椎间盘丸联合经皮椎间孔镜治疗腰椎间盘突出症的临床研究

Effect of Zhuijianpan pill combined with percutaneous transforaminal endoscopic discectomy for treating lumbar intervertebral disc herniation

目的观察椎间盘丸联合经皮椎间孔镜下髓核摘除术(PTED)治疗腰椎间盘突出症的临床疗效及安全性。方法根据治疗方案不同将82例腰椎间盘突出症患者分为PTED组37例和PTED+椎间盘丸组45例。2组术前术后基础治疗相同,PTED+椎间盘丸组术后第1天开始口服椎间盘丸,服用6个月。观察2组患者术前、术后1 d、术后1年、术后2年下腰痛JOA评分(29分法)情况,术后2年运用Mac Nab标准进行疗效评定。结果 2组均顺利完成手术,术后均无明显并发症发生。PTED组33例和PTED+椎间盘丸组40例获得随访,术后各时间点JOA评分均明显高于术前(P均<0.05);术后1 d和术后1年,2组JOA评分比较差异均无统计学意义(P均>0.05);术后2年,PTED+椎间盘丸组JOA评分和优良率均明显高于PTED组(P均<0.05)。结论椎间盘丸联合PTED是治疗腰椎间盘突出症的有效方法,远期疗效可观。

Objective It is to observe the clinical efficacy and safety of Zhuijianpan pill combined with percutaneous trans- foraminal endoscopic discectomy （PTED） on lumbar disc herniation. Methods 82 cases of patients with lumbar disc herniation were divided into PTED group and PTED ＋ Zhuijianpan pill group according to the treatment plan. The basic therapy was the same in both groups before and after operation, while PTED ＋ Zhuijianpan pill group was given Zhuijianpan pill orally from the first day after operation to 6 months after treatment. JOA scores （29 score method） of lower back pain before operation, at one day, one year, two year after operation were observed in both groups. The curative effect was evaluated according to MacNab standard at 2 years after operation. Results All operations were completed in both groups, no significant postoperative compli- cation occurred. There were 33 cases in PTED group and 40 cases in PTED ＋ Zhuijianpan pill group who were followed up, and their postoperative JOA score at each time point were significantly higher than that before operation （ P 〈 0.05 ） , no signif- icant difference was found between the two groups in one day and one year after operation （P 〉 0.05）. In 2 years after opera- tion, JOA scores and excellent rate in PTED ＋ Zhuijianpan pill group were higher than that in PTED group（P 〈 0.05 ）. Con- clusion Zhuijianpan pill combined with PTED is an effective method in the treatment of lumbar disc herniation, and the long- term effect is better.