独活寄生汤加减离子导入对椎间盘突出症脊柱内镜术后康复和残余症状的影响

Effect of Duhuo Jisheng Decoction Iontophoresis on Rehabilitation of Spinal Disc Herniation After Endoscopic Surgery and Residual Symptoms

目的:观察中药离子导入对椎间盘突出症患者术后康复和残余症状的影响。方法:将102例椎间盘突出症患者随机分为对照组和观察组。对照组50例患者在脊柱内镜术后进行早期康复训练治疗,观察组52例患者在对照组治疗基础上给予独活寄生汤加减离子导入治疗。21 d为1个疗程。治疗后比较两组残余腰痛、残余腿痛、直腿抬高试验阳性患者例数,比较治疗前后两组患者SF-36健康量表评分、Oswestry功能障碍指数(Oswestry disability index,ODI)、日常生活活动能力(activities of daily living,ADL)量表和肝肾亏虚证评分;并对两组患者进行安全性评价。结果:观察组有效率为90.37%,高于对照组的74.00%(χ2=5.219,P<0.05);观察组残余腰痛、残余腿痛及直腿抬高试验阳性发生率分别为13.46%、5.77%和3.85%,均低于对照组的44.00%、24.00%和20.00%(P<0.01);治疗后观察组SF-36健康量表躯体疼痛、精力、生理职能、一般健康、生理机能、情感职能、社会功能及精神健康等8个维度评分均高于对照组(P<0.01);观察组ODI量表疼痛、单项和日常活动能力3维度评分和总分均低于对照组(P<0.01);治疗后观察组ADL评分高于对照组,肝肾亏虚证评分低于对照组(P<0.01)。结论:独活寄生汤加减离子导入能有效改善椎间盘突出症脊柱内镜术后患者术后残余症状,促进患者功能恢复,提高患者生活质量,临床疗效显著。

Objective：To observe the effect of Duhuo Jisheng Decoction iontophoresis on rehabilitation of spinal disc herniation after endoscopic surgery and residual symptoms. Methods：102 cases of patients were randomly divided into the control group of 50 cases and the treatment group of 52 cases. The control group accepted rehabilitation training,while the treatment group added the treatment of Duhuo Jisheng Decoction iontophoresis on the basis of the control group. 21 days as a course of treatment. Compared the clinical effect of before and after treatment with the positive rate of residual lumbago,leg hurts,leg raising test,SF-36 Health scale score,Oswestry disability index（ ODI）,activities of daily living（ ADL）,and score of liver and kidney deficiency syndrome. And evaluated the safety of patients in the two groups. Results：The effective rate of the observation group was 90. 37%,obviously better than control group 74. 00%（ P〈0. 05）. The observation group was better than control group in the positive rate of residual lumbago（13. 46% vs 44. 00%）,residual leg pain（5. 77% vs 24. 00%）,leg raising test（3. 85% vs 20. 00%）. After treatment,SF-36 health scale body pain,energy,physiological role,general health,physiological function,emotional function,social function and mental health scores in the observation group were higher than the control group（ P〈0. 01）;ODI pain scale,individual and daily activities scores and total scores in the observation group were lower than the control group（ P〈0. 01）;after treatment,ADL score of observation group was higher than that of the control group,liver and kidney deficiency syndrome score lower than the control group（ P〈0. 01）. Conclusion：Duhuo Jisheng Decoction iontophoresis can effectively improve spinal disc herniation after endoscopic surgery in patients with postoperative residual symptoms,promote functional recovery,improve the quality of life,and the clinical effect is significant.