【摘要】 目的 研究补气活血方治疗气滞血瘀型腰椎间盘突出症（LDH）的效果及其对炎症因子水平的影响。方法 选择2022年3月至2023年6月浙江中医药大学附属金华中医院气滞血瘀型LDH患者90例，采用随机数表法分为对照组、观察1组、观察2组，每组各30例。对照组采用口服塞来昔布胶囊治疗，观察1组采用口服补气活血方治疗，观察2组采用口服塞来昔布胶囊联合补气活血方治疗，三组均连续治疗3周。观察并比较三组间中医病症疗效有效率、健康调查简表（SF-36）、疼痛视觉模拟评分法（VAS）、日本骨科学会下腰痛评分（JOA）、血清炎症因子白细胞介素（IL）-1、IL-6和肿瘤坏死因子-α(TNF-α)的差异。结果 三组患者均完成了治疗及随访。治疗前三组间SF-36评分、VAS评分、JOA评分、血清炎症因子IL-1、IL-6和TNF-α水平比较，差异均无统计学意义（P > 0.05）。治疗后8周，观察1组及观察2组总有效率及SF-36评分高于对照组，差异有统计学意义（P<0.05）；观察1组与观察2组两组间差异无统计学意义（P > 0.05）。治疗后3、8周，观察1组及观察2组VAS评分低于对照组，差异有统计学意义（P<0.05）;JOA评分高于对照组，差异有统计学意义（P<0.05）；观察1组与观察2组两组间VAS评分、JOA评分差异无统计学意义（P > 0.05）。治疗后1周，观察2组的IL-1、IL-6和TNF-α水平低于对照组，差异有统计学意义（P<0.05）；治疗后3周，观察1组及观察2组的IL-1、IL-6和TNF-α水平均低于对照组，差异有统计学意义（P<0.05）。结论 补气活血方可有效缓解气滞血瘀型LDH患者的疼痛症状、改善活动功能、降低血清炎症指标、改善生活质量。更多还原

【Abstract】 Objective To study the curative effect of Buqi Huoxue Prescription on LDH of qi stagnation and blood stasis type and its influence on inflammatory factors. Methods Ninety cases of LDH of qi stagnation and blood stasis type from Traditional Chinese Medical Hospital of Jinhua Affiliated to Zhejiang University of Chinese Medicine during March 2022 to June 2023 were randomly divided into control group, observation group 1 and observation group 2, 30 cases in each group. The control group was treated with celecoxib capsule, the observation group 1 was treated with Buqi Huoxue Prescription, and the observation group 2 was treated with celecoxib capsule combined with Buqi Huoxue Prescription. All three groups were treated continuously for three weeks. The effective rates of TCM symptoms, the MOS item short form health survey(SF-36) score, visual analog scale(VAS) score, Japanese orthopaedic association scores(JOA) score, serum inflammatory factors( interleukin [IL]-1, IL-6, tumor necrosis factor-α [TNF-α]) were compared among the three groups. Results All patients completed treatment and follow-up. There were no significant difference in SF-36 score, VAS score, JOA score,serum levels of IL-1, IL-6 and TNF-α among the three groups before treatment(P > 0.05). After eight weeks of treatment, the total effective rates and SF-36 scores of observation group 1 and observation group 2 were higher than those of control group(P < 0.05). There was no significant difference between observation group 1 and observation group 2(P > 0.05). Three and eight weeks after treatment, the scores of VAS in observation group 1 and observation group two were lower than control group(P < 0.05), and the scores of JOA higher than control group(P < 0.05), and there were no significant differences between observation group 1 and observation group 2(P > 0.05). One week after treatment, the levels of IL-1, IL-6 and TNF-α in observation group 2 were lower than those in control group(P < 0.05). Three weeks after treatment, the levels of IL-1, IL-6 and TNF-α of observation group 1 and observation group 2 were lower than those of control group(P < 0.05). Conclusion Buqi Huoxue Prescription can effectively relieve the pain symptom, improve the activity function, reduce the serum inflammatory level and improve the quality of life of patients with LDH of qi stagnation and blood stasis type.更多还原