舒筋健腰丸联合OLIF一期经皮椎弓根螺钉治疗退行性腰椎滑脱疗效观察

Observation of curative effect of Shujinjianyao pills combined with OLIF one-stage percutaneous pedicle screw treatment on degenerative lumbar spondylolisthesis

目的探讨舒筋健腰丸联合斜外侧椎间融合术(OLIF)一期经皮椎弓根螺钉治疗退行性腰椎滑脱的临床疗效。方法选取2018年7月—2019年9月于武汉市中医医院接受OLIF联合后路经皮椎弓根螺钉治疗的69例退行性腰椎滑脱患者,随机分为观察组34例及对照组35例,2组均给予常规OLIF围术期处理,在此基础上观察组口服舒筋健腰丸,对照组口服模拟剂。比较术前及术后1个月2组患者NRS评分、Oswestry功能障碍指数(ODI)、健康相关生命质量评分(HRQoLs)、血清肿瘤坏死因子(TNF-α)、高迁移率族蛋白-1(HMGB-1)水平变化。结果与术前比较,术后1个月2组患者NRS评分、ODI评分均明显降低(P均<0.05),观察组显著低于对照组(P均<0.05);2组HRQoLs均显著升高(P均<0.05),观察组显著高于对照组(P<0.05);2组血清TNF-α及HMGB-1水平均显著下降(P均<0.05),且观察组明显低于对照组(P均<0.05)。结论OLIF一期经皮椎弓根螺钉治疗退行性腰椎滑脱疗效确切,联合舒筋健腰丸口服治疗疗效优于单纯手术治疗,可抑制炎症反应,减轻疼痛,进一步改善术后腰椎功能及生活质量,无明显不良反应。

Objective It is to explore the clinical efficacy of Shujinjianyao pill combined with oblique lateral interbody fusion(OLIF)percutaneous pedicle screw in the treatment of degenerative lumbar spondylolisthesis.Methods A total of 69 patients with degenerative lumbar spondylolisthesis who received OLIF combined with posterior percutaneous pedicle screw treatment at Wuhan Hospital of Traditional Chinese Medicine from July 2018 to September 2019 were randomly divided into observation group(n=34)and control group(n=35),both groups were given routine perioperative treatment of OLIF.Additionally,the observation group was given Shujinjianyao pills and the control group was given a simulated agent.The changes in NRS scores,Oswestry dysfunction index(ODI),health-related quality of life scores(HRQoLs),the levels of serum tumor necrosis factor-α(TNF-α)and high mobility protein-1(HMGB-1)were compared between the two groups before and 1 month after surgery.Results Compared with before operation,the NRS scores and ODI scores of the two groups were significantly reduced at 1 month after the operation(P<0.05),and the observation group was significantly lower than the control group(P<0.05);HRQoLs was significantly increased(P<0.05),and the observation group was significantly higher than the control group(P<0.05);the levels of serum TNF-α and HMGB-1 were significantly decreased(P<0.05),and the observation group was significantly lower than the control group(P<0.05).Conclusion OLIF first-stage percutaneous pedicle screw is effective in treating degenerative lumbar spondylolisthesis.Combination with Shujinjianyao pills is more effective than simple surgical treatment.It can inhibit inflammation,relieve pain,further improve postoperative lumbar function and quality of life without obvious adverse reactions.