健步强督方联合系统宣教法对腰椎间盘突出症复发的影响

Effects of Jianbu Qiangdu Fang(健步强督方)Combined with Systematic Education on Recurrence of Lumbar Disc Herniation

目的:探讨健步强督方联合系统宣教法对腰椎间盘突出症患者症状复发的影响。方法:将80例腰椎间盘突出症患者随机分为治疗组和对照组,每组40例。治疗组使用健步强督方联合系统宣教法治疗,对照组予传统宣教方式联合甲钴胺注射液、塞来昔布胶囊治疗。研究分为2步进行,(1)观察患者出院时临床疗效指标和视觉模拟评分法(VAS)评分,对2组在院治疗效果进行评估;(2)对在院治疗评估为有效的患者,进行出院后16周的连续随访,分析健步强督方联合系统宣教法是否对患者腰椎间盘突出症的疾病复发产生影响。结果:(1)经住院治疗后,治疗组和对照组中各有1例患者症状加重,分别选择转院或手术治疗,治疗组显效率为65.00%,优于对照组的40.00%(P <0.05);2组总有效率均为97.50%,差异无统计学意义(P> 0.05);2组VAS评分均≤3分,差异无统计学意义(P> 0.05)。(2)随访后,治疗组复发人数、首次复发时间、复发次数和复发后治疗天数低于对照组(P <0.05)。结论:采用健步强督方的温养督脉法治疗联合系统宣教法指导患者日常行为、康复锻炼和结合心理疏导可以减少腰椎间盘突出症患者症状复发。

Objective:To explore the intervention effect of Jianbu Qiangdu Fang(健步强督方)combined with systematic education on recurrence of lumbar disc herniation.Methods:Eighty patients with lumbar disc herniation were randomly divided into a treatment group and a control group,with 40 cases in each group.The treatment group was mainly treated with Jianbu Qiangdu Fang combined with systematic education,while the control group was mainly treated with traditional educational method combined with mecobalamin injection and celecoxib capsule.The study was divided into two steps:(1) Observe the clinical efficacy index and visual analogue scale(VAS)of patients at discharge,and evaluate the treatment effect of the two groups in hospital;(2) For the patients whose treatments were evaluated as effective in the hospital,a continuous follow-up of 16 weeks after discharge was carried out to analyze whether the Jianbu Qiangdu Fang combined with systematic education had an impact on the recurrence of lumbar disc herniation.Results:(1) After hospitalization,symptoms of one patient in the treatment group and one patient in the control group got worse,and they chose to be transferred to other hospitals or operated for treatment respectively.The effective rate in the treatment group was 65.00%,which was better than 40.00% in the control group(P>0.05);The total effective rate of both groups was 97.50%,with no significant difference(P<0.05);The VAS of the two groups were not more than three points,and the difference was not statistically significant(P>0.05).(2) After follow-up,the number of patients suffering recurrence and the number of recurrence were smaller,and the time of first recurrence and the treatment days after recurrence were shorter in the observation group than those in the control group(P<0.05).Conclusion:The treatment of warming,nourishing and regulating the Du meridian with Jianbu Qiangdu Fang combined with systematic education to guide the daily behavior and rehabilitation exercise of patients and psychological counseling can reduce the recurrence of symptoms in patients with lumbar disc herniation.