甲钴胺片联合补肾通督方治疗老年腰椎间盘突出症的疗效

Curative effect of Mecobalamin Tablets combined with Bushen Tongdu Decoction in the treatment of elderly patients with lumbar disc herniation

目的探讨甲钴胺片联合补肾通督方治疗老年腰椎间盘突出症(LDH)的效果。方法选取完成手术治疗的老年LDH患者96例,随机分为治疗组与对照组,每组48例。对照组术后4 d开始口服甲钴胺片,治疗组在对照组治疗的基础上加服补肾通督方,疗程为4周。比较2组的临床预后,测量手术前后血清疼痛相关炎症因子白细胞介素-6(IL-6)与肿瘤坏死因子-α(TNF-α),评价疼痛模拟视觉量表(VAS)、日本骨科协会下腰痛评分(JOA)、Oswestry功能障碍指数(ODI)评分。结果术后7 d和1个月时,2组血清IL-6、TNF-α水平较术前均降低,且治疗组显著低于对照组(P<0.05)。术后7 d、1个月、3个月和6个月,2组VAS评分较术前均降低,且治疗组显著低于对照组(P<0.05)。术后1个月、3个月和6个月,2组JOA评分较术前均升高,且治疗组显著高于对照组(P<0.05);ODI评分较术前均降低,且治疗组显著低于对照组(P<0.05)。治疗组的预后优良率为93.75%,显著高于对照组的83.33%(P<0.05)。结论甲钴胺片联合补肾通督方治疗老年LDH近期疗效确切,可促进疼痛症状缓解及功能康复。

Objective To investigate the effect of Mecobalamin Tablets combined with Bushen Tongdu Decoction in the treatment of elderly lumbar disc herniation(LDH).Methods 96 elderly patients with LDH who had completed surgical treatment were randomly divided into treatment group and control group,with 48 cases in each group.The control group started to take Mecobalamin Tablets 4 days after the operation,the treatment group received Bushen Tongdu Decoction on the basis of the control group for 4 weeks.The clinical prognosis of the 2 groups was compared,the serum pain-related inflammatory factors interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were measured before and after surgery.The pain Visual Analog Scale(VAS),Japanese Orthopaedic Association scores(JOA),and Oswestry Dysfunction Index(ODI)scores were evaluated.Results 7 days and 1 month after operation,the serum levels of IL-6 and TNF-α in the 2 groups were lower than those before the operation,and the treatment group were significantly lower than the control group(P<0.05).At 7 days,1 month,3 months,and 6 months after operation,the VAS scores of the 2 groups were lower than those before the operation,and the treatment group were significantly lower than the control group(P<0.05).At 1 month,3 months,and 6 months after operation,the JOA scores of the 2 groups were higher than those before the operation,and the treatment group were significantly higher than the control group(P<0.05);the ODI scores were lower than that before the operation,and the treatment group were significantly lower than the control group(P<0.05).The good prognosis rate of the treatment group was 93.75%,which was significantly higher than the 83.33% of the control group(P<0.05).Conclusion Mecobalamin Tablets combined with Bushen Tongluo Decoction is effective for the treatment of the elderly patients with LDH,which can promote pain relief and functional recovery.