目的 观察祛风止痛胶囊联合甲钴胺片治疗腰椎间盘突出症的临床疗效。方法 选择2020年6月—2021年6月天津市北辰区中医医院收治的120例腰椎间盘突出症患者，随机将患者分为对照组和治疗组，每组各60例。对照组口服甲钴胺片，1片/次，3次/d。治疗组在对照组基础上口服祛风止痛胶囊，6粒/次，2次/d。两组患者连续治疗2周。观察两组患者临床疗效，比较治疗前后两组患者日本骨科协会评估治疗（JOA）、视觉模拟量表（VAS）和Oswestry功能障碍指数（ODI）评分，及5-羟色胺（5-HT）、神经肽Y（NPY）、P物质（SP）、肿瘤坏死因子-α（TNF-α）、环氧合酶-2（COX-2）水平。结果 治疗后，治疗组的临床有效率为91.67%，明显高于对照组的71.67%（P＜0.05）。治疗后，两组患者JOA评分明显升高，而VAS、ODI评分明显下降（P＜0.05），且治疗组的改善效果优于对照组（P＜0.05）。治疗后，两组患者5-HT、NPY、SP、TNF-α、COX-2水平明显下降（P＜0.05），且治疗组明显低于对照组（P＜0.05）。结论 祛风止痛胶囊联合甲钴胺片治疗腰椎间盘突出症，可改善腰椎功能和生活自理能力，降低炎症因子、致痛因子的表达。

Objective To observe the clinical effect of Qufeng Zhitong Capsules combined with mecobalamin in treatment of lumbar disc herniation. Methods Patients (120 cases) with lumbar disc herniation in Tianjin Beichen Traditional Chinese Medicine Hospital from June 2020 to June 2021 were randomly divided into control and treatment group, and each group had 60 cases. Patients in the control group were po administered with Mecobalamin Tablets, 1 tablet/time, three times daily. Patients in the treatment group were po administered with Qufeng Zhitong Capsules on the basis of the control group, 6 grains/time, twice daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical evaluation was evaluated, the scores of JOA, VAS and ODI, and the levels of 5-HT, NPY, SP, TNF-α and COX-2 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 91.67%, which was significantly higher than that of the control group (71.67%, P < 0.05). After treatment, JOA scores in two groups were significantly increased, while VAS and ODI scores were significantly decreased (P < 0.05), and the improvement effect of the treatment group was better than that of the control group (P < 0.05). After treatment, the levels of 5-HT, NPY, SP, TNF-α and COX-2 in two groups were significantly decreased (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Qufeng Zhitong Capsules combined with mecobalamin in treatment of lumbar disc herniation can improve lumbar function and self-care ability, and reduce the expression of inflammatory factors and pain-causing factors.

R982

天津市北辰区科技计划项目(SHGY2020046)