目的 探究腰痛寧膠囊治療寒濕痹阻型椎間盤源性腰痛患者的臨床效果。方法 選取2021年2月—2023年1月承德醫(yī)學(xué)院附屬醫(yī)院收治的符合納入標(biāo)準(zhǔn)的70例椎間盤源性腰痛患者，按照治療方式不同分為對照組（常規(guī)治療，n=35）和研究組（常規(guī)治療+腰痛寧膠囊，n=35）。兩組的治療周期均為4周。對比兩組患者的治療效果、中醫(yī)證候積分、疼痛情況[數(shù)字評分量表（NRS）]、腰部功能改善情況[日本骨科學(xué)會（JOA）評分、Oswestry功能障礙指數(shù)（ODI）]、疼痛介質(zhì)[β-內(nèi)啡肽（β-EP）、前列腺素E2(PGE2)、P物質(zhì)（SP）]、炎癥指標(biāo)[白細(xì)胞介素-1β(IL-1β)、腫瘤壞死因子-α(TNF-α)、核苷酸結(jié)合寡聚化結(jié)構(gòu)域樣受體蛋白3(NLRP3)]差異。結(jié)果 治療后，研究組的總有效率為97.14%，高于對照組的80.00%(P<0.05)；兩組患者下腰疼痛、僵硬麻木、肢體腫脹等各項(xiàng)中醫(yī)證候積分均低于同組治療前，且研究組低于對照組（P<0.05）；兩組患者治療后的NRS評分低于同組治療前，且研究組疼痛程度評分低于對照組（P<0.05）；兩組患者JOA評分高于同組治療前，研究組患者的JOA評分高于對照組，兩組患者ODI評分明顯低于同組治療前，且研究組ODI評分低于對照組（P<0.05）；兩組患者治療后疼痛介質(zhì)β-EP水平高于同組治療前，且研究組高于對照組，兩組患者治療后PGE2、SP水平低于同組治療前，且研究組低于對照組（P<0.05）；兩組患者治療后炎癥指標(biāo)IL-1β、TNF-α、NLRP3水平低于同組治療前，且研究組炎癥指標(biāo)水平均低于對照組（P<0.05）。結(jié)論 腰痛寧膠囊治療寒濕痹阻型椎間盤源性腰痛患者效果顯著，可降低患者的中醫(yī)證候積分評分，減輕患者疼痛程度，改善患者的腰部功能，調(diào)節(jié)疼痛介質(zhì)水平并抑制炎癥反應(yīng)。

Objective To explore the clinical curative effect of Yaotongning Capsule in patients with discogenic low back pain（DLBP） of cold-damp arthralgia syndrome. Methods The clinical data were collected from 70 patients with DLBP in the affiliated Hospital of Chengde Medical University from February 2021 to January 2023. According to random number table, patients were divided into control group（routine treatment, n= 35） and study group（Yaotongning capsules + routine treatment, n= 35）. All patients were treated for 4 weeks. The curative effect, scores of TCM syndromes, pain [numerical rating scale（NRS）], improvement of lumbar function [Japanese Orthopaedic Association（JOA）, Oswestry Disability Index（ODI）], pain mediators [β-endorphin（β-EP）, prostaglandin E2（PGE2）, substance P（SP）] and inflammatory indexes [interleukin-1β（IL-1β）, tumor necrosis factor-α（TNF-α）, nucleotide-binding oligomerization domain-like receptor protein 3（NLRP3）] in the two groups were compared. Results After treatment, total response rate of study group was higher than that of control group（97.14% vs 80.00%, P＜0.05）. After treatment, scores of TCM syndromes （low back pain, stiffness and numbness, limb swelling） were decreased in both groups, which were lower in study group than control group（P＜0.05）. After treatment, NRS score was decreased in both groups, which was lower in study group than control group（P＜0.05）. After treatment, JOA score was increased in both groups, which was higher in study group than control group, while ODI score was significantly decreased, which was lower in study group than control group（P＜0.05）. After treatment, β-EP level was increased in both groups, which was higher in study group than control group, while levels of PGE2 and SP were decreased, which were lower in study group than control group（P＜0.05）. After treatment, levels of IL-1β, TNF-α and NLRP3 were decreased in both groups, which were lower in study group than control group（P＜0.05）. Conclusion Curative effect of Yaotongning Capsule is significant in patients with DLBP of cold-damp arthralgia syndrome, which can reduce scores of TCM syndromes, relieve pain, improve lumbar function, regulate levels of pain mediators and inhibit inflammatory response.

R285.64

河北省承德市科學(xué)技術(shù)研究與發(fā)展計(jì)劃項(xiàng)目(202006A031)