| 引用本文: |
郭子健, 张意侗, 纪寅璞, 张宝文, 梁晖, 李刚.三乌汤联合选择性神经根阻滞治疗腰椎间盘突出症临床疗效观察[J].湖南中医药大学学报,2026,46(8):1590-1596[点击复制] |
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| 三乌汤联合选择性神经根阻滞治疗腰椎间盘突出症临床疗效观察 |
| 郭子健,张意侗,纪寅璞,张宝文,梁晖,李刚 |
| (河北北方学院, 河北 张家口 075000;石家庄市中医院, 河北 石家庄 050051) |
| 摘要: |
| 目的 探讨应用三乌汤联合选择性神经根阻滞治疗腰椎间盘突出症（寒湿阻络证）的临床效果。方法 选取2025年1月至2025年12月在石家庄市中医院收治并符合标准的 72 例腰椎间盘突出症患者，其中选择性神经根阻滞治疗36例（对照组），三乌汤＋选择性神经根阻滞治疗36例（联合组），2组均给予卧床休息、佩戴腰围支具等基础治疗，治疗时长为2周。观察对比各组患者的治疗数据资料：视觉模拟评分（VAS）、奥斯威斯特里功能障碍指数（ODI）评分、日本骨科协会（JOA）评分、直腿抬高试验（SLRT）角度、腰椎活动度、中医证候积分、血清炎性致痛介质、血液流变学指标以及临床疗效。结果 联合组的临床疗效优于对照组（P<0.05）。与治疗前相比，两组患者治疗后VAS评分、ODI评分、中医证候积分、血清炎性致痛介质及血液流变学水平均下降（P<0.05）；其中联合组各指标低于对照组（P<0.05）。与治疗前相比，两组患者治疗后JOA评分、SLRT角度、腰椎活动度均有所升高（P<0.05）；其中联合组各指标高于对照组（P<0.05）。结论 三乌汤联合选择性神经根阻滞治疗腰椎间盘突出症（寒湿阻络证）疗效较好，能够发挥显著的止痛效果，减轻炎症反应，促进血流动力学恢复，增加腰椎活动度，改善腰腿功能，从而提高生活质量，值得临床推广。 |
| 关键词: 选择性神经根阻滞|腰椎间盘突出症|三乌汤|寒湿阻络证|中西医结合|视觉模拟评分法|临床疗效 |
| DOI：10.3969/j.issn.1674-070X.2026.08.007 |
| 投稿时间：2026-05-27 |
| 基金项目:河北省中医药管理局科研计划项目（2019447）。 |
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| Efficacy of Sanwu Decoction combined with selective nerve root block in treating lumbar disc herniation |
| GUO Zijian, ZHANG Yitong, JI Yinpu, ZHANG Baowen, LIANG Hui, LI Gang |
| (Hebei North University, Zhangjiakou, Hebei 075000, China;Shijiazhuang Traditional Chinese Medicine Hospital, Shijiazhuang, Hebei 050051, China) |
| Abstract: |
| Objective To explore the efficacy of Sanwu Decoction combined with selective nerve root block for lumbar disc herniation (cold-dampness obstruction type). Methods Totally 72 participants with lumbar disc herniation admitted to Shijiazhuang Traditional Chinese Medicine Hospital from January 2025 to December 2025 were selected. Among them, 36 patients (control group) were treated with selective nerve root block, and 36 patients (combined group) were treated with the combination of Sanwu Decoction and selective nerve root block. Both groups were given basic treatments such as bed rest and wearing waist brace. The treatment lasted for 2 weeks. Such data of patients in each group before and after treatment were observed and compared as visual analogue scale (VAS) score, ODI score, Japanese Orthopaedic Association score (JOA) score, SLRT angle, lumbar mobility, TCM pattern score, serum inflammatory pain-causing medium, hemorheology index, and clinical efficacy. Results The clinical efficacy of the combined group was better than that of the control group (P<0.05). The VAS scores, ODI scores, TCM pattern scores, serum inflammatory pain mediators, and hemorheology levels of the two groups decreased after the treatment, while the downward trend of the combined group was more obvious than that of the control group (P<0.05). The JOA scores, SLRT angles, and lumbar mobility of the two groups increased after the treatment (P<0.05), while the upward trend of the combined group was more obvious than that of the control group (P<0.05). Conclusion The application of Sanwu Decoction combined with selective nerve root block for lumbar disc herniation (cold-dampness obstruction type) has a better effect. It can exert a significant analgesic effect, reduce inflammation, promote hemodynamic recovery, increase lumbar mobility, and improve lumbocrural function. These benefits contribute to an enhanced quality of life, thereby warranting its clinical application. |
| Key words: selective nerve root block|lumbar disc herniation|Sanwu Decoction|cold-dampness obstruction pattern|integrated Chinese and Western medicine|vlsual analogue score|clinical efficacy |
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