平乐郭氏正骨益气养血通督汤在脊髓型颈椎病术后应用研究

Clinical Study on Pingle Guo’s Zhenggu Yiqi Yangxue Tongdu Decoction in Postoperative Application of Cervical Spondylotic Myelopathy

目的 比较颈前路椎管减压联合平乐郭氏益气养血通督汤治疗脊髓型颈椎病的临床疗效。方法 回顾性分析河南省洛阳正骨医院(河南省骨科医院) 2017年12月—2020年12月脊髓型颈椎病颈前路手术患者74例,按随机数字表法分为中药组和对照组。比较手术前、手术后1个月、6个月随访时患者的颈椎疼痛视觉模拟评分(VAS)、日本骨科协会脊髓功能评分(JOA)与督脉瘀阻证候评分。结果 74例手术无重大并发症发生,均获得随访,随访时间6个月。2组患者JOA评分和督脉瘀阻证候积分较术前明显提高,VAS评分较术前明显降低,且差异有统计学意义(P <0.05)。术后1个月、6个月中药组JOA评分和督脉经络瘀阻证候分均高于对照组,VAS评分低于对照组,且差异有统计学意义(P <0.05)。2组术后6个月JOA的改善率差异有统计学意义(P <0.05)。结论 平乐郭氏正骨益气养血通督汤从气血论治脊髓型颈椎病术后能起到益气养血、温通督脉的效果,能进一步促进神经功能恢复的作用,较单纯颈前路减压手术疗效更好。

Objective To compare the clinical effects of treating cervical spondylotic myelopathy with anterior cervical spinal canal decompression combined with Pingle Guo ’s Yiqi Yangxue Tongdu decoction and simple anterior cervical spinal canal decompression.Methods A retrospective analysis was performed on 74 patients undergoing anterior cervical surgery from December 2017 to December2020. The patients were randomly divided into group of Pingle Guo’s Yiqi Yangxue Tongdu decoction( traditional Chinese medicine group)and the group of spinal decompression surgery alone( control group) according to the random number table. The visual analogue score of cervical pain( VAS),Japanese orthopaedic association spinal function score( JOA) and governor meridian stasis syndrome score were compared before and after operation between the two groups. Results No major complications occurred in 74 cases,and all were followed up for 6 months. The JOA score and Du Meridian stasis syndrome score of the two groups were significantly higher than those before operation,and the VAS score was significantly lower than those before operation( P < 0. 05). 1st and 6th months after the operation,the JOA score and Du Meridian stasis syndrome score of traditional Chinese medicine group were higher than those of control group,and the VAS score was lower than that of control group( P < 0. 05). Six months after the operation,the JOA improvement rate,The difference was statistically significant( P < 0. 05). Conclusion Pingle Guo’s Zhenggu Yiqi Yangxue Tongdu decoction has the effect of nourishing qi,nourishing blood and warming the governor vessel after treating cervical spondylotic myelopathy from the theory of qi and blood. It can further promote the neurological recovery and is more effective than anterior cervical decompression alone.