独活寄生汤加减对改善肝肾亏虚型腰椎间盘突出症患者疼痛和焦虑的效果

Effect of Duhuo Jisheng Decoction on improving pain and anxiety in patients with lumbar disc herniation due to deficiency of liver and kidney

摘要:

目的 研究独活寄生汤加减对肝肾亏虚型腰椎间盘突出症患者疼痛和焦虑的改善效果。 方法 选取西南医科大学附属中医医院骨伤科2018年1月至2019年1月收治的 92 例肝肾亏虚型腰椎间盘突出症患者，依据患者住院号的单双号不同分为观察组及对照组。对照组采用常规保守治疗，观察组在对照组基础上实施辨证加减口服独活寄生汤。于治疗前及治疗后2、4周采取疼痛视觉模拟评分（VAS）、日本骨科学会下腰痛（JOA） 评分及焦虑自评量表（SAS）分别评估患者的疼痛程度和焦虑状态。 结果 治疗2周及4周观察组患者的疼痛和焦虑评分均明显低于对照组，JOA分值明显高于对照组，差异均具有统计学意义（P < 0.05）。 结论 肝肾亏虚型的腰椎间盘突出症患者疼痛常伴有较多焦虑状态，予以独活寄生汤加减口服治疗，通过滋水涵木，补益肝肾，肝肾得充，肝疏气畅，气机畅达而能明显减轻患者的疼痛、改善腰部功能、缓解焦虑状态。

Abstract:

Objective To investigate the relief of pain and anxiety in patients with lumbar disc herniation （LDH） due to deficiency of liver and kidney after treatment with Duhuo Jisheng Decoction. Methods A total of 92 cases of LDH with deficiency of liver and kidney who were admitted to the Department of Orthopedics and Traumatology，the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University，from January 2018 to January 2019. The patients were randomly divided into observation group and control group according to their odd or even admission number. The two groups were both treated with conventional conservative treatment，while the observation group was orally given modified Duhuo Jisheng Decoction after syndrome differentiation by a doctor of Chinese medicine. Before treatment，at 2 weeks after treatment，and at 4 weeks after treatment，the visual analogue scale for pain，the Japan Orthopaedic Association （JOA） low back pain scoring system，and the Self-Rating Anxiety Scale were used to evaluate the patients’ pain degree and anxiety state. Results At 2 and 4 weeks after treatment，the observation group had significantly lower pain and anxiety scores and a significantly higher JOA score compared with the control group （P < 0.05）. Conclusion The patients with LDH due to liver and kidney deficiency often had pain accompanied by anxiety. The oral administration of modified Duhuo Jisheng Decoction can nourish the liver and kidney by nourishing water to moisten wood； once the liver and kidney are filled，the liver and Qi are smooth，and the Qi movement is unobstructed，which can significantly relieve the patient’s pain，improve the lumbar function，and alleviate the anxiety state.