杨淑荃 范德辉 卢桂梅 林湖广

【摘 要】 目的：观察“芍甘五藤汤”结合龙氏牵抖冲压法治疗腰椎间盘突出症的临床疗效。方法：将90例纳入病例随机分为对照组45例和观察组45例。对照组给予龙氏牵抖冲压法，观察组在此基础上加用“芍甘五藤汤”。采用简式McGill疼痛问卷（SF-MPQ）和改良日本骨科学会下腰痛评分表（M-JOA），评估患者腰腿疼痛、腰部功能变化及临床疗效。结果：观察组总有效率优于对照组（P<0.05）。治疗后两组SF-MPQ的疼痛分级指数、视觉模拟评分及现时疼痛强度评分较治疗前均降低（P<0.05），M-JOA的主观症状、临床体征、日常活动能力评分及JOA总分较治疗前均上升（P<0.05）。治疗后两组SF-MPQ和M-JOA的各项评分比较，差异均有统计学意义（P<0.05），观察组分值变化较对照组明显。结论：“芍甘五藤汤”结合龙氏牵抖冲压法治疗腰椎间盘突出症有较好的临床疗效，值得进一步推广。

【关键词】 芍甘五藤汤;牵抖冲压法;腰椎间盘突出症

【中图分类号】R681.5+3   【文献标志码】 A    【文章编号】1007-8517（2021）12-0119-04

Abstract：Objective To observe the clinical effect of “Shaoganwuteng Decoction” combined with Longshi prone traction，trembling and pressing method in patients with lumbar disc herniation. Methods 90 patients with lumbar disc herniation were randomly divided into two groups，45 in the observation group and 45 in the control group. In the control group，patients were given the treatment of Longshi prone traction，trembling and pressing method. In the observation group，patients were given “Shaoganwuteng Decoction” by Professor Luguimei on the basis of the control group. The patients were assessed with the simple McGill Pain Questionnaire （SF-MPQ） and the modified Japanese Orthopaedic Society low back pain scale （M-JOA） to assess the patients' low back and leg pain，changes in lumbar function and clinical effect. Results For clinical effect，the observation group was better than the control group （P<0.05）. The PRI，VAS and PPI scores of SF-MPQ in the two groups were lower than those before treatment （P<0.05）. The scores of subjective symptoms，clinical signs，daily activity ability and JOA in the two groups increased after treatment （P<0.05）. The scores in the observation group changed significantly compared with the control group after treatment （P<0.05）. Conclusion Professor Luguimei's “Shaoganwuteng Decoction” combined with Longshi prone traction，trembling and pressing method has a better clinical effect in the treatment of lumbar disc herniation and is worthy of further promotion in clinical treatment.

Keywords：Shaoganwuteng Decoction; Traction;Trembling and Pressing Method; Lumbar Disc Herniation

腰椎間盘突出症（Lumbar disc herniation，LDH）是椎间盘突出、压迫和刺激腰骶部神经及马尾神经引起的临床常见病症[1]，因病程较长、病情反复，严重干扰了患者的生活质量，甚者致其残废[2]。目前，西医主要有非手术治疗（卧床休息、腰椎牵引、物理疗法、口服西药及封闭注射等）、手术治疗（常规开放式和微创治疗为主）。但有研究[3]表明非手术治疗尚未达到满意疗效，2008年Cochrane协作网发现多数LDH勿需手术，经过保守治疗可痊愈[4]。近年来，中医药结合腰椎手法的干预模式被广泛应用于LDH。我国著名的脊柱病专家龙层花教授创立了龙氏治脊疗法，其传承人范德辉教授从事脊柱相关疾病的基础研究和中医临床工作多年，擅长运用俯卧牵抖冲压法治疗LDH。但是，基于此疗法的特效性，门诊患者需到医院就诊，由医务人员亲自操作。对于依从性较差、不能坚持疗程的患者不太合适，同时患者非就诊期间的疗效如何巩固，是临床医生需要考虑的问题。……