补肾活血方对腰椎术后功能恢复影响

Effect of Bushen Huoxue Decoction on Postoperative Functional Recovery of Lumbar Posterior Internal Fixation

目的观察补肾活血方配合功能锻炼改善腰椎后路短节段内固定术后患者功能障碍的临床疗效。方法将38例腰椎术后功能障碍患者随机分为两组,治疗组应用补肾活血方配合功能锻炼,共21例;对照组仅进行功能锻炼,共17例。比较两组患者的临床疗效及其治疗前后疼痛程度、功能状况及腰部软组织张力变化情况。分别于治疗前,治疗后2周、4周,随访1月、3月进行评估。结果应用补肾活血方配合功能锻炼治疗2周后有效率为90.47%,治疗4周后有效率为95.24%;在疼痛视觉模拟评分法(Visual analogue scales,VAS)及Oswestry功能障碍指数(Oswestry disability index,QDI)评分上,治疗2周、4周与随访均与治疗前差异有统计学意义(P<0.001);治疗4周、随访与治疗2周相比差异也有统计学意义(P<0.05);随访1月与3月比较差异无统计学意义(P>0.05);治疗2周、4周及随访1月、3月各访视点治疗组与对照组相比差异均有统计学意义(P<0.05)。疗程结束后,两组患者的软组织张力位移较治疗前均显著增加(P<0.05),且治疗组较对照组位移增加显著(P<0.05),3月随访时两组软组织张力位移较治疗前仍增加显著(P<0.05),但两组间差异无统计学意义(P>0.05)。结论补肾活血方配合功能锻炼能有效改善腰椎后路短节段内固定术后患者功能障碍,随访期疗效稳定。

Objective To observe the clinical efficacy of Bushen Huoxue Decoction with functional exercise in improving the dysfunction of patients postoperative lumbar posterior short segment internal fixation.Methods 38 cases of postoperative lumbar posterior internal fixation were randomly divided into two groups.In the treatment group,21 cases were treated with Bushen Huoxue Decoction combined with functional exercise;In the control group,17 case were treated only with functional exercise.The VAS,ODI and soft-tissue tension scores were recorded before treatment and after treatment 2 weeks,4 weeks as well as follow-up after 1 month,3 months while observing of the clinical symptoms and judging the curative effect.Results The clinical efficiency of 2 weeks of treatment group is 90.47%,95.24%after 4 weeks.There was a significant difference between the VAS and ODI scores of before treatment with after treatment and follow-up(P<0.001),so was that of 2 weeks of treatment with 4 weeks and follow-up(P<0.05);but there was no statistical significance between the follow-up 1 months and 3 months(P>0.05);There was a significant difference between treatment group and controls in each point of views after treatment and follow-up(P<0.05).At the end of the course of treatment,the soft tissue tension displacement of the two groups increased significantly(P<0.05),and that of the treatment group increased significantly(P<0.05)compared with the control group.At the 3-month follow-up,the soft tissue tension displacement of the two groups increased significantly(P<0.05),but there was no significant difference between the two groups(P>0.05).Conclusion Bushen Huoxue Decoction combined with functional exercise can significantly improve the clinical symptoms of dysfunction of patients postoperative lumbar posterior short segment internal fixation,and the curative effect is stable during follow-up period.