中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (36): 9462-9468.doi: 10.12307/2026.901

• 肌肉肌腱韧带组织构建 tissue construction of the muscle, tendon and ligament • 上一篇    下一篇

芍药甘草汤联合冲击波治疗臀中肌综合征：评价肌腱结构恢复的随机对照试验

石腾博1，2，张孟瑜3，王幸飞1，2，付  卓2，李晨阳2，4，孟祥熙1，2，刘  浩1，2，郭超韡2，贺自克1，5，倘艳锋2   

  1. 1河南中医药大学骨伤学院，河南省郑州市  450000；2河南省洛阳正骨医院(河南省骨科医院)髋部损伤中心，河南省洛阳市  471002；3南京中医药大学第一临床医学院，江苏省南京市  210029；4福建中医药大学，福建省福州市  350122；5河南省中医院关节科，河南省郑州市  450002
  • 收稿日期:2025-10-15 修回日期:2026-03-10 出版日期:2026-12-28 发布日期:2026-05-21
  • 通讯作者: 倘艳锋，硕士，副教授，硕士生导师，河南省洛阳正骨医院(河南省骨科医院)髋部损伤中心，河南省洛阳市 471002 共同通讯作者：贺自克，硕士，副教授，硕士生导师，河南中医药大学骨伤学院，河南省郑州市 450000；河南省中医院关节科，河南省郑州市 450002
  • 作者简介:石腾博，男，1998年生，河南省周口市人，汉族，河南中医药大学在读硕士，主要从事中医药防治创伤与骨不愈合研究。 共同第一作者：张孟瑜，女，1998年生，河南省洛阳市人，汉族，南京中医药大学在读博士，主要从事中医妇科及生殖内分泌疾病的研究。
  • 基金资助:
    河南省中医药科研专项课题(2025ZY1021)，项目负责人：倘艳锋；河南省中医药拔尖人才培养项目专项课题(2022ZYBJ22)，项目负责人：倘艳锋；河南省中医药科学研究专项重点项目(20-21ZY1061)，项目负责人：倘艳锋

Shaoyao Gancao Decoction combined with shock wave therapy for treating gluteus medius syndrome: a randomized controlled trial on structural improvement of the tendon

Shi Tengbo1, 2, Zhang Mengyu3, Wang Xingfei1, 2, Fu Zhuo2, Li Chenyang2, 4, Meng Xiangxi1, 2, Liu Hao1, 2, Guo Chaowei2, He Zike1, 5, #br# Tang Yanfeng2#br#   

  1. 1School of Bone and Injury of Henan University of Chinese Medicine, Zhengzhou 450000, Henan Province, China; 2Hip Injury Center of Henan Luoyang Bone-Setting Hospital (Henan Orthopaedic Hospital), Luoyang 471002, Henan Province, China; 3The First Clinical Medical College of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China; 4Fujian University of Traditional Chinese Medicine, Fuzhou 350122, Fujian Province, China; 5Joint Department, Henan Hospital of Traditional Chinese Medicine, Zhengzhou 450002, Henan Province, China
  • Received:2025-10-15 Revised:2026-03-10 Online:2026-12-28 Published:2026-05-21
  • Contact: Tang Yanfeng, MS, Associate professor, Master’s supervisor, Hip Injury Center of Henan Luoyang Bone-Setting Hospital (Henan Orthopaedic Hospital), Luoyang 471002, Henan Province, China Co-corresponding author: He Zike, MS, Associate professor, Master’s supervisor, School of Bone and Injury of Henan University of Chinese Medicine, Zhengzhou 450000, Henan Province, China; Joint Department, Henan Hospital of Traditional Chinese Medicine, Zhengzhou 450002, Henan Province, China
  • About author:Shi Tengbo, MS candidate, School of Bone and Injury of Henan University of Chinese Medicine, Zhengzhou 450000, Henan Province, China; Hip Injury Center of Henan Luoyang Bone-Setting Hospital (Henan Orthopaedic Hospital), Luoyang 471002, Henan Province, China Zhang Mengyu, PhD candidate, The First Clinical Medical College of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China Shi Tengbo and Zhang Mengyu contributed equally to this work.
  • Supported by:
    Special Project of Traditional Chinese Medicine Research in Henan Province, No. 2025ZY1021 (to TYF); Special Project of Top TCM Talents Training Project of Henan Province, No. 2022ZYBJ22 (to TYF); Special Key Project of TCM Scientific Research of Henan Province, No. 20-21ZY1061 (to TYF)

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摘要：



文题释义：
芍药甘草汤：由芍药和甘草两味中药组成的经典方剂，具有缓急止痛、调和肝脾的功效，常用于治疗肌肉痉挛、腹痛及四肢拘急等症。
体外冲击波：是一种利用高能量声波作用于患处的非侵入性物理治疗技术，主要用于治疗软组织疼痛、钙化性肌腱炎及骨不连等肌肉骨骼疾病。

