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[1]沈興潮,夏炳江,凌義龍,等.五福飲加減治療盤源性腰痛的臨床研究[J].中醫(yī)正骨,2020,32(02):23-29.
　SHEN Xingchao,XIA Bingjiang,LING Yilong,et al.A clinical study of Wufu Yin Jiajian(五福飲加減)for treatment of discogenic back pain[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2020,32(02):23-29.
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五福飲加減治療盤源性腰痛的臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期數(shù):
2020年02期
頁碼:
23-29
欄目:
臨床研究
出版日期:
2020-02-20

文章信息/Info

Title:
A clinical study of Wufu Yin Jiajian(五福飲加減)for treatment of discogenic back pain
作者:
沈興潮; 夏炳江; 凌義龍; 韋金忠; 許楊
(紹興市中醫(yī)院,浙江 紹興 312000)
Author(s):
SHEN Xingchao; XIA Bingjiang; LING Yilong; WEI Jinzhong; XU Yang
Shaoxing Hospital of Traditional Chinese Medicine,Shaoxing 312000,Zhejiang,China
關(guān)鍵詞:
腰痛;  五福飲;  臨床試驗(yàn)
Keywords:
low back pain;  Wufu Yin;  clinical trial
摘要:
目的:觀察五福飲加減治療盤源性腰痛(discogenic back pain,DBP)的臨床療效和安全性,并探討其可能的作用機(jī)制。方法:將符合要求的100例DBP患者隨機(jī)分為五福飲組和塞來昔布組,每組50例。五福飲組采用五福飲加減治療,每日1劑,分早晚2 次空腹溫服。塞來昔布組采用口服塞來昔布膠囊治療,每日2次,每次200 mg。每個療程均為7 d,均連續(xù)治療4個療程。治療期間2組均進(jìn)行適度腰背肌和腹肌功能鍛煉。測定患者的腰部疼痛視覺模擬量表(visual analogue scale,VAS)評分、Oswestry功能障礙指數(shù)(Oswestry disability index,ODI)、血清β-catenin含量,評估腰椎間盤MRI分級,觀察記錄試驗(yàn)期間2組并發(fā)癥的發(fā)生情況。結(jié)果:①腰部疼痛VAS評分。時間因素和分組因素不存在交互效應(yīng)(F=1.734,P=0.171)。五福飲組的腰部疼痛VAS評分總體低于塞來昔布組(F=8.658,P=0.009)。治療前后不同時點(diǎn)間腰部疼痛VAS評分的差異有統(tǒng)計(jì)學(xué)意義,即存在時間效應(yīng)(F=29.821,P=0.000); 2組患者的腰部疼痛VAS評分隨時間變化均呈降低趨勢,但2組的降低趨勢不完全一致[(6.20±1.93)分,(3.30±0.67)分,(3.00±0.82)分,(2.00±0.67)分,F=24.572,P=0.000;(6.50±2.17)分,(4.20 ±1.40)分,(4.30±1.25)分,(4.00±1.05)分,F=5.784,P=0.002]; 治療前,2組患者的腰部疼痛VAS評分比較,差異無統(tǒng)計(jì)學(xué)意義(t=0.326,P=0.748); 治療后1個月、3個月、6個月時,五福飲組的腰部疼痛VAS評分均低于塞來昔布組(t=2.633,P=0.043; t=2.751,P=0.013; t=5.071,P=0.000)。②ODI。時間因素和分組因素存在交互效應(yīng)(F=2.775,P=0.049)。2組患者的ODI總體比較,組間差異無統(tǒng)計(jì)學(xué)意義,即不存在分組效應(yīng)(F=1.815,P=0.195)。治療前后不同時點(diǎn)間ODI的差異有統(tǒng)計(jì)學(xué)意義,即存在時間效應(yīng)(F=85.320,P=0.000); 2組患者的ODI隨時間變化均呈先降低后升高的趨勢,但2組的變化趨勢不完全一致[(68.90±19.68)%,(33.30±9.88)%,(34.50±9.28)%,(38.50±9.42)%,F=17.281,P=0.000;(68.50±22.60)%,(43.10 ±11.94)%,(44.20±10.10)%,(48.80±8.08)%,F=6.819,P=0.001]; 治療前,2組患者的ODI比較,差異無統(tǒng)計(jì)學(xué)意義(t=0.042,P=0.967); 治療后1個月、3個月、6個月時,五福飲組的ODI均低于塞來昔布組(t=2.120,P=0.041; t=2.237,P=0.038; t=2.625,P=0.017)。③腰椎間盤MRI分級。治療前及治療后6個月,2組患者的腰椎間盤MRI分級比較,組間差異均無統(tǒng)計(jì)學(xué)意義(Z=-0.248,P=0.804; Z=-0.811,P=0.417)。④血清β-catenin含量。時間因素和分組因素存在交互效應(yīng)(F=21.178,P=0.000)。2組患者的血清β-catenin含量總體比較,組間差異無統(tǒng)計(jì)學(xué)意義,即不存在分組效應(yīng)(F=3.149,P=0.093)。治療前后不同時點(diǎn)間血清β-catenin含量的差異有統(tǒng)計(jì)學(xué)意義,即存在時間效應(yīng)(F=296.182,P=0.000); 2組患者的血清β-catenin含量隨時間變化均呈降低趨勢,但2組的變化趨勢不完全一致[(70.10±13.82)ng·mL-1,(47.90±15.73)ng·mL-1,(38.50±13.62)ng·mL-1,(27.60±9.00)ng·mL-1,F=18.515,P=0.000;(68.80±13.57)ng·mL-1,(62.60±14.02)ng·mL-1,(52.10±13.92)ng·mL-1,(42.40±13.96)ng·mL-1,F=7.049,P=0.001]; 治療前,2組患者的血清β-catenin含量比較,差異無統(tǒng)計(jì)學(xué)意義(t=0.212,P=0.834); 治療后1個月、3個月、6個月時,五福飲組的血清β-catenin含量均低于塞來昔布組(t=2.206,P=0.041; t=2.208,P=0.040; t=2.808,P=0.011)。⑤并發(fā)癥。治療及隨訪期間2組患者均未出現(xiàn)并發(fā)癥。結(jié)論:五福飲加減可有效改善DBP患者的腰部疼痛癥狀,改善其腰椎活動功能,效果優(yōu)于口服塞來昔布膠囊,而且具有較高的安全性; 其作用機(jī)制可能是通過調(diào)控Wnt/β-catenin通路,延緩腰椎間盤退變來起作用。
Abstract:
Objective:To observe the clinical curative effects and safety of Wufu Yin Jiajian(五福飲加減,WFYJJ)in treatment of discogenic back pain(DBP)and to explore its possible mechanism of actions.Methods:One hundred patients with DBP were enrolled in the study and were randomly divided into WFY group and celecoxib group,50 cases in each group.The patients in WFY group were treated with oral application of WFYJJ,one dose a day in the morning and evening respectively on an empty stomach for consecutive 4 courses of treatment,7 days for each course; while the others in celecoxib group were treated with oral application of celecoxib capsules,twice a day,200 mg at a time for consecutive 4 courses of treatment,7 days for each course.Meanwhile,moderate lumbodorsal muscle exercises and abdominal muscle exercises were conducted in patients in the 2 groups during