补阳还五汤配合理筋手法治疗退行性腰椎管狭窄的效果

Effect of Buyang Huanwu Decoction and Reasonable Tendon Manipulation on Degenerative Lumbar Spinal Stenosis

目的分析退行性腰椎管狭窄治疗中补阳还五汤和理筋手法的联合应用效果。方法选取该院2017年11月-2019年11月收治的100例退行性腰椎管狭窄患者。根据治疗方法应用不同,将患者分为观察组(50例)和对照组(50例)。对照组患者采用常规西医治疗,观察组患者给予理筋手法配合补阳还五汤,对比两组患者视觉模拟评分法(VAS)评分、炎症因子水平、中医症候评分以及日本骨科协会下腰痛评分(JOA)。结果观察组患者VAS评分(1.08±0.22)分明显低于对照组(3.11±0.77)分,差异有统计学意义(t=17.925,P<0.05);观察组患者白细胞介素-1α(6.42±1.01)ng/L、C反应蛋白(2.22±0.54)mg/L、肿瘤坏死因子(13.10±3.31)ng/L水平更低,差异有统计学意义(t=5.446、17.966、3.162,P<0.05);观察组中医症候评分低于对照组,差异有统计学意义(t=16.488、13.840、5.939、7.408,P<0.05);JOA评分中膀胱功能(8.46±1.14)分、日常活动受限度(9.21±0.15)分、主观症状(8.56±1.22)分、临床体征(4.86±1.95)分高于对照组,差异有统计学意义(t=5.992、38.014、5.675、5.378,P<0.05)。结论针对退行性腰椎管狭窄患者,在临床治疗上实施理筋手法和补阳还五汤的联合应用,能够有效降低患者疼痛程度和炎性因子水平,改善患者症状水平,临床疗效显著。

Objective To analyze the combined application effect of Buyang Huanwu Decoction and tendon manipulation in the treatment of degenerative lumbar spinal stenosis.Methods Selected 100 patients with degenerative lumbar spinal stenosis admitted to the hospital from November 2017 to November 2019.According to the application of different treatment methods,the patients were divided into observation group(50 cases)and control group(50 cases).Patients in the control group were treated with conventional Western medicine,and the patients in the observation group were treated with Jinjin manipulation combined with Buyang Huanwu Decoction.The visual analogue scale(VAS)score,inflammatory factor level,TCM Syndrome Score and the Low Back Pain Score of the Japanese Orthopaedic Association(JOA)were compared.Results The VAS score(1.08±0.22)points of the observation group was significantly lower than that of the control group(3.11±0.77)points,and the difference was statistically significant(t=17.925,P<0.05).In the observation group,the levels of interleukin-1α(6.42±1.01)ng/L,C-reactive protein(2.22±0.54)mg/L,and tumor necrosis factor(13.10±3.31)ng/L were lower,and the difference was statistically significant(t=5.446,17.966,3.162,P<0.05).The TCM syndrome scores of the observation group were lower than those of the control group,and the difference was statistically significant(t=16.488,13.840,5.939,7.408,P<0.05);the JOA score had bladder function(8.46±1.14)points,daily activity limitation(9.21±0.15)points,subjective symptom(8.56±1.22)points,and clinical signs(4.86±1.95)points were higher than the control group.The difference was statistically significant(t=5.992,38.014,5.675,5.378,P<0.05).Conclusion For patients with degenerative lumbar spinal stenosis,the combined application of tendon Manipulation and Buyang Huanwu Decoction in clinical treatment can effectively reduce the patient's pain degree and inflammatory factor level,improve the patient's symptom level,and have significant clinical effects.