中医三联康复疗法治疗腰椎间盘突出症术后残余神经症状临床观察

Clinical Observation on Residual Nerve Symptoms after Operation of Lumbar Disc Herniation Treated by TCM Triple Rehabilitation Therapy

目的:观察中医三联康复疗法治疗腰椎间盘突出症术后残余神经症状的临床疗效。方法:将60例腰椎间盘突出症术后残余神经症状患者随机分为治疗组和对照组,每组30例。治疗组采用中医三联康复疗法(即中药熏蒸+电针+功能锻炼),对照组采用常规康复疗法(热疗+低频电疗+麦肯基背伸训练)。2组均每周治疗5 d,共治疗2周。观察2组临床疗效,分别于治疗前、治疗结束后及治疗结束后4周复诊随访,采用视觉模拟评分法(VAS)、日本骨科协会评估治疗分数(JOA评分)对2组患者的疼痛、活动能力进行检测。结果:治疗组优9例,良16例,可5例,差0例,优良率为83.33%;对照组优2例,良15例,可13例,差0例,优良率为56.67%。2组比较,差异有统计学意义(P <0.05)。治疗结束后及治疗结束后4周,2组VAS评分均降低、JOA评分均提高(P <0.05);治疗结束后,2组VAS评分比较,差异无统计学意义(P> 0.05),治疗组JOA评分高于对照组(P <0.05)。治疗结束后4周,治疗组VAS评分明显低于对照组(P <0.05),JOA评分明显高于对照组(P <0.05)。结论:中医三联康复疗法对腰椎间盘突出症术后残余神经症状的恢复作用明显,能显著改善患者的临床症状,可在临床康复中推广运用。

Objective:To observe the clinical effect of TCM triple rehabilitation therapy on residual nerve symptoms after operation for lumbar disc herniation.Methods:Sixty patients with lumbar disc herniation were randomly divided into a treatment group and a control group,30cases in each group.The treatment group was treated with TCM triple rehabilitation therapy(a combination of herbal fumigation,electro-acupuncture and functional exercise),while the control group was treated with conventional rehabilitation therapy(a combination of hyperthermia,low frequency electrotherapy and McKenzie back stretch training).Both groups were treated5days per week for2weeks.The clinical efficacy of the two groups was observed.The two groups were followed up respectively before treatment,after treatment and after a subsequent visit4weeks later.Visual analogue scale(VAS)and JOA score were used to evaluate the pain and activity ability of the two groups.Results:In the treatment group,9cases were excellent,16cases were good,5cases were normally effective,no cases were ineffective,and the excellent and good rate was83.33%;while in the control group,2cases were excellent,15cases were good,13cases were effective,no cases were ineffective,and the excellent and good rate was56.67%.The difference between the two groups was statistically significant(P<0.05).After treatment and4weeks after treatment,the VAS decreased and JOA score increased in both groups(P<0.05).After treatment,there was no significant difference in VAS between the two groups(P>0.05),and the JOA score of the treatment group were higher that of the control group(P<0.05).Four weeks after treatment,the VAS of the treatment group was significantly lower than that of the control group,and the JOA score was significantly higher than that of the control group(P<0.05).Conclusion:TCM triple rehabilitation therapy has an obvious effect on the recovery of residual nerve symptoms after operation for lumbar disc herniation,can significantly improve clinical symptoms of patients,and can be popularized and applied in clinical rehabilitation.