加味桂枝加葛根汤治疗非特异性下腰痛寒湿证的临床研究

苏丽湘 廖向荣 林谦 何剑荣 黄培良 丁有奕 周树珊 黄少妮 林丽莉

摘要：目的 觀察加味桂枝加葛根汤治疗非特异性下腰痛（NLBP）寒湿证患者的临床疗效。方法 将符合NLBP的120例患者，按随机原则分为治疗组60例与对照组60例。治疗组给予加味桂枝加葛根汤，对照组给予双氯芬酸钠缓释片，2组的疗程均为10 d，记录2组患者治疗前后及治疗后1个月、3个月的VAS评分、ODI评分、中医证候积分、疗效及复发率。结果 治疗组治疗后、治疗后1个月、3个月的VAS评分、ODI评分、中医证候积分与治疗前比较，差异有统计学意义（P<0.05），治疗后VAS评分与对照组比较，差异无统计学意义（P>0.05），治疗后ODI、中医证后积分与对照组比较，差异有统计学意义（P<0.05）;治疗后1个月、3个月，治疗组的VAS、ODI及中医证候积分与对照组比较，差异均有统计学意义（P<0.05）。治疗组临床疗效总有效率为95%，对照组83.3%，两者差异有统计学意义（P<0.05）;随访3个月治疗组复发率21.7%，对照组复发率68.3%，差异有统计学意义（P<0.05）。结论 加味桂枝加葛根汤治疗非特异性下腰痛疗效确切，远期疗效好，复发率低，值得临床进一步研究和推广。

关键词：加味桂枝加葛根汤;非特异性下腰痛;临床疗效;复发

中图分类号：R681.5   文献标志码：B   文章编号：1007-2349（2021）07-0029-04

Clinical Study on Modified Cassia Twig and Pueraria Decoction in the Treatment ofNon-specific Low Back Pain Patients with Cold-Dampness Syndrome

SU Li-xiang， LIAO Xiang-rong， LIN Qian， HE Jian-rong， HUANG Pei-liang，DING You-yi， ZHOU Shu-shan， HUANG Shao-ni， LIN Li-li

（The Central Hospital of Chaozhou City， Chaozhou 521000， China）

【Abstract】Objective： To observe the clinical effect of modified Cassia twig and Pueraria Decoction in the treatment of non-specific low back pain （NLBP） patients with cold-damp syndrome. Methods： 120 patients who met NLBP criteria were randomly divided into a treatment group and a control group， 60 cases per group. The treatment group was given modified Cassia twig and Pueraria Decoction and the control group was given diclofenac sodium sustained-release tablets. The two groups had a 10-day course of treatment. The VAS scores and ODI scores of the two groups were recorded before and after treatment and the TCM syndrome score， curative effect and recurrence rate after treatment and after 1-month and 3-month treatment were compared with those of the prior treatment. Results： The VAS score， ODI score， TCM syndrome score of the treatment group after treatment and after 1-month and 3-month treatment were compared with those of the prior treatment and the difference was statistically significant （P<0.05）. The VAS score after treatment was compared with that of the control group and the difference was not statistically significant （P>0.05）. After treatment， the ODI and TCM scores of the treatment group were compared with those of the control group， and the difference was statistically significant （P<0.05）. After 1-month and 3-month treatment， the VAS， ODI and TCM syndrome scores of the treatment group were compared with those of the control group， and the difference was statistically significant （P<0.05）. The total clinical effective rate of the treatment group was 95% and that of the control group was 83.3%， and the difference was statistically significant （P<0.05）. The recurrence rate of the treatment group was 21.7% and the control group was 68.3% by a 3-month follow-up and the difference was statistically significant （P<0.05）. Conclusion： Modified Cassia twig and Pueraria Decoction has a definite curative effect in the treatment of non-specific low back pain patients， with good long-term curative effect and low recurrence rate， and is worthy of further clinical research and application.

【Key words】Modified Cassia Twig and Pueraria Decoction; Non-specific Low Back Pain; Clinical Effect; Recurrence

下腰痛是临床常见疾病之一，非特异性下腰痛（Nonspeciifc Low Back Pian，NLBP）在腰痛疾病中占很大的比重，约85%腰痛属于非特异性腰痛[1]，是指排除已知的特异性病理变化，没有确切病因所引起的后背及下腰部疼痛或不适感，可伴或不伴有下肢放射痛，其病程常大于3个月。据文献报道，高达70%～85%的人曾患有下腰痛的经历，对患者个人的生活质量及工作造成了严重影响[2]。目前尚没有针对病因治疗 NLBP的特异性治疗手段。笔者在临床诊治中，采用加味桂枝加葛根汤治疗寒湿证非特异性下腰痛，常取得满意疗效，现将加味桂枝加葛根汤与口服双氯芬酸钠缓释片进行比较，报道如下。

1 资料与方法

1.1 一般资料 本次研究符合NLBP的120例患者来源于本院2019年1月—2020年12月骨科及中医门诊，按随机原则分为治疗组60例与对照组60例。……