活血消肿汤加味联合经皮椎间孔镜手术治疗突出型腰椎间盘突出症30例临床观察

Clinical observation on 30 cases of prominent lumbar disc herniation treated by modified Huoxue Xiaozhong Tang( 活血消肿汤) combined with percutaneous endoscopic lumbar discectomy

目的观察活血消肿汤加味联合经皮椎间孔镜手术治疗突出型腰椎间盘突出症的临床疗效。方法将60例符合手术指征突出型腰椎间盘突出症患者采用随机数字表法分为治疗组和对照组,各30例。2组患者均行椎间孔镜手术,术后予以常规治疗和功能锻炼,在此基础上对照组术后第2天予塞来昔布胶囊口服治疗,治疗组术后第2天予活血消肿汤加味口服治疗,治疗2周后比较2组的临床疗效,并分别于术后1,2,6周比较2组的视觉模拟评分法(VAS)评分、日本骨科协会评估治疗(JOA)评分、Oswestry功能障碍指数(ODI)评分。结果对照组优良率为83.4%(25/30),治疗组为90.0%(27/30),2组比较差异有统计学意义(P<0.05)。术后1,2,6周,2组VAS、ODI评分明显降低,JOA评分明显升高,与同组术前比较差异均有统计学意义(P<0.05或P<0.01),且术后1,2,6周治疗组对VAS、JOA、ODI评分的改善作用明显优于同期对照组,2组比较差异均有统计学意义(P<0.05或P<0.01)。结论活血消肿汤加味联合经皮椎间孔镜手术治疗突出型腰椎间盘突出症临床疗效显著,值得临床推广应用。

Objective To observe the clinical efficacy of modified Huoxue Xiaozhong Tang( 活血消肿汤)combined with percutaneous endoscopic lumbar discectomy( PELD) in the treatment of prominent lumbar disc herniation( LDH). Methods Sixty patients with prominent LDH who met the surgical indications were divided into treatment group and control group by random number table method,with 30 cases in each group. Both groups underwent PELD,and received routine treatment and functional exercises after surgery,on this basis,the control group was given oral administration of celecoxib capsules,while the treatment group was given oral administration of modified Huoxue Xiaozhong Tang on the second day after surgery. After 2 weeks of treatment,scores of visual analogue scale( VAS),Japanese orthopedic association score( JOA) and Oswestry disability index( ODI) at 1 week,2 weeks,and 6 weeks after surgery were compared between the 2 groups. Results The total effective rate was 83.4%( 25/30) in the control group and 90.0%( 27/30) in the treatment group,and the difference was statistically significant between the 2 groups( P<0.05). After surgery for 1,2 and 6 weeks,VAS and ODI scores of the 2 groups significantly decreased,while JOA scores significantly increased,and the difference was statistically significant compared with those before treatment in the same group( P<0.05 or P<0.01),and the improvement of VAS,JOA and ODI scores in the treatment group after surgery for 1,2 and 6 weeks was significantly better than that in the control group at the same period,and the difference was statistically significant between the 2 groups( P<0.05 or P<0.01).Conclusion It has marked clinical efficacy to use modified Huoxue Xiaozhong Tang combined with PELD in the treatment of prominent LDH,which deserves clinical promotion and application.