the treatment period.The low back pain visual analogue scale(VAS)scores,Oswestry disability index(ODI)and serum content of β-catenin were measured and compared between the 2 groups,and the MRI grading of lumbar intervertebral disc was evaluated.Moreover,the complication incidences were observed and recorded during the trial.Results:There was no interaction between time factor and group factor in low back pain VAS scores(F=1.734,P=0.171).The low back pain VAS scores were lower in WFY group compared to celecoxib group in general(F=8.658,P=0.009).There was statistical difference in low back pain VAS scores between different timepoints before and after the treatment,in other words,there was time effect(F=29.821,P=0.000).The low back pain VAS scores presented a time-dependent decreasing trend in both of the 2 groups,while the 2 groups were inconsistent with each other in the variation tendency(6.20+/-1.93,3.30+/-0.67,3.00+/-0.82,2.00+/-0.67 points,F=24.572,P=0.000; 6.50+/-2.17,4.20+/-1.40,4.30+/-1.25,4.00+/-1.05 points,F=5.784,P=0.002).There was no statistical difference in low back pain VAS scores between the 2 groups before treatment(t=0.326,P=0.748).The low back pain VAS scores were lower in WFY group compared to celecoxib group at 1,3 and 6 months after the treatment respectively(t=2.633,P=0.043; t=2.751,P=0.013; t=5.071,P=0.000).There was interaction between time factor and group factor in ODI(F=2.775,P=0.049).There was no statistical difference in ODI between the 2 groups in general,in other words,there was no group effect(F=1.815,P=0.195).There was statistical difference in ODI between different timepoints before and after the treatment,in other words,there was time effect(F=85.320,P=0.000).The ODI presented a time-dependent trend of decreasing firstly and increasing subsequently in the 2 groups,while the 2 groups were inconsistent with each other in the variation tendency(68.90+/-19.68,33.30+/-9.88,34.50+/-9.28,38.50+/-9.42%,F=17.281,P=0.000; 68.50+/-22.60,43.10+/-11.94,44.20+/-10.10,48.80+/-8.08%,F=6.819,P=0.001).There was no statistical difference in ODI between the 2 groups before the treatment(t=0.042,P=0.967).The ODI was lower in WFY group compared to celecoxib group at 1,3 and 6 months after the treatment respectively(t=2.120,P=0.041; t=2.237,P=0.038; t=2.625,P=0.017).There was no statistical difference in MRI grading of lumbar intervertebral disc between the 2 groups before the treatment and at 6 months after the treatment(Z=-0.248,P=0.804; Z=-0.811,P=0.417).There was interaction between time factor and group factor in serum content of β-catenin(F=21.178,P=0.000).There was no statistical difference in serum content of β-catenin between the 2 groups in general,in other words,there was no group effect(F=3.149,P=0.093).There was statistical difference in serum content of β-catenin between different timepoints before and after the treatment,in other words,there was time effect(F=296.182,P=0.000).The serum content of β-catenin presented a time-dependent decreasing trend in both of the 2 groups,while the 2 groups were inconsistent with each other in the variation tendency(70.10+/-13.82,47.90+/-15.73,38.50+/-13.62,27.60+/-9.00 ng/mL,F=18.515,P=0.000; 68.80+/-13.57,62.60+/-14.02,52.10+/-13.92,42.40+/-13.96 ng/mL,F=7.049,P=0.001).There was no statistical difference in serum content of β-catenin between the 2 groups before the treatment(t=0.212,P=0.834).The serum content of β-catenin was lower in WFY group compared to celecoxib group at 1,3 and 6 months after the treatment respectively(t=2.206,P=0.041; t=2.208,P=0.040; t=2.808,P=0.011).No complications were found in the 2 groups during the treatment and follow-up period.Conclusion:Oral application of WFYJJ can effectively improve the low back pain and lumbar function of patients with DBP,and its curative effect is better than that of oral application of celecoxib capsules,moreover,it has high safety.Its mechanism of action may be that it works by delaying intervertebral disc degeneration through regulating Wnt/β-catenin signaling pathway.

