补肾通督汤辅助经皮微创减压术治疗退行性腰椎管狭窄

Clinical study of Bushen-Tongdu decoction combined with percutaneous minimally invasive surgery for the degenerative lumbar spinal stenosis

目的观察补肾通督汤辅助经皮微创减压术治疗退行性腰椎管狭窄症的疗效。方法将符合入选标准的80例退行性腰椎管狭窄症患者采用随机数字表法分为2组,每组40例。对照组采用经皮椎间孔镜微创减压术治疗,治疗组在对照组基础上加服补肾通督汤。2组均治疗14 d。治疗前后依据日本骨科学会腰背痛手术评分标准进行腰部疼痛、下肢痛及麻木、步行能力、感觉障碍、运动障碍、直腿抬高试验评分,评价临床疗效。结果治疗组总有效率为95.0%(38/40)、对照组为82.5%(33/40),2组比较差异有统计学意义(Z=-2.357,P=0.018)。治疗后,治疗组腰部疼痛、下肢痛及麻木、步行能力评分,以及感觉障碍、运动障碍、直腿抬高试验评分均高于对照组(t值分别为-2.180、-2.059、-1.985、-2.177、-2.045、-2.238,P值均<0.05)。结论补肾通督汤辅助经皮微创减压术可减轻退行性腰椎管狭窄症患者疼痛程度,提高步行能力,改善感觉及运动障碍,提高临床疗效。

Objective To observe the curative effect of Bushen-Tongdu decoction combined with percutaneous minimally invasive decompression for degenerative lumbar spinal stenosis.Methods A total of 80 patients with degenerative lumbar spinal stenosis were selected and divided into two groups of 40 cases by random number table. The control group was treated with percutaneous transforaminal minimally invasive decompression. The treatment group was given Bushen-Tongdu decoction on the basis of the control group. Both groups were treated for 14 days. The Japanese orthopedic Society back pain evaluation criteria for waist pain,leg pain and numbness,walking ability,sensory dysfunction,dyskinesia,straight leg raising test score were collected and compared.Results The total effective rate was 95.00% (38/40) in the treatment group and 82.50% (33/40) in the control group. The total effective rate of the two groups was statistically significant (Z=-2.357,P=0.018). After treatment,the levels of waist pain score,leg pain and numbness score,walking ability score,sensory dysfunction score,dyskinesia score and the straight leg raising test score in the treatment group were significantly higher than those in the control group(t=-2.180,-2.059,-1.985,-2.177,-2.045,-2.238,P<0.05).Conclusions The Bushen-Tongdu decoction combined with percutaneous minimally invasive decompression can reduce pain,improve walking ability,improve sensory and motor dysfunction,and improve clinical efficacy of the patients with degenerative lumbar spinal stenosis.