加味黄芪桂枝五物汤联合理筋推拿对椎动脉型颈椎病气虚血瘀证患者转化生长因子β1及血管内皮功能的影响OA
Effects of modified Huangqi Guizhi Wuwu Decoction combined with tendon Tuina therapy on transforming growth factor-β1 and vascular endothelial function in patients with cervical spondylosis of vertebral artery type with Qi deficiency and blood stasis
目的 观察加味黄芪桂枝五物汤联合理筋推拿治疗椎动脉型颈椎病气虚血瘀证的效果.方法 选取2021 年 9 月至 2023 年 6 月江西省中西医结合医院骨伤一科椎动脉型颈椎病气虚血瘀证患者 138 例,按照随机数字表法分为 2 组,每组 69 例.对照组采用甲磺酸倍他司汀片治疗,治疗组采用加味黄芪桂枝五物汤联合理筋推拿治疗,均治疗4 周.比较 2 组临床疗效,以及治疗前后颈椎功能障碍指数(NDI)、韦氏记忆量表中国修订版(WMS-RC)评分、中医症状积分,血清内皮素 1(ET-1)、转化生长因子β1(TGF-β1)、白细胞介素 6(IL-6)、血栓素B2(TXB2)、一氧化氮(NO)水平,双侧椎动脉、基底动脉平均峰流速,椎体角度位移、椎体屈伸活动范围.结果 治疗后,2 组WMS-RC评分均较本组治疗前升高(P<0.05),NDI评分、中医症状积分均较本组治疗前降低(P<0.05),且治疗组WMS-RC评分高于对照组,NDI评分、中医症状积分低于对照组(P<0.05).治疗后,2 组血清ET-1、IL-6、TXB2、TGF-β1 水平均较本组治疗前降低(P<0.05),NO水平较本组治疗前升高(P<0.05),且治疗后治疗组血清ET-1、IL-6、TXB2、TGF-β1 水平低于对照组(P<0.05),NO水平高于对照组(P<0.05).治疗后,2 组双侧椎动脉、基底动脉血流速度均较本组治疗前升高(P<0.05),且治疗组均高于对照组(P<0.05).治疗后,2 组椎体屈伸活动范围均较本组治疗前升高(P<0.05),椎体角度位移均较本组治疗前降低(P<0.05),且治疗组较对照组改善更显著(P<0.05).治疗组总有效率 95.65%(66/69),对照组总有效率82.61%(57/69),治疗组总有效率高于对照组(P<0.05).结论 加味黄芪桂枝五物汤联合理筋推拿治疗椎动脉型颈椎病气虚血瘀证有助于减轻炎症反应,改善血管内皮功能,降低TGF-β1 水平,促进颈椎功能恢复.
Objective To investigate the effect of modified Huangqi Guizhi Wuwu Decoction combined with tendon Tuina therapy for patients with cervical spondylosis of vertebral artery type(Qi deficiency and blood stasis).Methods Totally 138 patients with cervical spondylosis of vertebral artery type(Qi deficiency and blood stasis)who were admitted to the First Department of Bone Injury,Jiangxi Hospital of Integrated Traditional Chinese and Western Medicine from September 2021 to June 2023 were randomized 1∶1 to receive betahistine mesilate tablets(control group)or modified Huangqi Guizhi Wuwu Decoction combined with tendon Tuina therapy(treatment group)for 4 weeks.The aim was to compare the clinical efficacy,neck disability index(NDI),Wechsler Memory Scale-Revised Chinese version(WMS-RC)score,traditional Chinese medicine(TCM)symptom score,serum endothelin-1(ET-1),transforming growth factor-β1(TGF-β1),interleukin-6(IL-6),thromboxane B2(TXB2),and nitric oxide(NO),mean peak flow velocity of the bilateral vertebral and basilar arteries,vertebral horizontal displacement,and vertebral range of motion(ROM)(flexion and extension).Results After treatment,significantly increased WMS-RC,and decreased NDI and TCM symptom scores were detected in the both groups(all P<0.05),and the treatment group was superior to the control group for WMS-RC,INDI and TCM symptom scores(all P<0.05).Significantly decreased ET-1,IL-6,TXB2,TGF-β1,and increased NO were found in the both groups(all P<0.05),which were significantly pronounced in the treatment group(all P<0.05).The peak flow velocity of the bilateral vertebral and basilar arteries in the both groups was significantly increased(P<0.05),which was significantly higher in the treatment group than in the control group(P<0.05).Significantly increased vertebral ROM(flexion and extension),and decreased vertebral horizontal displacement were found in the both groups(all P<0.05),which were significantly pronounced in the treatment group(all P<0.05).The overall effective rate in the treatment group was significantly higher than that in the control group(95.65%[66/69]vs 82.61%[57/69],P<0.05).Conclusion Modified Huangqi Guizhi Wuwu Decoction combined with tendon Tuina therapy can reduce inflammatory response,improve vascular endothelial function,reduce TGF-β1 levels,and promote the recovery of cervical spine function in patients with cervical spondylosis of vertebral artery type(Qi deficiency and blood stasis).
陈玲玲;谢水华;孙雷;王星宇
江西中医药大学,江西 南昌 330004||江西省中西医结合医院骨伤一科,江西 南昌 330002江西省中西医结合医院骨伤一科,江西 南昌 330002江西省中西医结合医院骨伤一科,江西 南昌 330002江西省中西医结合医院骨伤一科,江西 南昌 330002
医药卫生
椎动脉型颈椎病气虚血瘀黄芪桂枝五物汤理筋推拿血管内皮功能转化生长因子-β1
Cervical spondylosis of vertebral artery typeQi deficiency and blood stasisHuangqi Guizhi Wuwu DecoctionSoothing tendonMassageVascular endothelial functionTransforming growth factor-β1
《河北中医》 2026 (3)
392-396,400,6
江西省中医药管理局科技计划项目(编号:2022B839)
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