參考文獻(xiàn)/References:

[1] PARK W M,MCCALL I W,O'BRIEN J P,et al.Fissuring of the posterior annulus fibrosus in the lumbar spine[J].Br J Radiol,1979,52(617):382-387.
[2] ITZ C J,GEURTS J W,VAN KLEEF M,et al.Clinical course of non-specific low back pain:a systematic review of prospective cohort studies set in primary care[J].Eur J Pain,2013,17(1):5-15.
[3] HARTVIGSEN J,HANCOCK M J,KONGSTED A,et al.What low back pain is and why we need to pay attention[J].The Lancet,2018,391(10137):2356-2367.
[4] 夏炳江,凌義龍,童培建.從五臟虛損論椎間盤退變性疾病[J].山東中醫(yī)雜志,2018,37(7):541-542.
[5] 張紅玉,楊鋒,王波波,等.五福飲增強(qiáng)化療藥抗腫瘤作用及保護(hù)骨髓造血功能的實(shí)驗(yàn)研究[J].浙江中醫(yī)藥大學(xué)學(xué)報,2014,38(6):682-685.
[6] 楊惠林,馬宏慶,王根林,等.全國腰椎退行性疾患座談會會議紀(jì)要[J].中華骨科雜志,2006,26(10):711-716.
[7] 周仲瑛.中醫(yī)內(nèi)科學(xué)[M].北京:中國中醫(yī)藥出版社,2003:515-520.
[8] MOHAN V,G S P,MERAVANIGI G,et al.Adaptation of the Oswestry disability index to kannada language and evaluation of its validity and reliability[J].Spine,2016,41(11):E674- E680.
[9] PFIRRMANN C W,METZDORF A.Magnetic resonance classification of lumbar intervertebarl diac degeneration[J].Spine,2001,26:1873-1878.
[10] 胡永勝,阿曼,周剛,等.椎間盤源性腰痛的治療方法選擇及療效評價[J].中國矯形外科雜志,2013,21(15):1497-1501.
[11] LU Y,GUZMAN J Z,PURMESSUR D,et al.Nonoperative management of discogenic back pain:a systematic review[J].Spine,2014,39(16):1314-1324.
[12] THAVANESWARAN P,VANDEPEER M.Lumbar artificial intervertebral disc replacement:a systematic review[J].ANZ Journal of Surgery,2014,84(3):121-127.
[13] NAKASHIMA H, KAWAKAMI N,TSUJI T,et al.Adjacent segment disease after posterior lumbar interbody fusion:based on cases with a minimum of 10 years of follow-up[J].Spine(Phila Pa 1976),2015,40(14):E831-E841.
[14] KAPURAL L,VROOMAN B,SARWAR S,et al.Radiofrequency intradiscal biacuplasty for treatment of discogenic lower back pain:a 12-month follow-up[J].Pain Med,2015,16(3):425-431.
[15] JACOBS W C,GAAG N A V D,KRUYT M C,et al.Total disc replacement for chronic discogenic low back pain:a Cochrane review[J].Spine,2013,38(1):24-36.
[16] 劉汝專,張磊,潘漢升,等.中藥復(fù)方干預(yù)椎間盤退變的實(shí)驗(yàn)研究進(jìn)展[J].中醫(yī)正骨,2019,31(4):42-45.
[17] 李滿意,張子揚(yáng),婁玉鈐,等.腰痹的源流及相關(guān)歷史文獻(xiàn)復(fù)習(xí)(上)[J].風(fēng)濕病與關(guān)節(jié)炎,2016,5(5):31-48.
[18] 朱少兵,張龍君,陳建良,等.腰痛病因病機(jī)述略[J].浙江中醫(yī)雜志,2012,47(7):502-503.
[19] 李滿意,張子揚(yáng),婁玉鈐,等.腰痹的源流及相關(guān)歷史文獻(xiàn)復(fù)習(xí)(下)[J].風(fēng)濕病與關(guān)節(jié)炎,2016,5(6):51-59.
