后路单开门椎管成形术结合加味补阳还五汤治疗颈椎管狭窄症临床疗效

Treating Cervical Spinal Canal Stenosis by Open-door Cervical Laminoplasty Combined Modified Buyang Huanwu Decoction

目的探讨后路单开门椎管成形术结合中药加味补阳还五汤治疗颈椎管狭窄症的临床疗效。方法 32例颈椎管狭窄症患者随机分成单纯手术组(A组,17例)和手术加中药组(B组,15例)。两组均行单开门颈椎管成形术,B组术后加用加味补阳还五汤2周。分别于术前和术后3、12个月进行视觉模拟评分法(visual analogue scale,VAS)评分、日本骨科学会(the Japanese Orthopedic Association,JOA)评分及颈椎残障功能量表(the neck disability index,NDI)评分。结果两组术前VAS评分、JOA评分及NDI评分比较,差异无统计学意义(P>0.05)。两组术后3、12个月VAS评分、JOA评分及NDI评分均较本组术前明显改善(P<0.01)。术后3个月,B组上述评分均明显优于A组(P<0.05);术后12个月,两组上述评分比较,差异均无统计学意义(P>0.05)。结论加味补阳还五汤有利于单开门椎管成形术后颈椎管狭窄症患者早期(术后3个月)神经功能的恢复。

Objective To explore the clinical efficacy of open-door cervical laminoplasty com- bined Modified Buyang Huanwu Decoction （MBHD） to treat cervical spinal canal stenosis （CSCS）. Meth- ods Totally 32 CSCS patients were randomly assigned to two groups, Group A （17 cases, treated by laminoplasty） and Group B （15 cases, treated by laminoplasty combined MBHD）. All patients received open-door cervical laminoplasty. Those in Group B took MBHD additionally for 2 weeks after surgery. The visual analogue scale （VAS）, the Japanese Orthopedic Association （JOA） score, and the neck disability index （NDI） were measured preoperative, postoperative 3 months and 12 months, respectively. Results There was no statistical difference in preoperative VAS, JOA, or NDI （P 〉0.05）.The VAS, JOA, and NDI were obviously improved 3 months and 12 months after surgery in the two groups, showing statistical difference when compared with before surgery in the same group （P 〈0.01 ）. At 3 months after surgery the aforesaid indices in Group B were superior to those in Group A （P 〈0.05）. There was no statistical difference in the aforesaid indices between the two groups at 12 months after surgery （P 〉0.05）. Conclu- sion MBHD favorably improved early recovery of neural functions of CSCS patients （3 months after surgery）.