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[1]王曉東,于杰,李嘉鈺,等.益腎養(yǎng)髓方聯(lián)合甲鈷胺治療脊髓型頸椎病肝腎虧虛證的臨床研究[J].中醫(yī)正骨,2019,31(02):26-30.
　WANG Xiaodong,YU Jie,LI Jiayu,et al.A clinical study of oral applications of Yishen Yangsui Fang(益腎養(yǎng)髓方)and mecobalamin for treatment of cervical spondylotic myelopathy with liver-kidney deficiency syndrome[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2019,31(02):26-30.
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益腎養(yǎng)髓方聯(lián)合甲鈷胺治療脊髓型頸椎病肝腎虧虛證的臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第31卷
期數(shù):
2019年02期
頁碼:
26-30
欄目:
臨床研究
出版日期:
2019-02-20

文章信息/Info

Title:
A clinical study of oral applications of Yishen Yangsui Fang(益腎養(yǎng)髓方)and mecobalamin for treatment of cervical spondylotic myelopathy with liver-kidney deficiency syndrome
作者:
王曉東1; 于杰2; 李嘉鈺1; 張玉亮1; 金鴻賓3
(1.天津中醫(yī)藥大學第一附屬醫(yī)院,天津 300193; 2.中國中醫(yī)科學院望京醫(yī)院,北京 100102; 3.天津市天津醫(yī)院,天津 300211)
Author(s):
WANG Xiaodong1; YU Jie2; LI Jiayu1; ZHANG Yuliang1; JIN Hongbin3
1.The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300193,China 2.Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China; 3.Tianjin Hospital,Tianjin 30021,China
關(guān)鍵詞:
頸椎病;  益腎養(yǎng)髓方;  甲鈷胺;  臨床試驗
Keywords:
cervical spondylosis;  Yishen Yangsui decoction;  Mecobalamin;  clinical trial
摘要:
目的:觀察益腎養(yǎng)髓方和甲鈷胺聯(lián)合應用治療脊髓型頸椎病肝腎虧虛證的臨床療效和安全性。方法:將符合要求的脊髓型頸椎病肝腎虧虛證患者隨機分為2組,益腎養(yǎng)髓方組口服益腎養(yǎng)髓方顆粒和甲鈷胺片,甲鈷胺組口服甲鈷胺片和安慰劑。益腎養(yǎng)髓方顆粒每次口服10 g,每日2次,連服8周; 甲鈷胺片每次口服0.5 mg,每日3次,連服8周; 安慰劑每次口服10 g,每日2次,連服8周。分別于治療前、治療開始4周后、治療結(jié)束后進行觀察。觀察指標包括日本骨科學會(Japanese Orthopedic Association,JOA)脊髓型頸椎病評分、頸椎功能障礙指數(shù)(the neck disability index,NDI)、心率、血壓、脈搏、呼吸及不良反應。治療結(jié)束后參照《中藥新藥臨床研究指導原則(試行版)》中頸椎病的療效判定標準評定總體療效。結(jié)果:①一般情況。納入研究的患者共100例,每組各50例。試驗過程中有8例患者被剔除,其中益腎養(yǎng)髓方組2例、甲鈷胺組6例,原因均為患者未按要求服藥或未能堅持治療。2組最終納入的患者在各觀察時點的心率、血壓、脈搏、呼吸指標均未見異常,也未出現(xiàn)其他不良反應。②JOA評分。時間因素與分組因素存在交互效應(F=1.612,P=0.002)。2組JOA評分總體比較,差異無統(tǒng)計學意義,即不存在分組效應(F=0.746,P=0.325)。治療前后不同時點之間JOA評分的差異有統(tǒng)計學意義,即存在時間效應(F=0.878,P=0.034)。2組JOA評分隨時間變化均呈增加趨勢,但2組的增加趨勢不完全一致; 治療前及治療開始4周后,2組的JOA評分比較,組間差異均無統(tǒng)計學意義[(12.86±2.25)分,(13.63±1.63)分,t=0.520,P=0.660;(14.53±2.16)分,(14.06±1.71)分,t=0.720,P=0.367]; 治療結(jié)束后益腎養(yǎng)髓方組的JOA評分高于甲鈷胺組[(15.60±2.18)分,(14.21±1.75)分,t=0.976,P=0.031]。③NDI。時間因素與分組因素存在交互效應(F=1.601,P=0.000)。2組NDI總體比較,差異有統(tǒng)計學意義,即存在分組效應(F=1.021,P=0.000)。治療前后不同時點之間NDI的差異有統(tǒng)計學意義,即存在時間效應(F=1.018,P=0.001)。2組NDI隨時間變化均呈降低趨勢,但2組的降低趨勢不完全一致; 治療前2組的NDI比較,差異無統(tǒng)計學意義[(26.80±9.65)%,(30.55±14.19)%,t=0.766,P=0.304]; 治療開始4周后及治療結(jié)束后,益腎養(yǎng)髓方組的NDI均低于甲鈷胺組[(18.41±9.89)%,(27.82±14.34)%,t=0.989,P=0.014;(12.61±7.87)%,(23.87±13.26)%,t=0.999,P=0.000]。④總體療效。治療結(jié)束時益腎養(yǎng)髓方組的總體療效優(yōu)于甲鈷胺組((-overR)益腎養(yǎng)髓方組=29.83,(-overR)甲鈷胺組=64.68,Z=-6.580,P=0.000)。結(jié)論:益腎養(yǎng)髓方聯(lián)合甲鈷胺口服可有效改善脊髓型頸椎病肝腎虧虛證患者的臨床癥狀和體征,安全性較高,療效優(yōu)于單純口服甲鈷胺治療。
Abstract:
Objective:To observe the clinical curative effects and safety of oral applications of Yishen Yangsui Fang(益腎養(yǎng)髓方,YSYSF)and mecobalamin for treatment of cervical spondylotic myelopathy(CSM)with liver-kidney deficiency syndrome.Methods:The patients with liver-kidney-deficiency type CSM enrolled in the study were randomly divided into 2 groups,and were treated with combination therapy of oral applications of YSYSF granules and mecobalamin tablets(YSYSF group)and combination therapy of oral applications of mecobalamin tablets and placebos(mecobalamin