目的 探讨采用根痛平胶囊与塞来昔布联合治疗腰椎间盘突出症的临床疗效及其对血清因子的影响，以期为临床中西医结合诊疗提供参考。方法 选取2023年11月—2025年12月洪湖市中医医院收治的124例腰间盘突出症患者，随机数字法将患者分为对照组和治疗组，每组各62例。对照组口服塞来昔布胶囊，0.2 g/次，1次/d。在对照组的基础上，治疗组口服根痛平胶囊，3片/次，3次/d。两组用药治疗4周。观察对比两组临床疗效，比较两组中医症状积分、日本骨科学会腰椎评价量表（JOA）、Oswestry功能障碍指数（ODI）、视觉模拟疼痛评分（VAS）、简明健康状况调查量表（SF-36）、5-羟色胺（5-HT）、白细胞介素-6（IL-6）、血浆血栓素B₂（TXB₂）、血清P物质（SP）水平及药物不良反应情况。结果 治疗后，治疗组总有效率明显高于对照组（96.77% vs 85.48%，P＜0.05）。治疗后，两组腰腿疼痛、腰部板硬、下肢麻木、肢体发凉等症状积分比治疗前均明显降低（P＜0.05）；且治疗后，与对照组对比，治疗组的腰腿疼痛、腰部板硬、下肢麻木、肢体发凉等状积分均降低更显著（P＜0.05）。治疗后，两组ODI评分、VAS评分比治疗前降低，而JOA评分、SF-36评分升高（P＜0.05）；且治疗后，与对照组对比，治疗组ODI评分、VAS评分、JOA评分和SF-36评分改善更明显（P＜0.05）。治疗后，两组血清5-HT、IL-6、TXB₂、SP水平比治疗前明显下降（P＜0.05）；且治疗后，与对照组对比，治疗组5-HT、IL-6、TXB₂、SP水平更低（P＜0.05）。结论 根痛平胶囊与塞来昔布协同治疗腰椎间盘突出症效果明显，可减轻腰部疼痛和炎症反应，有效改善腰椎功能，患者生活质量提升，且药物安全，值得借鉴与应用。

Objective To explore the clinical efficacy of Gentongping Capsules combined with celecoxib in treatment of lumbar disc herniation and its effects on serum-derived factors, so as to provide evidence-based references for integrated traditional Chinese and western medicine management in clinical practice. Methods A total of 124 patients diagnosed with lumbar disc herniation admitted to Honghu Hospital of Traditional Chinese Medicine, Hubei Province, between November 2023 and December 2025 were recruited and randomly allocated to a control group and a treatment group, with 62 patients in each group. Patients in the control group received oral celecoxib capsules at a dose of 0.2 g once daily. On this basis, the treatment group was additionally given Gentongping Capsules orally, 3 tablets per dose, three times a day. Both groups underwent a 4-week treatment course. The clinical therapeutic efficacy, traditional Chinese medicine (TCM) symptom scores, Japanese Orthopaedic Association (JOA) lumbar score, Oswestry Disability Index (ODI), Visual Analogue Scale (VAS), the 36-item Short-Form Health Survey (SF-36), serum 5-hydroxytryptamine (5-HT), interleukin-6 (IL-6), plasma thromboxane B₂ (TXB₂), serum substance P (SP), and drug-related adverse reactions were compared between the two groups. Results After treatment, the overall response rate was significantly higher in the treatment group than in the control group (96.77% vs. 85.48%, P < 0.05). After treatment, the symptom scores of lower back and leg pain, stiff waist, numbness in lower limbs, and coldness in limbs in both groups were significantly lower than those before treatment (P< 0.05), and after treatment, compared with control group, the symptom scores of lower back and leg pain, stiff waist, numbness in lower limbs, and coldness in limbs in treatment group decreased more significantly (P< 0.05). After treatment, the ODI scores, VAS scores of both groups were lower than those before treatment, while JOA scores, and SF-36 scores were higher (P < 0.05), and after treatment, compared with control group, the ODI scores, VAS scores, JOA scores, and SF-36 scores of treatment group improved more significantly (P < 0.05). After treatment, the levels of serum 5-HT, IL-6, TXB₂, and SP in both groups were significantly lower than those before treatment (P < 0.05), and after treatment, compared with control group, the levels of 5-HT, IL-6, TXB₂, and SP in treatment group were lower (P < 0.05). Conclusion Combined therapy with Gentongping Capsules and celecoxib produces satisfactory therapeutic effects on lumbar disc herniation. This synergistic regimen can relieve lumbar pain, suppress inflammatory responses, improve lumbar function and enhance patients’ quality of life with favorable safety profiles, which is worthy of clinical promotion and application.

R977

湖北省中医药管理局中医药科研项目（ZY2025L056）