目的 探讨寒湿痹阻型腰椎间盘突出症患者射频消融术后应用腰痛宁胶囊治疗的临床效果。方法 将2020年1月-2021年12月唐山工人医院收治的120例寒湿痹阻型腰椎间盘突出症患者按随机数字表法分为治疗组和对照组,每组60例。对照组患者给予腰椎间盘射频消融术治疗,治疗组患者在腰椎间盘射频消融术基础上口服腰痛宁胶囊,比较治疗前及治疗14、30d两组患者血清转化生长因子-β1(transforming growth factor-β1,TGF-β1)、γ干扰素(interferon-γ,IFN-γ)水平,视觉模拟评分(visual analogue scale,VAS)和功能障碍指数(Oswestry disability index,ODI)评分及两组治疗后的临床疗效。结果 治疗前,两组患者血清TGF-β1、IFN-γ水平差异无统计学意义(P>0.05)。治疗14、30d后,两组患者血清TGF-β1、IFN-γ水平均明显低于治疗前,且治疗时间越长血清TGF-β1、IFN-γ水平越低,差异有统计学意义(P<0.05);且治疗14、30d后,治疗组患者血清TGF-β1、IFN-γ水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗前,两组VAS和ODI评分差异无统计学意义(P>0.05)。治疗14、30d后,两组的VAS和ODI评分均下降,两类评分随治疗时间的延长分值下降越明显,差异有统计学意义(P<0.05);且治疗14、30d后,治疗组VAS和ODI评分均低于对照组,差异有统计学意义(P<0.05)。治疗组总有效率93.33%,对照组总有效率81.67%,差异有统计学意义(P<0.05)。结论 腰痛宁胶囊联合腰椎间盘射频消融术与单纯腰椎间盘射频消融术相比,可有效缓解寒湿痹阻型腰椎间盘突出症患者腰腿疼痛症状、改善生活质量,这可能与下调患者血清中TGF-β1、IFN-γ水平相关。

Objective To explore the clinical effect of Yaotongning Capsules (腰痛宁胶囊) in the treatment of lumbar disc herniation with cold-damp arthralgia syndrome after radiofrequency ablation. Methods A total of 120 patients with lumbar disc herniation of cold-damp arthralgia syndrome treated in Tangshan Workers’ Hospital from January 2020 to December 2021 were randomly divided into treatment group and control group, with 60 cases in each group. The control group was treated with radiofrequency ablation of lumbar disc herniation. The treatment group was treated with Yaotongning Capsules on the basis of radiofrequency ablation of lumbar disc herniation. The serum transforming growth factor-β1 (TGF-β1) and interferon-γ (IFN-γ) levels, the visual analogue scale (VAS) and Oswestry disability index (ODI) scores were compared between the two groups before treatment and 14 and 30 d after treatment and the clinical efficacy of the two groups after treatment. Results Before treatment, there was no significant difference between the two groups in the levels of serum TGF-β1 and IFN-γ (P> 0.05), but after 14 and 30 d of treatment, the serum levels of TGF-β1 and IFN-γ in both groups were significantly lower than those before treatment, and the serum levels of TGF-β1 and IFN-γ were decreased gradually with the prolongation of treatment time, there was a significant difference between the two groups (P< 0.05), and after 14 and 30 d of treatment, the levels of serum TGF-β1 and IFN-γ in the treatment group were significantly lower than those in the control group (P< 0.05). Before treatment, there was no significant difference in Vas and ODI scores between the two groups (P> 0.05) , but after 14 and 30 d of treatment, the VAS and ODI scores of both groups decreased, and the changes of the two kinds of scores significant decreased with the prolongation of treatment time (P< 0.05), and after 14 and 30 d of treatment, the VAS and ODI scores of the treatment group were lower than those of the control group (P< 0.05). The total effective rate was 93.33% in the treatment group and 81.67% in the control group, the difference was significant (P< 0.05). Conclusion Compared with simple lumbar disc herniation radiofrequency ablation, Yaotongning Capsules combined with radiofrequency ablation can effectively relieve the symptoms of lumbocrural pain and improve the quality of life in patients with lumbar disc herniation of cold-damp arthralgia syndrome, this may be related to the down-regulation of serum levels of TGF-β1 and IFN-γ.

R285.64

河北省中医药管理局项目（2020428）