加减独活寄生汤联合经皮椎间孔镜髓核摘除术治疗腰椎间盘突出症效果观察

Observation on the Effect of Modified Duhuo Jisheng Decoction Combined with Percutaneous Foramen Endoscopic Pulp Nucleectomy in the Treatment of Lumbar Disc Herniation

目的:评价加减独活寄生汤联合经皮椎间孔镜髓核摘除术治疗腰椎间盘突出症的效果。方法:将2019年1月—2020年1月收治的126例腰椎间盘突出症患者分为观察组和对照组,对照组给予经皮椎间孔镜髓核摘除术,观察组联合加减独活寄生汤治疗。比较两组疗效,治疗前后炎症因子、疼痛介质、JOA评分、ODI指数及术后感觉异常综合征发生情况。结果:观察组临床治疗总有效率为96.83%(61/63),较对照组的84.13%(53/63)显著提高。治疗前两组IL-1β、TNF-ɑ、SOD、MDA、PGE2、5-HT指标水平差异无统计学意义(P>0.05),治疗后两组IL-1β、TNF-ɑ、SOD、MDA、PGE2、5-HT指标水平均显著下降(P<0.05),且治疗后观察组IL-1β、TNF-ɑ、SOD、MDA、PGE2、5-HT指标水平显著低于对照组(P<0.05)。两组治疗前JOA、ODI评分差异无统计学意义(P>0.05);治疗后JOA、ODI评分均显著改善(P<0.05),且治疗后观察组JOA、ODI评分均优于对照组(P<0.05)。观察组感觉异常发生率为6.35%(4/63),较对照组19.05%(12/63)显著降低(P<0.05)。结论:加减独活寄生汤应用于行经皮椎间孔镜髓核摘除术治疗的腰椎间盘突出症患者可显著提高临床疗效,降低机体炎症反应,缓解机体疼痛,加速恢复,值得推广。

Objective:To evaluate the effect of modified Duhuo Jisheng decoction combined with percutaneous foraminal nucleus pulposus extraction for the treatment of lumbar disc herniation.Methods:126 patients with lumbar disc herniation admitted from January 2019 to January 2020 were selected and divided into the observation group and the control group.The control group was treated with percutaneous foraminal endoscopic nucleus pulposus removal,and the observation group was treated with Duhuo parasitic decoction.The effects of the two groups were compared,including inflammatory factors,pain mediators,JOA score,ODI index,and the incidence of postoperative paresthesia syndrome before and after treatment.Results:The total effective rate of clinical treatment in the observation group was 96.83%(61/63),significantly higher than 84.13%(53/63)IL-1β、TNF-α、There was no significant difference in the levels of SOD,MDA,PGE2and 5-HT(P>0.05).After treatment,IL-1β、TNF-α、The levels of SOD,MDA,PGE2,5-HT were significantly decreased(P<0.05),and IL-1 in the observation group after IL-1β、TNF-α、The levels of SOD,MDA,PGE2and 5-HT in the control group were significantly lower than those in the control group(P<0.05).There was no significant difference in JOA and ODI scores between the two groups before treatment(P>0.05).After treatment,JOA and ODI scores were significantly improved(P<0.05),and JOA and ODI scores in the observation group were better than those in the control group after treatment(P<0.05).The incidence of abnormal sensation in the observation group was 6.35%(4/63),which was significantly lower than that in the control group19.05%(12/63),(P<0.05).Conclusion:Modified Duhuo Jisheng Decoction can significantly improve the clinical efficacy,reduce the inflammatory reaction of the body,alleviate the pain of the body,and accelerate the recovery of patients with lumbar disc herniation treated by percutaneous foraminal endoscopic nucleus pulposus extraction.It is worth promoting.