桃红四物汤联合经皮椎间孔镜治疗腰椎间盘突出症疗效研究

Clinical study on the treatment of lumbar disc herniation with Taohong Siwu decoction combined with percutaneous endoscopic transluminal discectomy

目的:观察桃红四物汤联合经皮椎间孔镜治疗腰椎间盘突出症的临床疗效。方法:选取60例腰椎间盘突出症且中医辨证属于气滞血瘀型的患者,按随机数字表法分为对照组30例和观察组30例。对照组使用经皮椎间孔镜治疗,观察组在对照组基础上口服桃红四物汤治疗。分别于术前、术后1周、术后1个月及术后3个月进行VAS、ODI比较,术后3个月采用改良MacNab标准评价疗效。结果:术后两组患者的VAS评分、ODI指数较术前明显降低(P<0.05);观察组较对照组术后1周VAS评分、ODI指数比较无统计学意义(P>0.05)。观察组术后1个月、术后3个月VAS评分、及ODI指数均优于对照组,差异有统计学意义(P<0.05)。术后3个月采用改良MacNab评比,观察组、对照组优良率分别为93.3%、90.0%,两组优良率对比差异无统计学意义(P>0.05)。结论:桃红四物汤联合经皮椎间孔镜治疗腰椎间盘突出症(气滞血瘀型)能够明显改善患者术后症状,提高临床疗效。

Objective:To observe the clinical effect of Taohong Siwu decoction combined with percutaneous transforaminal endoscope on lumbar disc herniation. Methods:60 patients with lumbar disc herniation and belongs to Qizhi Xueyu type,according to random number table method were divided into the control group 30 cases and the observation group 30 cases,the control group treated with percutaneous endoscopic transluminal discectomy.The observation group was treated with Taohong Siwu decoction on the basis of the control group. VAS and ODI were compared before surgery,1 week,1 month and 3 months after surgery. Improved Mac Nab criteria were used to evaluate the efficacy 3 months after surgery. Results:VAS and ODI of the two groups were significantly lower after operation than before(P<0.05).VAS and ODI in the observation group were not statistically significant compared with those in the control group 1 week after surgery(P>0.05),and VAS and ODI in the observation group were both better than those in the control group 1 month after surgery and 3 months after surgery,with statistically significant differences(P< 0.05).Three months after the operation,the improved MacNab was evaluated,and the excellent and good rates of the observation group and the control group were 93.3% and 90.0%,respectively. There was no statistically significant difference in the excellent and good rates between the two groups(P>0.05).Conclusion:The combination of Taohong Siwu decoction and percutaneous transforaminal endoscope for lumbar disc herniation(Qizhi Xueyu type) can significantly improve the postoperative symptoms and improve the clinical effect.