王惠庭 张奕标 何丽丽 龚晓芳 许沛鑫 黄彩珍

【摘 要】 目的：观察中药定向透药联合功能锻炼协同干预慢性腰痛患者的临床效果。方法：选取72例慢性腰痛患者，随机分为对照组（n=36例）和观察组（n=36例）。对照组给予腰腹肌功能锻炼联合双氯芬酸钠缓释片口服;观察组给予腰腹肌功能锻炼联合中药定向透药，两组均连续干预2周。观察两组腰椎疼痛、腰椎功能、腰椎活动度变化，监测血清中炎症因子水平。结果：治疗后，观察组VAS评分、ODI显著低于对照组（P<0.05）;观察组的腰椎活动度改善优于对照组，腰椎右屈、左屈、后伸、前屈度明显大于对照组（P<0.05）;观察组的血清中IL-1β、TNF-α、TXB2水平均低于对照组（P<0.05）。结论：中药定向透药联合功能锻炼协同干预更利于减轻慢性腰痛患者的痛感，提高腰椎功能，改善腰椎关节活动度，降低血清中IL-1β、TNF-α、TXB2等炎症因子水平。

【关键词】 慢性腰痛;中药定向透药;功能锻炼;腰椎功能

【中图分类号】R681.5+5   【文献标志码】 A    【文章编号】1007-8517（2021）09-0104-03

Abstract：Objective To observe the clinical effect of Chinese traditional medicine directed permeation therapy combined with functional exercise in chronic lumbago.Methods 72 patients with chronic low back pain who visited our hospitalwere randomly divided into control group （n=36） and observation group （n=36）. Patients in the control group were given psoas abdominal muscle function exercise combined with diclofenac sodium sustained release tablets orally， and patients in the observation group were given psoas abdominal muscle function exercise combined with traditional Chinese medicine directed permeation. Patients in both groups were continuously interfered for 2 weeks. The changes of lumbar pain， lumbar function and lumbar mobility in the two groups were observed， and the levels of inflammatory factors in the serum were monitored.Results After treatment， the VAS score and ODI of the observation group were significantly lower than those of the control group （P<0.05）. The improvement of lumbar mobility in the observation group was better than that in the control group， and the right flexion， left flexion， posterior extension and anterior flexion of the lumbar spine were significantly greater than that of the control group （P<0.05）. The serum levels of IL-1β，TNF-αand TXB2 in the observation group were all lower than those in the control group （P<0.05）.Conclusion Chinese traditional medicine directed permeation therapy combined with functional exercise is more conducive to alleviating the pain of patients with chronic low back pain， improving lumbar function， improving lumbar joint range of motion， and reducing serum levels of IL-1β， TNF-αand TXB2.

Keywords：Chronic Low Back Pain; Directional Permeation of Traditional Chinese Medicine; Functional Exercise; Lumbar Function

慢性腰痛（Chronic low back pain，CLBP）是臨床常见病，患者以反复发作的腰骶部疼痛为主症，伴有酸胀、麻木等不适感，缠绵难愈的痛感严重影响患者的生活质量，是成人生产力降低、活动受限的主要原因之一[1]。目前，西医主要给予局部封闭药物、非甾体抗炎药等对症处理，能一定程度上能缓解疼痛，但易于复发，效果不甚理想[2]。因此，探究有效的根治镇痛方案是临床诊治CLBP的关键。近年来，我院采用中药定向透药联合功能锻炼协同干预慢性腰痛患者，收效满意，现报道如下。

1 资料与方法

1.1 一般资料 选取2019年1月至2019年6月就诊于我院的72例慢性腰痛患者为研究对象，随机分为对照组和观察组。对照组36例，其中男13例，女23例;年龄25～70岁，平均年龄（36.42±3.11）岁;病程6个月至5年，平均病程（1.47±0.35）年;观察组36例，其中男15例，女21例;年龄25～70岁，平均年龄（37.02±3.21）岁;病程6个月至7年，平均病程（1.51±0.21）年;两组一般资料经统计分析，差异均无统计学意义（P>0.05），具有可比性。