[20] 龐浩,劉祥準(zhǔn).五福飲對柔道運(yùn)動員抗疲勞效果的研究[J].中醫(yī)臨床研究,2014,6(34):1-3.
[21] 王國慶,朱曉鋒.加味五福飲聯(lián)合培美曲塞和順鉑治療晚期肺腺癌20例臨床觀察[J].江蘇中醫(yī)藥,2014,46(11):27-28.
[22] 夏炳江,侯明生,張磊,等.五福飲對大鼠尾部退變椎間盤的影響及其作用機(jī)制[J].中醫(yī)正骨,2018,30(1):18-24.
[23] SPRANGER S,BAO R,GAJEWSKI T F.Melanoma-intrinsic β-catenin signalling prevents anti-tumour immunity[J].Nature,2015,523(7559):231-235.
[24] DUAN P,BONEWALD L F.The role of the wnt/β-catenin signaling pathway in formation and maintenance of bone and teeth[J].Int J Biochem Cell Biol,2016,77(Pt A):23-29.
[25] DZOBO K,VOGELSANG M,PARKER M I.Wnt/β-Catenin and MEK-ERK signaling are required for fibroblast-derived extracellular matrix-mediated endoderm differentiation of embryonic stem cells[J].Stem Cell Rev,2015,11(5):761-773.
[26] RING A,KIM Y M,KAHN M.Wnt/catenin signaling in adult stem cell physiology and disease[J].Stem Cell Rev,2014,10(4):512-525.
[27] WANG Y,LI Y P,PAULSON C,et al.Wnt and the Wnt signaling pathway in bone development and disease[J].Front Biosci(Landmark Ed),2014,19(3):379-407.
[28] MAUPIN K A,DROSCHA C J,WILLIAMS B O.A comprehensive overview of skeletal phenotypes associated with alterations in wnt/β-catenin signaling in humans and mice[J].Bone Res,2013,1(1):27-71.
[29] 王晶.經(jīng)典Wnt/β-catenin信號通路在椎間盤退變中的作用及機(jī)制研究[D].武漢:華中科技大學(xué),2009.
[30] WANG M,TANG D,SHU B,et al.Conditional activation of β-catenin signaling in mice leads to severe defects in intervertebral disc tissue[J].Arthritis Rheum,2012,64(8):2611-2623.

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[9]夏炳江,侯明生,張磊,等.五福飲對大鼠尾部退變椎間盤的影響及其作用機(jī)制…[J].中醫(yī)正骨,2018,30(01):18.
　XIA Bingjiang,HOU Mingsheng,ZHANG Lei,et al.Effects of Wufu Yin(五福飲)on caudal degenerative intervertebral disc in rats and its mechanism of action[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(02):18.
[10]李展新,劉建航,李錦威,等.韋氏脊柱整治手法結(jié)合核心肌群訓(xùn)練治療非職業(yè)高爾夫運(yùn)動者非特異性腰痛[J].中醫(yī)正骨,2018,30(04):13.
　LI Zhanxin,LIU Jianhang,LI Jinwei,et al.Wei's spinal remediation manipulation combined with core muscle training for treatment of nonspecific low back pain in non-professional golfers[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(02):13.

備注/Memo

備注/Memo:
(收稿日期:2019-07-10 本文編輯:李曉樂)基金項(xiàng)目:浙江省自然科學(xué)基金項(xiàng)目(LQ18H270006); 浙江省中醫(yī)藥科技計(jì)劃項(xiàng)目(2017ZB091,2018ZA125) 通訊作者:夏炳江 E-mail:[email protected]
更新日期/Last Update: 2020-02-15