group)respectively.The YSYSF granules were taken for consecutive 8 weeks,two times a day,10 g at a time.The mecobalamin tablets were taken for consecutive 8 weeks,three times a day,0.5 mg at a time.The placebos were taken for consecutive 8 weeks,two times a day,10 g at a time.Japanese Orthopedic Association(JOA)CSM scores,the neck disability index(NDI),heart rate,blood pressure,pulse,respiration and adverse reactions were observed before treatment,after 4-week treatment and after the end of the treatment respectively.The total curative effects were evaluated after the end of the treatment according to the therapeutic effect evaluation standard of cervical spondylopathy which was extracted from Guiding principles of clinical research on new Chinese medicine(try out).Results:One hundred patients were enrolled in the study,50 cases in each group.Two patients in YSYSF group and 6 patients in mecobalamin group were excluded for failing to take medication or finish the treatment as required.The examination results of heart rate,blood pressure,pulse and respiration were normal and no adverse reactions were found at each observation timepoint in patients of the 2 groups.There was interaction between time factor and group factor in JOA scores(F=1.612,P=0.002).There was no statistical difference in JOA scores between the 2 groups in general,in other words,there was no group effect(F=0.746,P=0.325).There was statistical difference in JOA scores between different timepoints before and after the treatment,in other words,there was time effect(F=0.878,P=0.034).The JOA scores presented a time-dependent increasing trend in both of the 2 groups,while the 2 groups were inconsistent with each other in the increasing trend of JOA scores.There was no statistical difference in JOA scores between the 2 groups before treatment and after 4-week treatment(12.86+/-2.25 vs 13.63+/-1.63 points,t=0.520,P=0.660; 14.53+/-2.16 vs 14.06+/-1.71 points,t=0.720,P=0.367).The JOA scores were higher in YSYSF group compared to mecobalamin group after the end of the treatment(15.60+/-2.18 vs 14.21+/-1.75 points,t=0.976,P=0.031).There was interaction between time factor and group factor in NDI(F=1.601,P=0.000).There was statistical difference in NDI between the 2 groups in general,in other words,there was group effect(F=1.021,P=0.000).There was statistical difference in NDI between different timepoints before and after the treatment,in other words,there was time effect(F=1.018,P=0.001).The NDI presented a time-dependent decreasing trend in both of the 2 groups,while the 2 groups were inconsistent with each other in the increasing trend of NDI.There was no statistical difference in NDI between the 2 groups before treatment(26.80+/-9.65 vs 30.55+/-14.19%,t=0.766,P=0.304).The NDI was lower in YSYSF group compared to mecobalamin group after 4-week treatment and after the end of the treatment(18.41+/-9.89 vs 27.82+/-14.34%,t=0.989,P=0.014; 12.61+/-7.87 vs 23.87+/-13.26%,t=0.999,P=0.000).The YSYSF group surpassed the mecobalamin group in total curative effect at the end of treatment((-overR)YSYSF group=29.83,(-overR)mecobalamin group=64.68,Z=-6.580,P=0.000).Conclusion:Oral applications of YSYSF and mecobalamin can effectively improve clinical symptoms and signs of patients with liver-kidney-deficiency type CSM,and its curative effect is better than that of monotherapy of oral application of mecobalamin,meanwhile it has high safty.

