补肾活血汤联合微创减压对腰椎管狭窄症患者腰椎功能、疼痛及炎症因子的影响

Effect of Bushen Huoxue Decoction(补肾活血汤)Combined with Minimally Invasive Decompression on Lumbar Vertebral Function,Pain and Inflammatory Factors in Patients with Degenerative Lumbar Spinal Stenosis

目的探讨补肾活血汤联合微创神经根减压对退变性腰椎管狭窄症(DLSS)患者腰椎功能、疼痛及炎症因子的影响。方法选取2018年10月—2020年10月在该院接受微创神经根减压的DLSS患者110例为研究对象,随机分为对照组(55例)与观察组(55例);对照组术后予以一般处理及塞来昔布、甲钴胺口服,观察组在对照组基础上予以补肾活血汤口服,两组均连续用药4周,随访至术后6个月;比较两组优良率,记录两组术前及术后1、3、6个月日本整形外科学会制定评估法(JOA)评分及视觉模拟评分(VAS),观察两组腰椎稳定性,并比较两组术前及术后4周血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、IL-1β水平。结果观察组优良率为85.45%(47/55),高于对照组的65.45%(36/55),差异有统计学意义(P<0.05)。术后1、3、6个月时间点上,观察组JOA评分均高于对照组(P<0.05),VAS评分均低于对照组(P<0.05)。术后6个月随访时,两组均未见腰椎不稳定表现。术后4周,观察组血清TNF-α、IL-6、IL-1β水平均低于对照组,差异有统计学意义(P<0.05)。结论补肾活血汤联合微创神经根减压治疗DLSS疗效较好,能够减轻疼痛症状,促进腰椎功能恢复,抑制炎症因子表达。

Objective To investigate the effect of Bushen Huoxue Decoction(补肾活血汤)combined with minimally invasive nerve root decompression on lumbar vertebral function,pain and inflammatory factors in patients with degenerative lumbar spinal stenosis(DLSS).Methods A total of 110 patients with DLSS who received minimally invasive nerve root decompression in the hospital from October 2018 to October 2020 were randomly divided into control group(55 cases)and observation group(55 cases).The control group was given routine treatment,celecoxib and mecobalamin after operation.The observation group was given Bushen Huoxue Decoction on the basis of the control group.The two groups were treated for 4 weeks continuously,followed up to 6 months after operation.The good efficacy rates of the two groups were compared.The JOA score and VAS score were recorded before operation and 1,3 and 6 months after operation.The lumbar stability of the two groups was observed,and the levels of serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-1β(IL-1β)before operation and 4 weeks after operation between two groups were compared.Results The good efficacy rate of the observation group was 85.45%(47/55),which was higher than 65.45%(36/55)of the control group,and the difference was statistically significant(P<0.05).At 1,3 and 6 months after operation,the JOA score of the observation group was higher than that of the control group(P<0.05),and the VAS score of the observation group was lower than that of the control group(P<0.05).At 6 months follow-up,there was no lumbar instability in both groups.At 4 weeks after operation,the levels of serum TNF-α,IL-6 and IL-1βin the observation group were significantly higher than those in the control group and the difference was statistically significant(P<0.05).Conclusion Bushen Huoxue Decoction combined with minimally invasive nerve root decompression is effective in the treatment of DLSS.It can relieve pain symptoms,promote the recovery of lumbar vertebral function and inhibit the expressions of inflammatory factors.