脊康方在经皮腰椎间孔镜围手术期运用的临床研究

Clinical Study of Jikang Decoction for Patients with Percutaneous Endoscopic Lumbar Discectomy in Period of Perioperative

目的:基于"从督论治"的治疗理念探讨脊康方(原方名腰突颗粒)在腰椎间盘突出症患者经皮腰椎间孔镜术围手术期的临床应用价值。方法:选取2015年2月至2016年2月在本病区采用经皮椎间孔镜微创手术治疗的腰椎间盘突出症患者共96例,按随机数字表法分为治疗组、对照组各48例。治疗组在术前3d及术后1周常规治疗基础上予以口服脊康方煎煮剂;对照组未口服脊康方煎煮剂。于术前3d、术后1周、术后2周采用VAS评分、ODI指数、督脉瘀阻症候积分对患者的症状体征进行评价。结果:两组患者术后1周、术后2周VAS评分、ODI指数及督脉瘀阻症候积分均明显优于术前3d,且差异有统计学意义。治疗组术后1周、术后2周VAS评分及ODI均低于对照组,督脉瘀阻症候积分则高于对照组,差异均有统计学意义(P<0.05)。术后2周治疗组的手术相关并发症为4.17%,低于对照组的14.58%,差异有统计学意义(P<0.05)。结论:通过经皮椎间孔镜微创手术摘除神经根致压物,同时在围手术期口服脊康方补肾通督、活血化瘀、疏通督脉,促进受压神经恢复功能。

Objective：To investigate the clinical value of Jikang decoction for patients with percutaneous endoscopic lumbar discectomy in period of perioperative based on the concept of＂Congdulunzhi＂.Methods：A total of 96 patients with lumbar disc herniation underwent percutaneous endoscopic lumbar discectomy surgery in our hospital from February 2015 to February 2016,were selected and randomly divided into treatment group（n=48）and control group（n=48）.The patients in the treatment group were given orally Jikang decoction on the basis of routine treatment at 3 dbefore operation and 1 week after operation.The control group was given no oral lumbar granule decoction.The symptoms and signs of the patients were evaluated by VAS score,ODI index and Du stasis syndrome score at 3 dbefore operation,1 week and 2 weeks after operation.Results：The scores of VAS score,ODI index,and Du stasis syndrome scores at 1 week and 2 weeks postoperatively were significantly better than preoperative 3 d,both of which were significantly different.The ODI and VAS score at 1 week and 2 weeks after operation in the treatment group were lower than that in the control group,and the score of Dukes stasis resistance syndrome was higher than that in the control group,the differences were statistically significant（P〈0.05）.The rate of complications postoperative was 4.17% in treatment group compared with 14.58% of the control group 2 weeks after operation（P〈0.05）.Conclusion：Percutaneous endoscopic lumbar discectomy removal of nerve root compression,combined with Jikang decoction in perioperative time can reinforce the kidney and smooth Governor vessel,promote the blood circulation,and promote the recovery of compression nerve root function.