益气逐瘀利水方治疗青少年腰椎间盘突出症的疗效观察

Effect of Yiqizhuyulishui decoction in the treatment of adolescent lumbar disc herniation.

目的通过与成年患者的临床对照研究,观察益气逐瘀利水方对青少年腰椎间盘突出症的疗效及重吸收的影响。方法以苏州中医院骨伤科门诊的27例青少年腰椎间盘突出症患者和79例成年患者为研究对象,以益气逐瘀利水方为主要治疗手段,采用JOA评分,ODI指数,指地距以及直腿抬高度数观测进行疗效评估;通过MRI观察,对青少年腰椎间盘突出症患者突出类型与重吸收的关系进行相关析因分析。结果提高患者的JOA评分,降低ODI指数,提高直腿抬高度数,减少指地距对于青少年和成年患者的吸收率进行Mann-Whitney秩和检验,青少年吸收率与成年患者吸收率无统计学差异对于所有样本后纵韧带破裂型和后纵韧带非破裂型的吸收率进行fisher精确概率计算检验结果具有统计学意义(P=0.003)。结论益气逐瘀利水方对于青少年腰椎间盘突出症具有良好的疗效。青少年与成年患者在突出髓核的吸收机率方面无明显差异。腰椎间盘突出症患者,后纵韧带破裂型突出较易发生重吸收。

Objective To observe the therapeutic effect of Yiqizhuyulishui decoction in thetreatment of adolescent lumbar disc herniation （LDH）. Methods From September 2009 to April 2012,27 adolescent patients and 79 adult patients with LDH were enrolled in the research. After treated by Yiqizhuyulishui decoction,the efficacy was evaluated by JOA score,Oswestry Disable In- dex （ODI）,straight leg raise （SLR） test and Finger to Ground Distance Test. Results After treated by Yiqizhuyulishui decoction,JOA score was improved,the ODI was reduced,the SLR test was im- proved. The results of Mann-Whitney test showed that the resorption rate between adolescent group and adult group had no statistically significant difference （Z=-1.117,P=0.264）. Analyzed by Fisher probabilities in 2×2 table,the results showed that the resorption rate between the type of posterior longitudinal ligament in nonrnpture,and the type of posterior longitudinal ligament rupture had statistically significant difference（P=0.003）. Conclusions Yiqizhuyulishui decoction in the treatment of adolescent lumbar disc herniation has good therapeutic effect,the effect is same as adult patients. Adolescent and adult patients have no significant difference in the absorption probability of the herniated nucleus pulposus. The posterior longitudinal ligament rupture herniated nucleus pulposus is more easily to be reabsorbed.