背景：臀中肌综合征是一种以臀中肌肌腱退变、无菌性炎症或肌筋膜损伤为主要病理特征的慢性疼痛性疾病，目前西医治疗以体外冲击波和非类固醇抗炎药为主，但长期疗效有限；中药芍药甘草汤作为经典方剂，具有活血止痛之效，但其与体外冲击波疗法联合应用的临床效果尚不明确。
目的：应用芍药甘草汤联合体外冲击波治疗臀中肌综合征，评估二者在疼痛缓解、功能恢复及炎症调控方面的协同作用。
方法：采用前瞻性随机对照试验，纳入165例符合中西医诊断标准的臀中肌综合征患者，随机分为3组，每组55例。冲击波组患者单纯使用冲击波治疗机进行体外冲击波治疗，每3 d 1次，连续4次；中药组单纯服用芍药甘草汤治疗，每日1剂，共15 d；联合组接受芍药甘草汤同时进行体外冲击波治疗。于治疗前后比较患者目测类比评分、髋关节Harris评分、超声回声强度，检测血清炎症因子(前列腺素E2、P物质、白细胞介素6、肿瘤坏死因子α)水平，评估中医药疗效和不良反应。
结果与结论：①联合组患者在治疗后3 d、1周、1个月和3个月时的目测类比评分均显著低于单一治疗组(P < 0.05)，治疗后3个月Harris评分(86.4分)优于冲击波组(79.6分)和中药组(76.8分)；②超声显示联合组患者臀中肌肌腱结构修复更显著，回声强度112.6优于冲击波组138.7和中药组158.4；③炎症因子检测表明，联合组患者血清前列腺素E2、P物质、白细胞介素6及肿瘤坏死因子α水平下降更明显(P < 0.05)；④联合组患者总有效率达80%，显著高于冲击波组(64%)和中药组(59.2%)，且不良反应发生率低。结果表明：芍药甘草汤联合体外冲击波可协同缓解臀中肌综合征疼痛、促进功能恢复并抑制炎症反应，疗效优于单一疗法，安全性良好。

https://orcid.org/0009-0008-8240-4872 (石腾博)


中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程

关键词: 芍药甘草汤, 体外冲击波, 臀中肌综合征, 炎症, 气滞血瘀

Abstract: BACKGROUND: Gluteus medius syndrome is a chronic painful disorder characterized by tendon degeneration, aseptic inflammation, or myofascial injury of the gluteus medius muscle. Current Western treatments primarily include extracorporeal shock wave therapy and nonsteroidal anti-inflammatory drugs, but long-term efficacy remains limited. Shaoyao Gancao Decoction, a classical formula, is known for its blood-activating and pain-relieving effects. However, the clinical efficacy of its combination with extracorporeal shock wave remains unclear.
OBJECTIVE: To evaluate the clinical efficacy of Shaoyao Gancao Decoction combined with extracorporeal shock wave therapy in treating gluteus medius syndrome (qi stagnation and blood stasis syndrome) and assess its synergistic effects on pain relief, functional recovery, and inflammation modulation.
METHODS: A prospective randomized controlled trial was conducted, enrolling 165 patients with gluteus medius syndrome meeting both Western and traditional Chinese medicine diagnostic criteria. Participants were randomly divided into three groups: the extracorporeal shock wave therapy group (extracorporeal shock wave therapy alone, every 3 days for a total of 4 consecutive sessions), the Shaoyao Gancao Decoction group (Shaoyao Gancao Decoction alone, once daily for 15 days), and the combination group (Shaoyao Gancao Decoction + extracorporeal shock wave therapy), with 55 patients in each group. Patients’ visual analog scores, Harris hip scores, and ultrasound echo intensity were compared before and after treatment. Serum levels of inflammatory cytokines (prostaglandin E2, substance P, interleukin-6, tumor necrosis factor-α) were also detected to evaluate the efficacy and adverse reactions of traditional Chinese medicine.
RESULTS AND CONCLUSION: (1) The combination group exhibited significantly lower visual analog scale scores at 3 day, 1 week, and 3 months after treatment compared with monotherapy groups (P < 0.05). At 3 months post-treatment, the Harris Hip Score in the combination group (86.4) surpassed those of the extracorporeal shock wave therapy group (79.6) and the Shaoyao Gancao Decoction group (76.8). (2) The repair of gluteus medius tendon structure in the combination group was more significant, and the echo intensity was 112.6, which was better than that of the extracorporeal shock wave therapy group (138.7) and the Shaoyao Gancao Decoction group (158.4). (3) Inflammatory markers (prostaglandin E2, substance P, interleukin-6, tumor necrosis factor-α) decreased more markedly in the combination group (P < 0.05). (4) The total effective rate was 80% in the combination group, significantly higher than that in the extracorporeal shock wave therapy group (64%) and the Shaoyao Gancao Decoction group (59.2%), with a lower incidence of adverse events. To conclude, the combination of Shaoyao Gancao Decoction and extracorporeal shock wave therapy synergistically alleviates pain, promotes functional recovery, and suppresses inflammatory responses in gluteus medius syndrome, demonstrating superior efficacy to monotherapies with a favorable safety profile.

Key words: Shaoyao Gancao Decoction, extracorporeal shock wave therapy, gluteus medius syndrome, inflammation, qi stagnation and blood stasis syndrome

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