经皮椎间孔镜下髓核切除术联合通督活血汤治疗腰椎间盘突出症临床研究

Clinical Study on Percutaneous Transforaminal Nucleotomy Combined with Tongdu Huoxue Tang for Lumbar Disc Herniation

目的:观察经皮椎间孔镜下髓核切除术联合通督活血汤治疗腰椎间盘突出症的临床疗效。方法:选取86例气滞血瘀型腰椎间盘突出症患者作为研究对象,按随机数字表法分为对照组及观察组各43例。对照组行经皮椎间孔镜髓核切除术治疗,观察组在对照组基础上于第2天给予通督活血汤治疗。比较2组术前及术后3个月、术后12个月疼痛视觉模拟评分法(VAS)、Oswestry功能障碍指数量表评分(ODI)的变化,比较2组临床疗效,观察2组术后并发症发生情况。结果:术后3个月及术后12个月,2组VAS评分均较术前下降,差异均有统计学意义(P<0.05);术后3个月及术后12个月,观察组VAS评分均低于同一时间段对照组,差异均有统计学意义(P<0.05)。术后3个月及术后12个月,2组ODI评分均较术前下降,差异均有统计学意义(P<0.05);术后3个月及术后12个月,观察组ODI评分均低于同一时间段对照组,差异均有统计学意义(P<0.05)。治疗后,对照组临床疗效优良率为81.4%,观察组为95.35%,2组比较,差异有统计学意义(P<0.05)。结论:经皮椎间孔镜下髓核切除术联合通督活血汤治疗腰椎间盘突出症能有效促进患者术后功能恢复,缓解患者临床症状,减缓疼痛,提高生活质量。

Objective:To observe the clinical effect of percutaneous transforaminal nucleotomy combined with Tongdu Huoxue tang for lumbar disc herniation.Methods:A total of 86 cases of patients with lumbar disc herniation of qi stagnation and blood stasis type were selected as the study subjects,and divided into the control group and the observation group according to the random number table method,with 43 cases in each group.The control group was treated with percutaneous transforaminal nucleotomy,and the observation group was treated with Tongdu Huoxue tang since the second day based on the treatment of the control group.Before surgery,and three and twelve months after surgery,the changes in scores of pain in Visual Analogue Scale(VAS)and Oswestry Disability Index(ODI)in the two groups were compared.The clinical effects in the two groups were compared.After surgery,the incidence of complications in the two groups was observed.Results:Three and twelve months after surgery,VAS scores in the two groups were decreased when compared with those before surgery,differences being significant(P<0.05);VAS scores in the observation group were lower than those in the control group at the same time period,differences being significant(P<0.05).Three and twelve months after surgery,ODI scores in the two groups were decreased when compared with those before surgery,differences being significant(P<0.05);ODI scores in the observation group were lower than those in the control group at the same time period,differences being significant(P<0.05).After treatment,the total effective rate of clinical effect was 81.40%in the control group and 95.35%in the observation group,the difference being significant(P<0.05).Conclusion:Percutaneous transforaminal nucleotomy combined with Tongdu Huoxue tang for lumbar disc herniation can effectively promote the postoperative functional recovery,alleviate the clinical symptoms,relieve pain and improve the quality of life.