益气活血补肾法对腰椎间盘突出症术后恢复的影响

Effect of supplementing qi, blood-activating and kidney-nourishing therapy on postoperative recovery in patients with lumber disc herniation

目的探讨益气活血补肾法对腰椎间盘突出症术后患者功能活动及生活质量的临床疗效。方法选择2010年1月~2012年5月在广州南方医科大学附属南方医院脊柱骨科住院行手术治疗,术前中医辨证为肝肾亏虚的腰椎间盘突出症患者120例,经患者同意参加试验。采用随机数字表法随机分为观察组60例,对照组60例。对照组术后给予单纯西医常规对症治疗,观察组在西医常规对症治疗基础上给予益气活血补肾方。分别在各个观察时点对疼痛的视觉模拟评分（VAS系统）、JOA下腰痛评分、WHOQOL-BREF评分、住院天数、不良事件进行观察。结果 120例腰椎间盘突出症患者全部得到随访,进入结果分析,没有脱失。术后2、4、8周观察组在VAS、JOA、WHOQOL-BREF评分要优于对照组,有统计学差异（P〈0.01）。术后半年及1年后随访,观察组和对照组在VAS、WHOQOL-BREF评分之间无统计学意义（P〉0.01）。但在JOA评分方面,观察组要优于对照组,差异有统计学意义（P〈0.01）。结论益气活血补肾法对腰椎间盘突出症患者术后恢复,改善术后主要症状体征及减少不良事件方面存在优势。

Objective To investigate the effect of supplementing qi, activating blood circulation and tonifying kidney therapy on the postoperative outcomes of patients undergoing lumber intervertebral disc herniation. Methods From January 2010 to May2012, 120 patients with lumbar intervertebral disc herniation undergoing surgical treatment in Nanfang hospital were randomized into two equal groups to receive routine therapy（control group） and additional treatment with Yiqi Houxue Bushen Decoction（treatment group）. The effect of the interventions was evaluated by assessing the Visual Analogue Scale（VAS）, Japanese Orthopedic Association Scores（JOA）, WHO Quality of Life- BREF（WHOQOL- BREF）, length of hospital stay and adverse event. Results All the 120 patients were followed up and analyzed. Significant differences were found between the treatment and control groups in VAS, JOA Scores, and WHOQOL-BREF（P〈0.01） at 2, 4, and 8 week and at 6 and 12 months after the surgery. At 6 and 12 months postoperatively, the JOA Scores（P〈0.01）, but not the VAS and WHOQOL-BREF, differed significantly between the two groups. Conclusion Blood- activating and kidney- nourishing therapy is effective in promoting postoperative recovery and helps reduce the clinical symptoms and minimize the adverse events in patients undergoing surgery for lumber intervertebral disc herniation.