世界中医药

目的:探讨养元活血汤联合温针灸治疗产后腰痛的临床效果。方法:选取2017年2月至2018年4月孝感市妇幼保健院收治的产后腰痛患者64例作为研究对象,按照随机数字表法分为对照组和观察组,每组32例,对照组患者单纯给予温针灸治疗;观察组患者则在对照组基础上加用养元活血汤内服,连续治疗2周为1个疗程。比较2组患者的临床效果,评估患者的腰部疼痛程度、功能障碍程度,采用SF-36生命质量表评价治疗前后的生命质量,检测血清中6-酮前列腺素Flα(6-Keto-PGFlα)、白细胞介素-1β(IL-1β)、降钙素基因相关肽(CGRP)、血栓素2(TXB2)水平。结果:观察组的有效率90.62%明显高于对照组的75.00%(P<0.05);观察组患者的VAS、ODQ评分明显低于对照组(P<0.05);2组患者的生命质量相关睡眠、精神、食欲、日常生活能力等评分较治疗前明显升高(P<0.05);观察组患者的睡眠、精神、食欲、日常生活能力评分明显高于对照组(P<0.05);2组患者的血清6-Keto-PGFlα水平较治疗前上升,IL-1β、CGRP、TXB2水平较治疗前下降(P<0.05);观察组患者的血清6-Keto-PGFlα水平高于对照组;IL-1β、CGRP、TXB2水平均低于对照组(P<0.05)。结论:养元活血汤联合温针灸利于减轻产后腰痛患者的痛感,改善腰功能障碍,提高产后患者的生命质量,其起效的机制可能在于通过调控血清中6-Keto-PGFlα、IL-1β、CGRP、TXB2水平而改善血液微循环,抑制血小板聚集和血栓形成,抑制致炎物质,从而发挥镇痛作用。

English Summary:

To explore the clinical effect of self-designed Yangyuan Huoxue Decoction combined with warming needle moxibustion on postpartum backache.Methods:A total of 64 patients with postpartum low back pain who were admitted to Xiaogan maternal and child health care hospital in Hubei province from February 2017 to April 2018 were selected.They were divided into the control group and the observation group,with 32 cases each.Patients in the control group were treated with warming needle moxibustion alone.Observation group patients were given self-designed Yangyuan Huoxue Decoction for oral administration on the basis of control group,continuous treatment for 2 weeks as a course of treatment.The clinical effects of the two groups were compared.Before and after treatment,the degree of the patients' waist pain and disability was evaluated,and Sf-36 quality of life table was used before and after treatment to evaluate the quality of life.Serum levels of 6-Keto-PGFlα,IL-1β,CGRP and TXB2 were detected.Results:The effective rate of 90.62% in the observation group was significantly higher than that in the control group of 75.00%,(P<0.05).The VAS and ODQ scores of the observation group were significantly lower than those of the control group(P<0.05).The scores of sleep,spirit,appetite and daily living ability in the two groups were significantly higher than those before treatment(P<0.05).The scores of sleep,spirit,appetite and daily living ability in the observation group were significantly higher than those in the control group(P<0.05).Serum levels of 6-Keto-PGFlα were increased and IL-1β,CGRP and TXB2 were decreased in both groups(P<0.05).Serum levels of 6-Keto-PGFl alpha were higher in the observation group than in the control group.The levels of IL-1β,CGRP and TXB2 were lower in the observation group than those of the control group(P<0.05).Conclusion:The self-designed Yangyuan Huoxue Decoction combined with warming needle moxibustion is helpful to relieve pain in postpartum lumbago patients,improve lumbar dysfunction,and improve postpartum patients' quality of life.The mechanism may be the improvement of blood microcirculation through 6-Keto-PGFlα,IL-1β,CGRP,TXB2 regulation,inhibition of platelet aggregation and thrombosis,and inhibition of inflammatory substances.

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