黄芪桂枝五物汤治疗胸腰椎骨折脊髓损伤研究

Study on the clinical efficacy of Huangqi Guizhi Wuwu Decoction in the treatment of thoracolumbar fractures and spinal cord injuries

目的观察黄芪桂枝五物汤联合后路椎板减压术治疗胸腰椎骨折合并脊髓损伤(TFSCI)患者临床疗效。方法选择80例TFSCI患者为研究对象,随机分为观察组和对照组。各40例。对照组应用后路椎板减压术治疗,观察组应用黄芪桂枝五物汤联合后路椎板减压螺钉置入修复术治疗。比较2组治疗总有效率,椎体形态学,神经功能,日常生活能力,胸腰椎功能。结果观察组总有效率(92.50%,37/40)高于对照组(72.50%,29/40)(P<0.05)。治疗后,2组椎体前缘高度、椎间隙高度、Cobb角均增加,观察组椎体形态学增加幅度高于对照组(P<0.05);2组针刺感觉、轻触感觉、运动感觉评分均增加,观察组增加幅度高于对照组(P<0.05);2组BI、JOA评分均增加,观察组增加幅度高于对照组(P<0.05)。结论黄芪桂枝五物汤联合后路椎板减压术治疗TFSCI患者,可提高临床疗效,促进椎体形态学、胸腰椎功能修复,提高日常生活能力。

Objective To observe the clinical effect of Huangqi Guizhi Wuwu Decoction combined with the posterior laminectomy in the treatment of patients with thoracolumbar fractures complicated with spinal cord injuries(TFSCI).Methods A total of 80 TFSCI patients were selected as the research subjects and randomly divided into an observation group and a control group,with 40 cases in each group.The control group was treated with the posterior laminar decompression,and the observation group was treated with Huangqi Guizhi Wuwu Decoction combined with the posterior laminar decompression screw placement and repair.The total effective rate,vertebral morphology,neurological function,daily living ability and thoracolumbar function were compared between the two groups.Results The total effective rate in the observation group(92.50%,37/40)was higher than that in the control group(72.50%,29/40)(P<0.05).After treatment,the anterior vertebral height,intervertebral space height and Cobb angle in the two groups were all increased,and the vertebral body morphology was increased in the observation group higher than that in the control group(P<0.05).The scores of acupuncture sensation,light touch sensation and motor sensation were increased in the two groups,and the increase rate in the observation group was higher than that in the control group(P<0.05).After treatment,the scores of the Barthel Index(BI)and Japanese Orthopaedic Association(JOA)in the two groups were both increased,and the increase in the observation group was higher than that in the control group(P<0.05).Conclusion Huangqi Guizhi Wuwu Decoction combined with the posterior laminectomy can improve the clinical efficacy of TFSCI patients,promote the vertebral morphology,the thoracolumbar function repair,and improve the daily living ability.