參考文獻/References:

[1] CUELLAR J,PASSIAS P.Cervical Spondylotic Myelopathy A Review of Clinical Diagnosis and Treatment[J].Bull Hosp Jt Dis,2017,75(1):21-29. [2] 唐勇,賈治偉,吳劍宏,等.脊髓型頸椎病預后相關(guān)因素的研究進展[J].中國骨傷,2016,29(3):216-219. [3] PARK M S,JU Y S,MOON S H,et al.Reoperation rates after anterior cervical discectomy and fusion for cervical spondylotic radiculopathy and myelopathy a National population-based study[J].Spine(Phila Pa 1976),2016,41(20):1593-1599. [4] 李增春,陳德玉,吳德升,等.第三屆全國頸椎病專題座談會紀要[J].中華外科雜志,2008,46(23):1796-1799. [5] 張麗美,師彬.頸椎病中醫(yī)辨證分型及中藥治療研究進展[J].中成藥,2013,35(7):1522-1525. [6] 任明達,劉樹學,郭永飛,等.脊髓損傷的MRI表現(xiàn)與Frankel分級相關(guān)性研究[J].中國傷殘醫(yī)學,2016,24(6):5-8. [7] RUDWALEIT M,LISTING J,BRANDT J,et al.Prediction of a major clinical response(BASDAI 50)to tumour necrosis factor alpha blockers in ankylosing spondylitis[J].Ann Rheum Dis,2004,63(6):665-670. [8] 伍少玲,馬超,伍時玲,等.頸椎功能障礙指數(shù)量表的效度與信度研究[J].中國康復醫(yī)學雜志,2008,23(7):625-628. [9] 鄭筱萸.中藥新藥臨床研究指導原則(試行版)[M].北京:中國醫(yī)藥科技出版社,2002:349. [10] ANWAR M A,AL SHEHABI T S,EID A H.Inflammogenesis of secondary spinal cord injury[J].Front Cell Neurosci,2016,10(98):1-24. [11] ZHAO C M,CHEN Q,ZHANG Y,et al.Anterior cervical discectomy and fusion versus hybrid surgery in multilevel cervical spondylotic myelopathy A meta-analysis[J].Medicine(Baltimore),2018,97(34):e11973. [12] 郭耀,霍建忠.保守與手術(shù):脊髓型頸椎病的治療方案[J].中華臨床醫(yī)師雜志(電子版),2016,10(5):732-735. [13] TONG M J,HU Y B,WANG X Y,et al.The Spinal Cord Line Can Predict Postoperative Recovery for Multilevel Cervical Spondylotic Myelopathy[J].World Neurosurg,2017,104:361-366. [14] 陳印磊,夏建龍,蔡平.中醫(yī)對脊髓型頸椎病的認識及治療進展[J].中醫(yī)藥臨床雜志,2018,30(10):1957-1961. [15] 睦順姬,葉秀蘭,姚敏,等.中醫(yī)藥治療脊髓型頸椎病的機理研究概況[J].世界中醫(yī)藥,2017,12(1):222-224.

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備注/Memo

備注/Memo:
基金項目:國家中醫(yī)藥管理局中醫(yī)藥行業(yè)科研專項項目(201407001) 通訊作者:李嘉鈺 E-mail:[email protected](收稿日期:2018-10-04 本文編輯:李曉樂)
更新日期/Last Update: 2019-02-20