从肝肾论治联合微创介入治疗腰椎间盘突出症

Observation of Treatment by Regulating Liver and Kidney Combined with Minimally Invasive Interventional Therapy in Lumbar Disc Herniation

目的：观察腰椎间盘突出症从肝肾论治结合经皮椎间孔镜下间盘摘除（Percutaneous Endoscopic Lumbar Discectomy,PELD）联合臭氧注射微创介入综合治疗效果。方法：2012年1月-2012年12月,共有31例腰椎盘突出症患者纳入研究,采用PELD联合臭氧注射微创介入并口服自拟中药补肾蠲痹汤加减综合疗法,根据患者疼痛的视觉模拟评分法（Visual Analogue Scale/Score,VAS）,JOA下腰痛评分（Japanese Orthopaedic Association Scores）和改良的Macnab评分标准以及参照《中医病证诊断疗效标准》,分别进行统计学分析;比较治疗前后及近期随访时患者疼痛的VAS分值及JOA分值、并发症等。结果：随访8-10个月,平均6.8个月,使用Macnab标准评估治疗后6个月优良率93.55%,参照《中医病证诊断疗效标准》评定优良率90.32%。VAS评分JOA评分治疗前、治疗后1个月、治疗后6个月评分比较差异有统计学意义（P〈0.01）。结论：腰椎间盘突出症从肝肾论治结合微创PELD联合臭氧注射综合疗法具有针对性强、安全、微创、疗效肯定、康复快等特点,是一种很好的治疗方法。

Objective：To observe the effect of treatment by regulating liver and kidney combined with percutaneous endoscopic lumbar discectomy（PELD）and minimally invasive interventional ozone injection in lumbar disc herniation.Methods：All 31 patients of lumbar disc herniation were received PELD and minimally invasive interventional ozone injection combined with oral traditional Chinese medicine Bushen Juanbi Tang.The visual analogue scale/score（VAS）,Japanese orthopedic association scores（JOA）,modified Macnab score and diagnostic efficacy of standard TCM Syndrome were evaluated before and after treatment.Results：All the patients were followed up in 8to 10 months.The rate of fineness was 93.55%in the sixth month after treatment evaluated by modified Macnab Score,and 90.32% by Diagnostic efficacy of standard TCM Syndrome.The VAS and JOA score in the first month and the sixth month after treatment were significantly better than base line（P〈0.01）.Conclusion：Treatment by regulating liver and kidney combined with PELD and ozone injection in lumbar disc herniation is a directly,safe,minimally invasive and effective therapy.