通络益肾汤联合推拿治疗坐骨神经痛临床研究

目的：观察通络益肾汤联合推拿治疗坐骨神经痛的临床效果。方法：将78例坐骨神经痛患者以随机数字表法分为观察组与对照组各39例。2组均给予对症治疗，对照组加推拿治疗，观察组在对照组基础上加通络益肾汤治疗，共治疗20 d。比较2组临床疗效，并比较2组治疗前后疼痛视觉模拟评分法（VAS） 评分、Oswestry功能障碍指数问卷表（ODI） 评分、坐骨神经痛不适指数（SBI） 评分及血清炎症因子、神经生长因子（NGF）、疼痛物质表达水平。结果：观察组总有效率97.44%，高于对照组82.05% （P＜0.05）。治疗后，2 组VAS、ODI、SBI评分均降低（P＜0.05），且观察组低于对照组（P＜0.05）。治疗后，2组血清白细胞介素-1β（IL-1β）、白细胞介素-6 （IL-6）、白细胞介素-8 （IL-8）、肿瘤坏死因子-α （TNF-α） 水平均降低（P＜0.05），且观察组低于对照组（P＜0.05）。治疗后，2组血清P物质（SP） 水平均降低（P＜0.05），且观察组低于对照组（P＜0.05）；2组NGF均升高（P＜0.05），且观察组高于对照组（P＜0.05）。结论：对坐骨神经痛患者以通络益肾汤联合推拿治疗可减轻患者疼痛程度，提高肢体功能，减少坐骨神经不适，进一步提升临床疗效，其作用机制可能与降低机体炎症反应、调节机体NGF及疼痛物质表达有关。

Clinical Study on Tongluo Yishen Decoction Combined with Tuina for Sciatica

Abstract：Objectives：To observe the clinical effect of Tongluo Yishen Decoction combined with tuinaon sciatica. Methods：A total of 78 cases of patients with sciatica were divided into the observation groupand the control group according to the random number table method， with 39 cases in each group. Bothgroups were given symptomatic treatment；the control group was additionally treated with tuina，and theobservation group was additionally treated with Tongluo Yishen Decoction based on the treatment of thecontrol group. Both groups were treated for 20 days. The scores of Visual Analogue Scale (VAS) for pain，Oswestry Disability Index (ODI)， and Sciatica Bothersomeness Index (SBI)， and the expression levels ofserum inflammatory factors，nerve growth factors (NGF)，and pain substance before and after treatment，as well as clinical effects were compared between the two groups. Results： The total effective rate was97.44% in the observation，higher than that of 82.05% in the control group (P＜0.05). After treatment，thescores of VAS， ODI， and SBI in the two groups were deceased (P＜0.05)， and the above scores in theobservation group were lower than those in the control group (P＜0.05). After treatment， the levels ofinterleukin-1β (IL-1β)，interleukin-6 (IL-6)，interleukin-8 (IL-8)，and tumor necrosis factor-α (TNF-α) in serum in the two groups were decreased (P＜0.05)， and the above levels in the observation group werelower than those in the control group (P＜0.05). After treatment，the level of serum substance P (SP) in thetwo groups were decreased (P＜0.05)， and the SP level in the observation group were lower than that inthe control group (P＜0.05)；the level of serum NGF in the two groups were increased (P＜0.05)，and theNGF level in the observaton group were higher than that in the control group (P＜0.05). Conclusion： Forpatients with sciatica， Tongluo Yishen Decoction combined with tuina can relieve their pain degree，improve limb function，reduce sciatic nerve discomfort and further improve clinical effects. The mechanismmay be related to reducing the body''s inflammatory responses，and regulating the expressions of NGF andpain substances.