独活寄生汤联合推拿治疗慢性非特异性下腰痛的临床效果及对腰背功能和血清IL-1β、IL-6、TNF-α的影响*

Clinical efficacy of Duhuo Jisheng Decoction combined with Tuina for chronic nonspecific low back pain and its effects on lumbar function and serum IL-1β，IL-6，and TNF-α

关键词:  独活寄生汤  推拿  慢性非特异性下腰痛  中医证候  腰背功能

Key words:  Duhuo Jisheng Decoction  Tuina  chronic non-specific lower back pain  traditional Chinese medicine syndrome  lower back function

摘要:

[目的] 探究独活寄生汤联合推拿治疗慢性非特异性下腰痛（CNLBP）的临床效果及腰背功能和血清白细胞介素（IL）-1β、IL-6、肿瘤坏死因子-α（TNF-α）的影响。[方法] 选取于邢台市中心医院治疗的126例CNLBP患者，采用随机数字表法分为推拿组和联合组，每组63例。推拿组采用中医推拿手法治疗，联合组采用独活寄生汤联合推拿治疗。比较两组临床效果、中医证候积分、腰背功能、血清炎症因子（IL-1β、IL-6、TNF-α）水平及不良反应发生率。[结果] 联合组患者的总有效率为95.24%，显著高于推拿组的76.19%（P＜0.05）；治疗后，两组中医证候积分、腰背屈/伸比（F/E）、血清IL-1β、IL-6及TNF-α水平均下降，且联合组显著低于推拿组（P＜0.05）；治疗后，峰力矩（PT）、腰背伸展状态平均功率（AP）均上升，且联合组显著高于推拿组（P＜0.05）；两组均无不良反应发生。[结论] 独活寄生汤联合推拿治疗CNLBP能够发挥良好的临床效果，有效缓解患者中医证候，恢复患者腰背功能，有效抑制相关炎症因子的释放，控制病情发展，安全性高。

Abstract:

[Objective] To investigate the clinical efficacy of Duhuo Jisheng Decoction combined with Tuina in treating chronic non-specific lower back pain（CNLBP），and its impacts on lower back function and serum levels of interleukin-1β（IL-1β），interleukin-6（IL-6），and tumor necrosis factor-α（TNF-α）. [Methods] A total of 126 patients with CNLBP treated in Xingtai Central Hospital were stochastically grouped into a Tuina group and a combination group using a random number table，with 63 cases in each group. The Tuina group was treated with traditional Chinese Tuina techniques，while the combination group was treated with Duhuo Jisheng Decoction combined with Tuina. Two groups were compared in terms of clinical efficacy，traditional Chinese medicine syndrome score，lower back function，serum levels of inflammatory factors（IL-1β，IL-6，TNF-α），and incidence of adverse reactions. [Results] The total effective rate of the combination group was 95.24%，significantly higher than the 76.19% of the Tuina group（P＜0.05）. After treatment，the scores of traditional Chinese medicine syndrome，back flexion/extension ratio（F/E），serum IL-1β，IL-6，and TNF-α levels in both groups decreased，and the combination group was significantly lower than the Tuina group（P＜0.05）. After treatment，peak torque（PT） and the average power under lumbar and back extension（AP） increased，and the combination group was significantly higher than the Tuina group（P＜0.05）. No adverse reactions occurred in either group. [Conclusion] The combination of Duhuo Jisheng Decoction and Tuina can achieve good clinical effects in treating CNLBP，it can effectively alleviate traditional Chinese medicine syndrome，restore their lower back function，effectively inhibit the release of related inflammatory factors，control the development of the disease，and has high safety.