.00%） was significantly higher than that in the control group （66.67%）， and the difference was statistically significant （χ2=4.812， P<0.05）. After treatment， the VAS， PPI， TPRI， and APRI in the observation group were significantly lower than before treatment and after treatment in the control group， and the differences were statistically significant （P<0.05）. The levels of TNF-α， SP and IL-1 in the observation group after treatment were significantly lower than those before treatment and after treatment in the control group， and the differences were statistically significant （P<0.05）. The incidence of adverse reactions in the observation group was 6.67% and there was no significant difference between the control group and 16.67%（χ2= 0.647， P>0.05）. Conclusion External Application of Warm Menstruation Medicine wine combined with acupoint injection of traditional Chinese medicine has good curative effect， good safety.

[Key words] Warm menstruation medicine; Acupoint bolus injection; Lumbar disc herniation

腰椎间盘突出症（LDH）属于临床医学中较为常见的疾患，症状一般表现为腰疼伴下肢放射性疼痛，病重者可致肌肉瘫痪，严重影响患者的生活质量[1]。研究表明，国内大约10%～15%的腰痛门诊患者被诊断为腰椎间盘突出，其中男性患者占到该病发病人数的85%以上，左侧患病率60%以上，其发病率在常见慢性病中高居第7[2]。目前治疗LDH多行及穴位注射，但存在见效慢，病程拖沓等不足[3-4]。中医在LDH的治疗中历史悠久，经验丰富，温经药酒为常见中医理血剂，其有温经散寒，养血祛瘀的功效。为比较温经药酒外敷配合中药穴位注射的疗效，该研究随机选择该院2015年9月—2018年9月收治的60例腰椎间盘突出症患者作为研究对象，结果较为满意，现报道如下。……