The Clinical Study Of Modified Simiaoshuyao Prescription In Treating The Lumbar Disc Herniation Of Damp-heat Type

ObjectiveIn this study,patients LDH of damp-heat type were divided into three groups for treatment and curative effect observation.The clinical effect of the Modified Simiaoshuyao Prescription on LDH of damp-heat type was observed,and the clinical basis was provided for the treatment of LDH by clearing heat and removing dampness legislation.To explore the distribution of traditional Chinese medical science constitution identification in patients with LDH of damp-heat type,and to broaden the thinking for traditional Chinese medical science treatment of such diseases.MethodsThis study collected 90 cases of LDH from May 2018 to December 2018' in the Department of Spine,Zhongshan Hospital of Traditional Chinese Medicine,Guangzhou University of Traditional Chinese Medicine.The patients were randomly divided into routine physiotherapy group(group A),oral diclofenac sodium sustained-release tablets+routine physiotherapy group(group B)and Modified Simiaoshuyao Prescription+routine physiotherapy group(group C),and treated for 2 weeks.The basic information of patients,the classification of LDH,the identification of traditional Chinese medicine(TCM)constitution,VAS,JOA and other related scores were collected.Parallel correlative efficacy determination and data parallel correlation statistical analysis.Result1.There was no significant difference in VAS score between the three groups before treatment(P=1.000>0.05 in group A compared with group B;P=1.000>0.05 in group A compared with group C;P=1.000>0.05 in group B compared with group C;),which was comparable.Inter group comparison,One week after treatment,there was significant difference between group A and group B(P=0.024<0.05).there was significant difference between group A and group C(P=0.015<0.05).There was no significant difference between group B and group C(P=1.000>0.05).After 2 weeks of treatment,there was significant difference between group A and group B(P=0.013<0.05).there was significant difference between group A and group C(P=0.001<0.01).There was no significant difference between group B and group C(P=1.000>0.05).Intra group comparison,The VAS scores of group A,B and C after one week and two weeks of treatment were significantly different from those before treatment(P=0.000<0.01?P=0.000<0.01?P=0.000<0.01;P=0.000<0.01?P=0.000<0.01?P=0.000<0.01);the VAS scores of group A,B and C after two weeks of treatment were significantly different from those after one week of treatment(P=0.000<0.01?P=0.000<0.01?P=0.000<0.01).2.There was no significant difference in JOA score between the three groups before treatment(P=0.229>0.05 in group A compared with group B;P=0.065>0.05 in group A compared with group C;P=0.513>0.05 in group B compared with group C),which was comparable.Inter group comparison,After one week of treatment,there was no significant difference between group A and group B(P=0.051>0.05).There was significant difference between group A and group C(P=0.001<0.01).There was no significant difference between group B and group C(P=0.196>0.05).After two weeks of treatment,there was significant difference between group A and group B(P=0.008<0.01).There was significant difference between group A and group C(P=0.000<0.01).There was no significant difference between group B and group C(P=0.139>0.05).Intra group comparison,the JOA scores of group A,B and C after 1 week and 2 weeks of treatment were significantly different from those before treatment C(P=0.000<0.01?P=0.000<0.01?P=0.000<0.01;P=0.000<0.01?P=0.000<0.01?P=0.000<0.01);the JOA scores of group A,B and C after 2 weeks of treatment were significantly different from those after 1 week of treatment(P=0.000<0.01?P=0.000<0.01?P=0.000<0.01).3.In comparison with the improvement rate of JOA score in three groups,the average improvement rate of group A,group B and group C was 61.45%,69.43%and 75.41%respectively after 2 weeks of treatment.There was a significant difference in the improvement rate of JOA among the three groups(P=0.011<0.05).4.Ninety cases of LDH of damp-heat type were included in this study,including 6 cases of Yang deficiency,5 cases of Yin deficiency,4 cases of Qi deficiency,10 cases of phlegm-dampness,7 cases of blood stasis,37 cases of damp-heat,3 cases of idiosyncrasy,3 cases of qi depression and 13 cases of calm temperament.There was no significant difference in the distribution of constitution identification between different genders(P=0.441>0.05).Overall,damp-heat,calm and phlegm-dampness were the main constitutions of the patients with Damp-heat LDH,accounting for 41.11%,14.44%and 11.11%respectively.There was a significant difference in the evaluation of clinical efficacy between the three groups after 2 weeks of treatment(P=0.028<0.05).5.After 2 weeks of treatment,there were significant differences in JOA improvement grade distribution between patients with Damp-heat quality and patients without damp-heat quality in group C(P=0.020<0.05).6.No significant hepatorenal toxicity and other serious adverse reactions were observed in patients taking Modified Simiaoshuyao Prescription.Conclusion1.Modified Simiaoshuyao Prescription,which is based on clearing away hoat and dampness,can effectively improve the main symptoms such as pain and JOA score of patients with LDH of damp-heat type.The clinical effect is remarkable.2.Modified Simiaoshuyao Prescription can improve JOA score and JOA score improvement rate of damp-heat LDH patients more quickly and effectively.3.In the constitution identification of TCM for patients with LDH of damp-heat type,damp-heat type,calm type and phlegm-dampness type were the main constitutions of patients with Damp-heat type,accounting for 41.11%,14.44%and 11.11%respectively.4.Modified Simiaoshuyao Prescription has no obvious toxic effect on liver and kidney,and has high safety.