目的 探究腰痛宁胶囊治疗寒湿痹阻型椎间盘源性腰痛患者的临床效果。方法 选取2021年2月—2023年1月承德医学院附属医院收治的符合纳入标准的70例椎间盘源性腰痛患者，按照治疗方式不同分为对照组（常规治疗，n=35）和研究组（常规治疗+腰痛宁胶囊，n=35）。两组的治疗周期均为4周。对比两组患者的治疗效果、中医证候积分、疼痛情况[数字评分量表（NRS）]、腰部功能改善情况[日本骨科学会（JOA）评分、Oswestry功能障碍指数（ODI）]、疼痛介质[β-内啡肽（β-EP）、前列腺素E2(PGE2)、P物质（SP）]、炎症指标[白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)]差异。结果 治疗后，研究组的总有效率为97.14%，高于对照组的80.00%(P<0.05)；两组患者下腰疼痛、僵硬麻木、肢体肿胀等各项中医证候积分均低于同组治疗前，且研究组低于对照组（P<0.05）；两组患者治疗后的NRS评分低于同组治疗前，且研究组疼痛程度评分低于对照组（P<0.05）；两组患者JOA评分高于同组治疗前，研究组患者的JOA评分高于对照组，两组患者ODI评分明显低于同组治疗前，且研究组ODI评分低于对照组（P<0.05）；两组患者治疗后疼痛介质β-EP水平高于同组治疗前，且研究组高于对照组，两组患者治疗后PGE2、SP水平低于同组治疗前，且研究组低于对照组（P<0.05）；两组患者治疗后炎症指标IL-1β、TNF-α、NLRP3水平低于同组治疗前，且研究组炎症指标水平均低于对照组（P<0.05）。结论 腰痛宁胶囊治疗寒湿痹阻型椎间盘源性腰痛患者效果显著，可降低患者的中医证候积分评分，减轻患者疼痛程度，改善患者的腰部功能，调节疼痛介质水平并抑制炎症反应。

Objective To explore the clinical curative effect of Yaotongning Capsule in patients with discogenic low back pain（DLBP） of cold-damp arthralgia syndrome. Methods The clinical data were collected from 70 patients with DLBP in the affiliated Hospital of Chengde Medical University from February 2021 to January 2023. According to random number table, patients were divided into control group（routine treatment, n= 35） and study group（Yaotongning capsules + routine treatment, n= 35）. All patients were treated for 4 weeks. The curative effect, scores of TCM syndromes, pain [numerical rating scale（NRS）], improvement of lumbar function [Japanese Orthopaedic Association（JOA）, Oswestry Disability Index（ODI）], pain mediators [β-endorphin（β-EP）, prostaglandin E2（PGE2）, substance P（SP）] and inflammatory indexes [interleukin-1β（IL-1β）, tumor necrosis factor-α（TNF-α）, nucleotide-binding oligomerization domain-like receptor protein 3（NLRP3）] in the two groups were compared. Results After treatment, total response rate of study group was higher than that of control group（97.14% vs 80.00%, P＜0.05）. After treatment, scores of TCM syndromes （low back pain, stiffness and numbness, limb swelling） were decreased in both groups, which were lower in study group than control group（P＜0.05）. After treatment, NRS score was decreased in both groups, which was lower in study group than control group（P＜0.05）. After treatment, JOA score was increased in both groups, which was higher in study group than control group, while ODI score was significantly decreased, which was lower in study group than control group（P＜0.05）. After treatment, β-EP level was increased in both groups, which was higher in study group than control group, while levels of PGE2 and SP were decreased, which were lower in study group than control group（P＜0.05）. After treatment, levels of IL-1β, TNF-α and NLRP3 were decreased in both groups, which were lower in study group than control group（P＜0.05）. Conclusion Curative effect of Yaotongning Capsule is significant in patients with DLBP of cold-damp arthralgia syndrome, which can reduce scores of TCM syndromes, relieve pain, improve lumbar function, regulate levels of pain mediators and inhibit inflammatory response.

R285.64

河北省承德市科学技术研究与发展计划项目(202006A031)