芪参还五胶囊治疗无骨折脱位型颈脊髓损伤急性期痛觉过敏的临床观察

Clinical observation on Qishen Huanwu capsule on acute hyperalgesia of cervical spinal cord injury without fracture and dislocation

目的探讨芪参还五胶囊治疗无骨折脱位型颈脊髓损伤(CSCIWORA)急性期痛觉过敏(DPS)的临床疗效。方法选取2017年1月—2018年1月在河北省沧州中西医结合医院住院治疗的CSCIWORA以DPS为主要表现,且辨证为气虚血瘀证患者60例,采用随机对照方法分为对照组30例、治疗组30例。对照组给予甘露醇、甲泼尼龙琥珀酸钠常规治疗,治疗组在此基础上服用芪参还五胶囊2周,观察比较2组入院后及治疗1周后、2周后、1个月后VAS评分、ASIA评分、颈椎JOA评分。结果2组治疗1周后、治疗2周后及1个月后随访时ASIA评分均较治疗前明显增加(P均<0.05),且治疗组治疗后各时间点ASIA评分均明显高于对照组(P均<0.05)。2组治疗1周后、治疗2周后及1个月后随访时VAS评分均较治疗前明显降低(P均<0.05),且治疗组治疗后各时间点VAS评分均明显低于对照组(P均<0.05)。2组治疗1周后、治疗2周后及1个月随访时颈椎JOA评分均较治疗前明显增高(P均<0.05),且治疗组治疗1周后、治疗2周后颈椎JOA评分均明显高于对照组(P均<0.05),1个月随访时2组JOA评分比较差异无统计学意义(P>0.05)。结论采用芪参还五胶囊联合治疗CSCIWOR急性期以DPS为主要症状的患者,可明显减轻脊髓水肿,促进神经功能恢复,改善患者临床症状。

Objective It is to explore the clinical efficacy of Qishen Huanwu capsule in the treatment of acute hyperalgesia of cervical spinal cord injury without fracture and dislocation.Methods A total of 60 cases of patients with acute hyperalgesia of cervical spinal cord injury without fracture and dislocation with Qi deficiency and blood stasis syndrome,who were hospitalized in Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2017 to January 2018 were selected.They were divided into a control group and a treatment group groups according to randomized controlled method,each group had 30 cases.The control group was treated with conventional medicine such as mannitol and methylprednisolone sodium succinate,the treatment group was treated with Qishen Huanwu capsules for 2 weeks based on the control group.The VAS score,ASIA score,and cervical JOA score were observed and compared between the two groups after admission,1 week after treatment,2 weeks after treatment,and 1 months later.Results The ASIA scores of the two groups after 1,2 weeks of treatment,and 1 month follow-up were significantly higher than those before treatment,and the ASIA scores of the treatment group at each time point after treatment were significantly higher than those of the control group(P<0.05).After 1,2 weeks of treatment,and 1 month follow-up,the VAS scores of the two groups were significantly lower than those before treatment(P<0.05),and the VAS scores of the treatment group were significantly lower than those of the control group at all time points after treatment(P<0.05).The JOA scores of the cervical spine in the two groups after 1,2 weeks of treatment and 1 month follow-up were significantly improved compared to before treatment,and the JOA scores of the cervical spine in the treatment group improved more significantly than the control group after 1 and 2 weeks of treatment(P<0.05).The follow-up results after 1 month showed that the JOA score difference between the two groups was not statistically significant(P>0.05).Conclusion Qishen huanwu capsules can significantly reduce spinal cord edema,promote the recovery of nerve function,and improve the clinical symptoms in the treatment of patients with acute hyperalgesia of cervical spinal cord injury without fracture and dislocation.