目的 觀察祛風止痛膠囊聯合甲鈷胺片治療腰椎間盤突出癥的臨床療效。方法 選擇2020年6月—2021年6月天津市北辰區(qū)中醫(yī)醫(yī)院收治的120例腰椎間盤突出癥患者，隨機將患者分為對照組和治療組，每組各60例。對照組口服甲鈷胺片，1片/次，3次/d。治療組在對照組基礎上口服祛風止痛膠囊，6粒/次，2次/d。兩組患者連續(xù)治療2周。觀察兩組患者臨床療效，比較治療前后兩組患者日本骨科協會評估治療（JOA）、視覺模擬量表（VAS）和Oswestry功能障礙指數（ODI）評分，及5-羥色胺（5-HT）、神經肽Y（NPY）、P物質（SP）、腫瘤壞死因子-α（TNF-α）、環(huán)氧合酶-2（COX-2）水平。結果 治療后，治療組的臨床有效率為91.67%，明顯高于對照組的71.67%（P＜0.05）。治療后，兩組患者JOA評分明顯升高，而VAS、ODI評分明顯下降（P＜0.05），且治療組的改善效果優(yōu)于對照組（P＜0.05）。治療后，兩組患者5-HT、NPY、SP、TNF-α、COX-2水平明顯下降（P＜0.05），且治療組明顯低于對照組（P＜0.05）。結論 祛風止痛膠囊聯合甲鈷胺片治療腰椎間盤突出癥，可改善腰椎功能和生活自理能力，降低炎癥因子、致痛因子的表達。

Objective To observe the clinical effect of Qufeng Zhitong Capsules combined with mecobalamin in treatment of lumbar disc herniation. Methods Patients (120 cases) with lumbar disc herniation in Tianjin Beichen Traditional Chinese Medicine Hospital from June 2020 to June 2021 were randomly divided into control and treatment group, and each group had 60 cases. Patients in the control group were po administered with Mecobalamin Tablets, 1 tablet/time, three times daily. Patients in the treatment group were po administered with Qufeng Zhitong Capsules on the basis of the control group, 6 grains/time, twice daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical evaluation was evaluated, the scores of JOA, VAS and ODI, and the levels of 5-HT, NPY, SP, TNF-α and COX-2 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 91.67%, which was significantly higher than that of the control group (71.67%, P < 0.05). After treatment, JOA scores in two groups were significantly increased, while VAS and ODI scores were significantly decreased (P < 0.05), and the improvement effect of the treatment group was better than that of the control group (P < 0.05). After treatment, the levels of 5-HT, NPY, SP, TNF-α and COX-2 in two groups were significantly decreased (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Qufeng Zhitong Capsules combined with mecobalamin in treatment of lumbar disc herniation can improve lumbar function and self-care ability, and reduce the expression of inflammatory factors and pain-causing factors.

R982

天津市北辰區(qū)科技計劃項目(SHGY2020046)