经皮椎间孔镜下髓核摘除术联合身痛逐瘀汤治疗气滞血瘀型腰椎间盘突出症临床研究

Clinical Observation of Percutaneous Transforaminal Endoscopic Discectomy Combined with Shentong Zhuyu Decoction in The Treatment of Lumbar Disc Herniation of Qi Stagnation and Blood Stasis Type

目的观察经皮椎间孔镜下髓核摘除术联合身痛逐瘀汤治疗气滞血瘀型腰椎间盘突出症的临床疗效。方法70例腰椎间盘突出症患者按就诊顺序分为治疗组和对照组,每组各35例,治疗组选用经皮椎间孔镜下髓核摘除术+身痛逐瘀汤口服治疗,对照组选用单纯的经皮椎间孔镜下髓核摘除术治疗,观察两组患者治疗1个月、3个月后的VAS评分、JOA评分及中医证候改善情况并进行统计学分析。结果治疗前两组患者的一般资料、VAS评分、JOA评分均无明显差异(P>0.05);治疗1个月后,两组患者的VAS评分、JOA评分均较治疗前明显改善(P<0.05),且治疗组改善更明显,差异具有统计学意义(P<0.05);治疗3个月后,治疗组与对照组的VAS评分比较无明显差异(P>0.05),而JOA评分比较有差异(P<0.05),治疗组JOA评分改善情况仍优于对照组(P<0.05)。经治疗后的中医证候改善情况总有效率:治疗组为94.29%、对照组为85.71%,两组比较具有显著差异(P<0.05)。结论经皮椎间孔镜下髓核摘除术联合身痛逐瘀汤治疗气滞血瘀型腰椎间盘突出症在减轻患者疼痛、改善临床症状、提高术后功能恢复等方面均明显于单纯的经皮椎间孔镜下髓核摘除术,值得临床推广应用。

Objective To observe the clinical efficacy of percutaneous transforaminal endoscopic discectomy combined with Shentong Zhuyu Decoction in the treatment of lumbar disc herniation of Qi stagnation and blood stasis type.Methods 70 patients with lumbar disc herniation were divided into treatment group and control group according to the order of treatment,35 cases in each group.The treatment group was treated with percutaneous transforaminal endoscopic discectomy+Shentong Zhuyu Decoction,while the control group was treated with simple percutaneous transforaminal endoscopic discectomy.The VAS score,JOA score and TCM Syndrome improvement of the two groups were observed and compared after 1 month and 3 months of treatment statistical analysis.Results Before treatment,there was no significant difference in general information,VAS score and JOA score between the two groups(P>0.05);after 1 month of treatment,the VAS score and JOA score of the two groups were significantly improved(P<0.05),and the improvement of the treatment group was more obvious,the difference was statistically significant(P<0.05);after 3 months of treatment,there was no significant difference in VAS score between the treatment group and the control group(P>0.05),but the JOA score was significantly higher.The improvement of JOA score in the treatment group was still better than that in the control group(P<0.05).After treatment,the total effective rate of TCM syndrome improvement was 94.29%in the treatment group and 85.71%in the control group,with significant difference between the two groups(P<0.05).Conclusion Percutaneous transforaminal endoscopic discectomy combined with Shentong Zhuyu Decoction in the treatment of lumbar disc herniation of Qi stagnation and blood stasis type is significantly better than simple percutaneous transforaminal endoscopic discectomy in relieving pain,improving clinical symptoms and improving postoperative functional recovery,which is worthy of clinical application.