复元活血汤加减联合椎间孔镜治疗腰椎间盘突出症的临床疗效研究

Clinical Effect of Fuyuan Huoxue Decoction Combined with Percutaneous Endoscopic Lumbar Discectomy on Lumbar Disc Herniation

目的:观察复元活血汤加减联合椎间孔镜治疗腰椎间盘突出症的临床疗效。方法:选取我院2017年6月—2020年12月收治的腰椎间盘突出症患者80例,按照随机数字表分为治疗组与对照组,每组40例。治疗组采用复元活血汤加减联合椎间孔镜手术治疗,对照组仅采用椎间孔镜手术治疗。记录并比较两组患者治疗前、术后1 d,术后2周、1个月、3个月的疼痛视觉模拟评分(VAS评分)、Oswestry功能指数(ODI评分)、JOA评分、足底红外热成像温差值。结果:术前、术后1 d、术后2周,两组患者腰腿疼痛VAS评分差异无统计学意义(P>0.05);术后1个月、术后3个月,治疗组腰腿疼痛VAS评分低于对照组,差异有统计学意义(P<0.05);患者术前、术后1 d,两组ODI评分差异无统计学意义(P>0.05);术后2周、术后1个月、3个月,治疗组ODI评分低于对照组,差异有统计学意义(P<0.00);术前、术后1 d,两组患者JOA评分差异无统计学意义(P>0.05);术后2周、术后1个月、3个月JOA评分,治疗组低于对照组,差异有统计学意义(P<0.05);术前、术后1 d、术后2周,两组患者足底红外温差差异无统计学意义(P>0.05);术后1个月、3个月,两组足底红外温差有统计学意义(P<0.05)。结论:复元活血汤加减联合椎间孔镜治疗腰椎间盘突出症的临床效果较好,术后肢体疼痛、功能恢复快,且并发症少。

Objective To observe the clinical effect of Fuyuan Huoxue decoction combined with percutaneous endoscopic lumbar discectomy in treating lumbar disc herniation.Methods 80 patients meeting the diagnostic,inclusion and exclusion criteria were selected and randomly divided into treatment group and control group according to the enrollment order.The treatment group was treated with Fuyuan Huoxue Decoction combined with percutaneous endoscopic lumbar discectomy,and the control group was treated only with percutaneous endoscopic lumbar discectomy.The VAS score,ODI score,JOA score and plantar infrared thermal imaging temperature difference of patients before treatment,1 day after surgery,2 weeks,1 month and 3 months after surgery were recorded and statistically analyzed.Results There was no statistical difference in VAS score of lumbar and leg pain between the two groups before surgery,1 day after surgery and 2 weeks after surgery(P>0.05).VAS scores of lumbar and leg pain in the treatment group were lower than those in the control group 1 month and 3 months after surgery,and the difference was statistically significant(P<0.05).There was no significant difference in ODI score between 2 groups before surgery and 1 day after surgery(P>0.05).The ODI score of the treatment group was lower than that of the control group at 2 weeks,1 month and 3 months after surgery,and the difference was statistically significant(P<0.00).There was no significant difference in JOA score between 2 groups before surgery and 1 day after surgery(P>0.05).The JOA score of the treatment group was lower than that of the control group at 2 weeks,1 month and 3 months after surgery,and the difference was statistically significant(P<0.05).There was no statistical difference between the infrared plantar temperature difference of the two groups before surgery,1 day after surgery and 2 weeks after surgery(P>0.05);1 month and 3 months after surgery,the infrared temperature difference of the plantar had statistical significance(P<0.05).The VAS score,ODI score,JOA score and infrared plantar temperature difference of the 2 groups were all improved 1 day,2 weeks,1 month and 3 months after surgery,with statistical difference(P<0.05).Conclusion Fuyuan Huoxue Decoction combined with percutaneous endoscopic lumbar discectomy in the treatment of lumbar disc herniation has good clinical effect,the postoperative limb pain and function quickly recovery,with less complications.