活血消瘢冲剂预防腰椎间盘突出术后硬膜外瘢痕的临床研究

Clinical research of Huoxue Xiaoban powder in prevention from epidural scar formation post-discectomy

目的 :探讨活血消瘢冲剂预防腰椎间盘突出术后硬膜外瘢痕形成的有效性。方法 :4 5例腰椎间盘突出病人随机分为 3组 :活血消瘢冲剂组 (中药组 ) ,双氯芬酸钠组 (西药组 ) ,空白对照组 (空白组 ) ,均行标准的后正中入路、单侧椎板间开窗、髓核摘除手术。中、西药组术后分别给予活血消瘢冲剂、扶他林缓释片口服。 3组于术前及术后 1、2周测定血液流变学、血浆前列腺素E2 (PGE2 )的含量、尿羟脯氨酸 (UHOP)含量。术后 8周行增强CT扫描并按陆裕朴疗效标准评定手术效果。结果 :中、西药组术后各阶段各项生化指标与空白组比较差异有显著性意义。术后 8周增强CT扫描示中、西药组硬膜外瘢痕增强程度较空白组为轻 ,手术优良率明显高于空白组。结论 :活血消瘢冲剂有减少腰椎间盘术后硬膜外瘢痕的作用。

Objective:To probe into the validity of Huoxue Xiaoban powder used as inhibitor to prevent from the formation of epidural scar post-discectomy.Methods:Forty-five patients with lumbar disc herniation were divided into three groups randomly:Huoxue Xiaoban powder group (Herb group),diclofenac sodium group (Western medicine group),and vacuity control group (Control group).All the patients underwent classic discectomies.The first day after operation Huoxue Xiaoban powder was given to Herb group three times a day and a packet one time which had 15 g herbs till the second week.75 mg diclofenac sodium (Votalin) was given to Western medicine group once a day after supper.Following biochemical indexes were observed preoperatively in the first and the second week post-operatively:the level of hemorheology,PGE 2 and urinary hydroxyproline (UHOP).Enhanced CT scan was examined in the eighth week.The clinical effect of operation was judged according to the standard of LU Yu-pu.Results:There was significant difference between Herb group and Control group in the biochemical indexes postoperatively,as well as Western medicine group and control group.Enhanced CT scan revealed protrusion with different scope and density around dura mater in all groups but enhanced extent was different (P<0 05) in the eighth week.The excellent and good rate in Herb group was higher than that in Control group.Conclusion:Huoxue Xiaoban powder can reduce the epidural scar formation post-discectomy and be used to prevent from the epidural fibrosis and adhesion.