痹痛消治疗颈椎病颈痛的临床研究

作者	单位
李金学	中国中医研究院骨伤科研究所!北京100700
向昌菊	中国中医研究院骨伤科研究所!北京100700
刘秀芹	中国中医研究院骨伤科研究所!北京100700
程爱华	中国中医研究院骨伤科研究所!北京100700
王尚全	中国中医研究院骨伤科研究所!北京100700
蔡静怡	中国中医研究院骨伤科研究所!北京100700

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中文摘要:

目的 :探讨痹痛消治疗颈椎病颈痛的镇痛机理。方法 :随机将 10 2例患者分为两组 ,分别用痹痛消和颈复康治疗 ,并测定治疗前后血清亮脑啡肽 (LEK)、P物质 (SP)和前列腺素E2 (PGE2 )等指标。结果 :治疗组 52例 ,临床痊愈 12例 ,显效 3 6例 ,有效 3例 ,无效 1例 ,愈显率为 92 3 % ;对照组 50例 ,分别为 3例、3 3例、14例、0例和 72 0 %。治疗后治疗组疼痛积分值的减少明显大于对照组 (P <0 0 1)。治疗前两组患者血清LEK含量普遍低下 ,治疗后治疗组LEK含量较对照组显著升高 (P <0 0 5)。两组血清SP含量治疗后较治疗前均显著升高 (P <0 0 1) ;PGE2 含量未见显著性变化。结论 :颈椎病患者血清LEK低下 ,痹痛消具有很强的镇痛作用 ,并可升高血清LEK和SP含量

英文摘要:

To study the analgesic mechanism of Bitongxiao (BTX, a Chinese herbal decoction) in treating neck pain due to cervical spondylitis (CS). Methods: BTX and Jingfukang (JFK) granule were used to treat the treated and the control group separately in 102 CS cases. Plasma leucine enkephalin (LEK), substance P (SP) and prostaglandin E 2 (PGE 2) before and after treatment were assayed by radioimmunoassay (RIA). Results: Twelve patients in the treated group were clinically cured, 36 markedly effectively, 3 effectively and 1 ineffectively, while in the control group they were 5, 33, 14 and 0 cases respectively. The cured and marked effective rate in the treated group was 92.3%, while that in the control group 72.0%. After treatment the pain score (VAS) of both groups were significantly reduced, but the reduction was higher in the treated group than that in the control. Before treatment, plasma LEK in all patients was abnormally low, but after treatment, it raised obviously more in the treated group than that in the control (P<0 05). Plasma SP of both groups were obviously elevated, and PGE 2 revealed unaltered after treatment. Conclusion: BTX has strong, fast acting and long lasting analgesic effect with no side effects, it could elevate the lowered plasma LEK level in cervical spondylitis patients and increase plasma SP level. The analgesic mechanism of BTX might be associated with its effect on LEK, SP or other endorphins, directly acting on the pain modulation system.

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