通痹止痛汤治疗腰椎间盘突出症PTED术后残余痛临床研究

Clinical Study on Tongbi Zhitong Tang for Patients with Residual Pain After PTED for Lumbar Disc Herniation

目的:观察通痹止痛汤治疗腰椎间盘突出症(LDH)经皮椎间孔镜下椎间盘髓核摘除术(PTED)术后残余痛患者的临床疗效。方法:选取150例LDH行PTED术后残余痛患者作为研究对象,按照治疗方式不同分成2组,对照组75例给予术后常规康复治疗,观察组75例给予术后常规康复治疗联合通痹止痛汤治疗。比较2组腰椎功能、症状评分、炎症因子表达水平。结果:治疗前,2组日本骨科协会评分(JOA)及腰椎Oswetry功能障碍指数(ODI)评分比较,差异无统计学意义(P>0.05);治疗后,2组JOA评分均升高(P<0.05),ODI评分均降低(P<0.05),且观察组JOA评分高于对照组,ODI评分低于对照组(P<0.05)。治疗前,2组各症状视觉模拟评分法(VAS)评分比较,差异无统计学意义(P>0.05);治疗后,2组各症状VAS评分均降低(P<0.05),且观察组低于对照组(P<0.05)。治疗前,2组血清丙二醛(MDA)、超氧化物歧化酶(SOD)、肿瘤坏死因子-α (TNF-α)、白细胞介素-6 (IL-6)水平比较,差异无统计学意义(P>0.05);治疗后,2组血清SOD水平均升高(P<0.05),MDA、TNF-α、IL-6水平均降低(P<0.05),且观察组血清SOD水平高于对照组(P<0.05),MDA、TNF-α、IL-6水平低于对照组(P<0.05)。结论:通痹止痛汤治疗LDH行PTED术后残余痛患者效果确切,能有效缓解疼痛,改善腰椎功能,抑制炎性因子表达。

Objective:To observe the clinical effect of Tongbi Zhitong Tang for patients with residual pain after percutaneous transforaminal endoscopic discectomy(PTED) for lumbar disc herniation(LDH).Methods:A total of 150 cases of LDH patients with residual pain after PTED were selected as the study subjects and divided into two groups according to the treatment methods,with 75 cases in each group.After operation,the control group was treated with routine rehabilitation,and the observation group was treated with routine rehabilitation combined with Tongbi Zhitong Tang.The lumbar function,symptom scores and the expression levels of inflammatory factors in the two groups were compared.Results:Before treatment,there was no significant difference being found in the comparison of scores of Japanese Orthopaedic Association(JOA) and Oswestry Disability Index(ODI) between the two groups(P>0.05).After treatment,the JOA scores in the two groups were increased(P0.05).After treatment,the scores of each symptom in VAS in the two groups were decreased(P0.05).After treatment,the SOD levels in serum in the two groups were increased(P<0.05),and the levels of MDA,TNF-α and IL-6 were decreased(P<0.05);the SOD level in serum in the observation group was higher than that in the control group(P<0.05),and the levels of MDA,TNF-α and IL-6 were lower(P<0.05).Conclusion:Tongbi Zhitong Tang has a definite effect in treating patients with residual pain after PTED for LDH,which can effectively relieve pain,improve lumbar function and inhibit expressions of inflammatory factors.