身痛逐瘀汤结合椎间孔镜髓核摘除术治疗腰椎间盘突出症患者的效果

Effect of Shentong Zhuyu Decoction Combined with Endoscopic Foraminal Nucleus Pulposus Removal in the Treatment of Patients with Lumbar Intervertebral Disc Herniation

目的探讨身痛逐瘀汤结合椎间孔镜髓核摘除术治疗腰椎间盘突出症患者的效果。方法选择2020年10月至2021年10月于南阳市万和医院治疗的100例腰椎间盘突出症患者,以随机数字表法分组,观察组患者50例,接受身痛逐瘀汤结合椎间孔镜髓核摘除术治疗,参照组患者50例,接受椎间孔镜髓核摘除术治疗。治疗前、后检测两组患者白细胞介素-17(IL-17)、细胞间黏附分子-1(ICAM-1)、单核细胞趋化蛋白1(MCP-1)、白细胞介素-1β(IL-1β)、神经肽Y(NPY)、6-酮前列腺素E1α(6-keto-PGE1α)、β内啡肽(β-EP)、P物质(SP)水平,疼痛情况通过视觉模拟评分(VAS)评价,腰椎功能通过日本骨科协会(JOA)评估治疗分数评价,生活质量通过健康状况调查表(SF-36)评价,观察两组患者临床疗效。结果观察组IL-17、ICAM-1、MCP-1、IL-1β水平低于参照组(P<0.05),观察组β-EP水平高于参照组(P<0.05),观察组6-keto-PGE1α、SP、NPY水平低于参照组(P<0.05),观察组患者VAS评分低于参照组(P<0.05),观察组患者JOA、SF-36评分高于参照组(P<0.05),观察组患者总有效率(98.00%)较参照组(86.00%)高(P<0.05)。结论采用身痛逐瘀汤结合椎间孔镜髓核摘除术治疗腰椎间盘突出症,可抑制患者炎症,减轻疼痛,改善腰椎功能,提升生活质量及临床效果。

Objective To explore the curative effect of Shentong Zhuyu decoction combined with endoscopic foraminal nucleus pulposus removal in the treatment of patients with lumbar disc herniation.Methods A total of 100 patients with lumbar disc herniation who were treated in Nanyang Wanhe Hospital from October 2020 to October 2021 were selected.They were divided into groups by random number table method.Fifty patients in the observation group received Shentong Zhuyu decoction combined with endoscopic foraminal nucleus pulposus removal,and 50 patients in the reference group received endoscopic foraminal nucleus pulposus removal.Interleukin-17(IL-17)and intercellular adhesion molecule-1(ICAM-1),monocyte chemoattractant protein 1(MCP-1),interleukin-1β(IL-1β),neuropeptide Y(NPY),6-keto prostaglandin E1α(6-keto-PGE1α),β-endorphin(β-EP),substance P(SP)levels were detected before and after treatment.Pain was evaluated by visual analogue scale(VAS),lumbar spine function was evaluated by Japanese Orthopaedic Association(JOA)assessment score,and quality of life was evaluated by 36-item short form health survey(SF-36).The clinical efficacy of the two groups of patients were observed.Results The levels of IL-17,ICAM-1,MCP-1 and IL-1βin the observation group were lower than those in the reference group(P<0.05),and the level ofβ-EP in the observation group was higher than that in the reference group(P<0.05).The levels of 6-keto-PGE1α,SP and NPY were lower than those in the reference group(P<0.05).The VAS in the observation group was lower than that in the reference group(P<0.05),and the JOA and SF-36 scores in the observation group were higher than those in the reference group(P<0.05).The total effective rate of patients in the observation group(98.00%)was higher than that(86.00%)in the reference group(P<0.05).Conclusion For patients with lumbar intervertebral disc herniation,Shentong Zhuyu decoction combined with endoscopic foraminal nucleus pulposus removal can inhibit inflammation,relieve pain,improve lumbar spine function,improve quality of life and clinical efficacy.