Clinical Efficacy of Modified Shentong Zhuyutang in Treatment of Acute Discogenic Low Back Pain Due to Wind-Cold and Stasis Obstruction Syndrome / 中国实验方剂学杂志

Objective:To evaluate of modified Shentong Zhuyutang combined with celecoxib capsules in the treatment of acute discogenic low back pain due to wind-cold and stasis obstruction sydrome. Method:One hundred and forty eligible patients were randomly divided into control group （70 cases） and observation group （70 cases）. Patients in both groups took the celecoxib capsules orally， 200 mg/time. On this basis， patients in the control group were further treated with Tongluo Huoxue capsule orally， 6 capsules/time， 3 times/day， while those in the observation group received the modified Shentong Zhuyutang， 1 bag/day， for three weeks. The short-form McGillpain questionnaire （SF-MPQ）， including pain rating index （PRI）， present pain intensity （PPI）， and visual analog scale （VAS）， Oswestry disability index （ODI）， wind-cold obstruction and stasis syndrome， and abilities of daily living （ADL） scoring and the Schober's test were conducted before and after treatment. The tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>）， interleukin-1<italic>β</italic> （IL-1<italic>β</italic>）， IL-6， thromboxane B₂ （TXB₂）， and 6-keto prostaglandin F₁<italic>_α</italic> （6-keto-PGF₁<italic>_α</italic>） levels before and after treatment were measured， followed by the safety evaluation. Result:The PRI， VAS， and PPI scores in SF-MPQ of the observation group were reduced in contrast to those in the control group （<italic>P</italic><0.01）. The wind-cold and stasis obstruction syndrome and ODI scores in the observation group also declined as compared with those of the control group （<italic>P</italic><0.01）， while the ADL and Schober's test scores were elevated （<italic>P</italic><0.01）. The TNF-<italic>α</italic>， IL-1<italic>β</italic>， IL-6， and TXB₂ levels in the observation group were lower than those in the control group （<italic>P</italic><0.01）， whereas the 6-keto-PGF₁<italic>_α</italic> was higher （<italic>P</italic><0.01）. The excellent and good rate of the observation group was （51/63） 80.95%， significantly better than （39/63） 61.90% of the control group （<italic>χ</italic>²＝5.601， <italic>P</italic><0.05）. No adverse reactions occurred after the intake of Chinese medicinal prescriptions. Conclusion:The modified Shentong Zhuyutang combined with celecoxib capsules is efficient and safe in inhibiting inflammation， easing back pain， enhancing lumbar spine mobility， and improving the ADL of patients with acute DLBP of wind-cold obstruction syndrome.

Clinical Efficacy of Modified Bushen Huoxuetang Combined with LCP in Treatment of Nonunion of Limb Long Bone Shaft Fracture / 中国实验方剂学杂志

Objective:To discuss the clinical efficacy of modified Bushen Huoxuetang combined with autologous bone grafting and locking compression plate （LCP） in treating nonunion of long bone fractures， and the effect on microcirculation， osteogenic differentiation factor and bone metabolism index. Method:A total of 70 patients were randomly divided into control group and observation group by random number table， with 35 cases in each group. Patients in both groups received LCP. Patients in control group got Dieda Shenggu granule， 10 g/time， 1 time/day. Patients in observation group got Bushen Huoxuetang， 1 dose/day. The course of treatment lasted for 3 months， and 3-month follow-up data were recorded. On a weekly basis， the main symptoms， such as pain， tenderness， longitudinal percussion pain and swelling were checked， and the time of disappearing of main symptoms and signs were compared. On a weekly basis， a X-ray examination was performed for callus formation and fracture line， and the fracture healing time was recorded. Before and after treatment， Fugl-Meyer （FMA） was scored， and levels of fibrinogen （FIB）， whole blood viscosity （BV） （high shear， low shear）， plasma viscosity （PV）， platelet aggregation rate （PAR）， <italic>D</italic>-Dimer （<italic>D</italic>-D）， bone morphogenetic protein-2 （BMP-2）， BMP-7， insulin-like growth factor-1 （IGF-1）， vascular endothelial growth factor （VEGF）， transforming growth factor-<italic>β</italic>₁ （TGF-<italic>β</italic>₁）， osteocalcin （BGP）， osteoprotegerin （OPG）， procollagen type Ⅰ N-terminal propeptideserum amino pro peptide （PINP）， serum type 1 collagen cross-linked C-terminal peptide （S-CTX） and serum tartrate resistant acid phosphatase （TRACP） of type I procollagen were detected， and the safety was evaluated. Result:Disappearance time of symptoms and signs and fracture healing time in observation group were all lower than those in control group （<italic>P</italic><0.01）. At the third month after treatment， and during the three-month follow-up， scores of callus and FMA （upper and lower limbs） in observation group were all higher than those in control group （<italic>P</italic><0.01）. Levels of <italic>D</italic>-D， FIB， PAR， BV and PV （high-cut and low-cut）， BMP-2， BMP-7， IGF-1， VEGF， TGF-<italic>β</italic>₁， S-CTX and TRACP were all lower than those in control group （<italic>P</italic><0.01）， whereas levels of BGP， OPG and PINP were higher than those in control group （<italic>P</italic><0.01）. The curative effect of fracture healing was better than that of control group （<italic>Z</italic>=1.977， <italic>P</italic><0.05）. And the limb function recovery was superior to that in control group （<italic>Z</italic>=1.970， <italic>P</italic><0.05）. Conclusion:Based on autogenous bone and LCP， modified Bushen Huoxuetang can promote the fracture healing， shorten the course of disease， and promote the recovery of limb function， with a good clinical efficacy. It can improve microcirculation， promote the expression of osteogenic differentiation factor， regulate bone metabolism， and play a role in promoting fracture healing， with a safety in clinical use.