内窥镜联合中药治疗腰椎间盘突出症(督脉瘀阻型)的临床效果

Clinical Observation of Endoscope Combined with Traditional Chinese Medicine for Treating Lumber Intervertebral Disc Herniation(Du Meridian Stagnation Type)

目的:探讨内窥镜联合中药治疗腰椎间盘突出症(督脉瘀阻型)的临床效果。方法:自2016年1月至2016年7月,选取督脉瘀阻型腰椎间盘突出症的患者68例,分为对照组(内窥镜组)及治疗组(内窥镜加中药组)。比较治疗前、治疗后1个月及末次随访时两组患者疼痛视觉模拟评分(VAS)、下腰痛功能分级评分(FRS)与改良日本骨科学会下腰痛评分(M-JOA)及督脉瘀阻证候积分;随访时间6~12周。结果:治疗组总有效率为94.18%,对照组为74.47%,两组差异有统计学意义(P<0.05)。两组治疗1个月后和末次随访时,VAS及M-JOA评分与督脉瘀阻证候积分均较治疗前明显下降,FRS评分较治疗前明显增高,差异均有统计学意义(P<0.01)。治疗后1个月时,治疗组的VAS及M-JOA评分与督脉瘀阻证候积分均低于对照组,FRS评分高于对照组,差异均有统计学意义(P<0,05)。至末次随访时治疗组的督脉瘀阻证候积分、VAS与M-JOA评分仍低于对照组,FRS评分高于对照组,差异有统计学意义(P<0.05)。结论:督脉瘀阻型椎间盘突出症内窥镜治疗可解除督脉瘀阻水肿和压迫以疏通督脉,联合中药治疗可改善微循环、消除炎症介质、进一步疏通督脉,以促进功能恢复。

Objective：To detect the clinical effect of endoscope combined with traditional Chinese medicine for lumbar intervertebral disc herniation（LDH）with Du meridian stagnation type.Methods：All 68 patients with LDH of Du meridian stagnation type were collected from January 2016 to July 2016.All patients were divided into control group（endoscope group）and treatment group（endoscope combined with traditional Chinese medicine）,followed-up for 6~12 weeks.The visual analogue pain scale（VAS）,the function rating scale for low back pain（FRS）,modified Japanese orthopaedic society lower lumbago score（M-JOA）and the syndrome score of Du meridian stagnation of the patients in two groups were compared preoperative,postoperative,1st and the last follow-up respectively.Results：The effective rate of treatment group was 94.18%,the control group was 74.71%（P〈0.05）.At the time of postoperative,1st month and the last follow-up,the VAS score,the M-JOA score and the syndrome score of Du meridian stagnation of two groups were lower than preoperative,and the FRS score were higher（P〈0.01）.After treatment for 1 month,the VAS score,the M-JOA score and the syndrome score of Du meridian stagnation of treatment group were lower than control group,and the FRS score were higher than control group（P〈0.05）.At the last follow-up,the VAS score,the M-JOA score and the syndrome score of Du meridian stagnation of treatment group were still lower than control group,and the FRS score were still higher than control group.Conclusion：The endoscope operation on LDH of Du meridian stagnation type can reduce the edema and remove the compression of the Du meridian.The traditional Chinese medicine can improve the microcirculation,remove inflammatory mediator and dredge Du meridian further so that it can accelerate recovery of spinal nerve’s function.