通督舒筋汤加减配合理筋手法治疗退行性腰椎管狭窄

Effect of Tongdu Shujin Decoction(通督舒筋汤)plus Lijin(理筋)manipulation on degenerative lumbar spinal stenosis

目的:探讨运用通督舒筋汤加减配合手法治疗腰椎管狭窄的临床疗效。方法:对2015年10月至2017年10月确诊为腰椎管狭窄50例患者临床资料进行回顾性研究,分为治疗组和对照组,各25例。治疗组中男10例,女15例;年龄(53.43±5.26)岁;病程(6.9±2.3)年;给予通督舒筋汤加减配合手法治疗。对照组中男12例,女13例;年龄(56.37±4.61)岁;病程(7.1±3.4)年;予以口服腺苷钴胺片和洛索洛芬钠片治疗。两组均以4周为1个疗程。治疗后,采用腰痛疗效评价标准(JOA)和视觉模拟评分法(VAS)评定两组临床疗效。结果:50例患者获得随访,随访时间2.2~3.2(2.62±0.47)个月。治疗后两组JOA评分和VAS评分较治疗前均有明显改善,差异有统计学意义(P<0.01),且治疗后治疗组改善程度优于对照组,差异有统计学意义(P<0.01)。结论:通督舒筋汤加减配合手法治疗腰椎管狭窄症有较好疗效。

Obejective:To explore the clinical efficacy of Tongdu Shujin Decoction(通督舒筋汤,TSD)combined with manipulation for the treatment of lumbar spinal stenosis.Methods:The clinical data of 50 patients with lumbar spinal stenosis diagnosed from October 2015 to October 2017 were retrospectively studied.Fifty patients were divided into a treatment group and a control group,25 cases in each group.In the treatment group,25 patients were treated by TSD plus combined manipulation,including 10 males and 15 females,with an average age of(53.43±5.26)years old,the course of disease was(6.9±2.3)years.In the control group,25 patients were treated by the adenosine cobalamin tablets and loxoprofen sodium tablets,including 12 males and 13 females,with an average age of(56.37±4.61)years old,the course of disease was(7.1±3.4)years.The two groups were treated for 4 weeks.After treatment,the clinical efficacy of the two groups were evaluated by the low back pain evaluation criteria(JOA)and visual analogue scale(VAS).Results:Fifty patients were followed up for 2.2 to 3.2(2.62±0.47)months.After treatment,JOA and VAS scores of the two groups were significantly improved compared with those before treatment,the difference was statistically significant(P<0.01),and the improvement degree of the treatment group was better than that of the control group,the difference was statistically significant(P<0.01).Conclusion:TSD combined with manipulation for the treatment of lumbar spinal stenosis has a good effect.