药罐联合独活寄生汤治疗寒湿瘀阻型腰椎间盘突出症临床研究OA

Objective:To observe the clinical efficacy of medicated cupping combined with Duhuo Jisheng Decoction in the treatment of lumbar disc herniation(LDH)with cold-damp stagnation and obstruction syndrome.Methods:A retrospective analysis was conducted on the clinical data of 162 LDH patients with cold-damp stagnation and obstruction syndrome who were admitted to the Department of Orthopedics of Wenzhou TCM Hospital of Zhejiang Chinese Medical University between June 2023 and June 2024.After excluding 22 cases based on exclusion criteria,140 patients were ultimately included as study subjects.They were divided into the Duhuo Jisheng group(64 cases)and the medicated cupping combination group(76 cases)based on their treatment regimens.The Duhuo Jisheng group received treatment with Duhuo Jisheng Decoction alone,while the medicated cupping combination group received combined treatment with medicated cupping on the basis of treatment of Duhuo Jisheng group.The clinical efficacy,Japanese Orthopaedic Association(JOA)assessment scores,traditional Chinese medicine syndrome scores,serum inflammatory factor levels[transforming growth factor-β1(TGF-β1),matrix metalloproteinase-2(MMP-2),interleukin-23(IL-23)],levels of pain-related factors[cyclooxygenase-2(COX-2),nerve growth factor(NGF),calcitonin gene-related peptide(CGRP)],and incidence of adverse reactions were compared between the two groups.Results:The total effective rate was 93.42%(71/76)in the medicated cupping combination group and 81.25%(52/64)in the Duhuo Jisheng group,with a statistically significant difference between the two groups(P＜0.05).After treatment,traditional Chinese medicine syndrome scores decreased(P＜0.05)and JOA scores increased(P＜0.05)in both groups compared to before treatment.The medicated cupping combination group had lower traditional Chinese medicine syndrome scores(P＜0.05)and higher JOA scores(P＜0.05)than the Duhuo Jisheng group.After treatment,serum levels of TGF-β1,MMP-2,and IL-23 decreased in both groups compared to before treatment(P＜0.05),and the levels of these indicators in the medicated cupping combination group were lower than those in the Duhuo Jisheng group(P＜0.05).After treatment,the levels of COX-2,NGF,and CGRP decreased in both groups compared to before treatment(P＜0.05),and the levels of these indicators in the medicated cupping combination group were lower than those in the Duhuo Jisheng group(P＜0.05).The incidence of adverse reactions was 5.26%(4/76)in the medicated cupping combination group and 4.69%(3/64)in the Duhuo Jisheng group,with no statistically significant difference between the two groups(P＞0.05).Conclusion:The combination of medicated cupping and Duhuo Jisheng Decoction demonstrates good efficacy in the treatment of LDH with cold-damp stagnation and obstruction syndrome.It can downregulate serum levels of inflammatory factors and pain-related factors,and improve traditional Chinese medicine syndromes and lumbar function.