独活寄生汤治疗腰椎间盘突出症椎间孔镜术后临床研究

Clinical Study on Duhuo Jisheng Tang for Lumbar Disc Herniation after Percutaneous Transforaminal Endoscopic Discectomy

目的:观察椎间孔镜术后采用独活寄生汤治疗腰椎间盘突出症的临床疗效。方法:将腰椎间盘突出症进行椎间孔镜术后的120例患者,按照随机分组的原则分为对照组与观察组各60例。对照组在术后给予常规抗生素抗感染治疗,观察组在常规抗感染治疗基础上,联用独活寄生汤中西医结合治疗。比较2组在治疗前后腰椎功能改善情况,采用日本骨科协会评估治疗(JOA)评分进行比较;比较2组治疗前后疼痛视觉模拟评分(VAS)改变情况;比较2组总体疗效。结果:治疗前,2组JOA评分比较,差异无统计学意义(P>0.05)。治疗后,2组腰椎功能均得到改善,JOA评分均下降,但与对照组相比,观察组JOA评分更优,差异有统计学意义(P<0.05)。治疗前,2组疼痛VAS评分比较,差异无统计学意义(P>0.05)。治疗1个月后、治疗3个月后,2组患者疼痛均得到改善,但与对照组相比,观察组VAS评分更优,差异有统计学意义(P<0.05)。与对照组相比,观察组总疗效更优,差异有统计学意义(P<0.05)。结论:在椎间孔镜术的基础上,联合独活寄生汤治疗腰椎间盘突出症,可取得明显疗效,效果优于单独手术治疗,可改善患者腰椎功能,缓解术后疼痛,减少因手术带来的痛苦,改善患者生活质量。

Objective:To observe the clinical effect of Duhuo Jisheng tang for lumbar disc herniation after percutaneous transforaminal endoscopic discectomy.Methods:Divided 120 cases of patients with lumbar disc herniation undergoing percutaneous transforaminal endoscopic discectomy into the control group and the observation group randomly,60 cases in each group.The control group was given routine antibiotic treatment for anti-infection,while the observation group was additionally given integrated Chinese and western medicine therapy with Duhuo Jisheng tang.Compared the improvements of lumbar vertebrae function before and after treatment in both groups via the scores of Japanese Orthopaedic Association(JOA),the changes of Visual Analogue Scale(VAS)in two groups before and after treatment and compared the overall clinical effect in both groups.Results:Before treatment,comparing the scores of JOA in both groups,there was no significant difference being found(P>0.05).After treatment,the lumbar vertebrae function in both groups was improved,and the scores of JOA were decreased;comparing with the control group,the score of JOA in the observation group was better,difference being significant(P<0.05).Before treatment,comparing the scores of VAS in both groups,there was no significant difference being found(P>0.05).After 1 and 3 months of treatment,pain in patients of both groups was improved;comparing with the control group,the score of VAS in the observation group was better,difference being significant(P<0.05).Comparing with the control group,the total curative effect in the observation group was better,difference being significant(P>0.05).Conclusion:The application of Duhuo Jisheng tang based on percutaneous transforaminal endoscopic discectomy for lumbar disc herniation have obvious curative effect,which has better clinical effect than simple operation.It can improve lumbar vertebrae function,relieve postoperational and surgical pain,improve the quality of life.