督脉活血汤联合中药外敷治疗气虚血瘀型腰椎管狭窄症的临床研究

Clinical Study on Dumai Huoxue Decoction Combined with External Application of Traditional Chinese Medicine in the Treatment of Lumbar Spinal Stenosis of Qi Deficiency and Blood Stasis Type

目的:探讨督脉活血汤联合中药外敷治疗气虚血瘀型腰椎管狭窄症的临床效果。方法:选择2019年6月—2021年6月厦门思明景元中医院收治的100例气虚血瘀型腰椎管狭窄症患者,以随机数表法分为两组,各50例。两组均进行常规治疗,对照组采用督脉活血汤治疗,观察组采用督脉活血汤联合中药外敷治疗,均持续治疗2个月。比较治疗2个月后两组的临床效果;于治疗前及治疗1个月、2个月后,以视觉模拟评分法(VAS)评估两组疼痛程度;于治疗前、治疗2个月后采用日本骨科协会评估治疗分数(JOA)及Oswestry功能障碍指数(ODI)评估患者腰椎功能;比较治疗前、治疗2个月后两组6 min步行距离试验(6MWD)及腰椎后伸角度。结果:治疗2个月后,观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗1个月、2个月后,两组VAS评分均较治疗前降低,且观察组VAS评分低于对照组,差异有统计学意义(P<0.05);治疗2个月后,两组JOA均较治疗前提高,ODI均较治疗前下降,且观察组JOA评分高于对照组,ODI低于对照组,差异有统计学意义(P<0.05);治疗2个月后,两组6MWD、腰椎后伸角度均优于治疗前,且观察组6MWD、腰椎后伸角度均优于对照组,差异有统计学意义(P<0.05)。结论:督脉活血汤联合中药外敷治疗气虚血瘀型腰椎管狭窄症患者的临床效果较好,能有效减轻患者疼痛程度,改善腰椎活动度及功能,恢复其运动耐量。

Objective:To explore the clinical efficacy of Dumai Huoxue Decoction combined with external application of traditional Chinese medicine in the treatment of lumbar spinal stenosis of Qi deficiency and blood stasis type.Method:A total of 100 patients with lumbar spinal stenosis of Qi deficiency and blood stasis type who included in the Xiamen Siming Jingyuan Hospital of Traditional Chinese Medicine from June 2019 to June 2021.They were divided into two groups by random number table method,with 50 cases in each group.Both groups received routine treatment,the control group was treated with Dumai Huoxue Decoction,and the observation group was treated with Dumai Huoxue Decoction combined with external application of traditional Chinese medicine,both of which lasted for 2 months.The clinical effects of the two groups were compared after 2 months of treatment.Before treatment,1 month and 2 months after treatment,the pain degree of the two groups was evaluated by visual analogue scale(VAS).The lumbar function of the patients was evaluated by the Japanese Orthopaedic Association assessment treatment score(JOA)and Oswestry dysfunction index(ODI)before and after treatment for 2 months.The 6-minute walking distance test(6MWD)and lumbar extension activity were compared between the two groups before and after 2 months of treatment.Result:After 2 months of treatment,the total effective rate of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).After 1 month and 2 months of treatment,the VAS scores of two groups were lower than those before treatment,and the VAS score of the observation group was lower than that of the control group,the differences were statistically significant(P<0.05).After 2 months of treatment,the scores of JOA in two groups were higher those before treatment,and the ODI in two groups were lower than those before treatment,and the score of JOA in the observation group was higher than that in the control group,and the ODI was lower than that in the control group,the differences were statistically significant(P<0.05).After 2 months of treatment,the 6MWD and lumbar extension angle of two groups were better compared with those before treatment,and the 6MWD and lumbar extension angle of the observation group were better than those of the control group,the differences were statistically significant(P<0.05).Conclusion:Dumai Huxue Decoction combined with external application of traditional Chinese medicine has a good clinical effect on patients with lumbar spinal stenosis of Qi deficiency and blood stasis type,which can effectively reduce the degree of pain,improve the range of motion and function of lumbar spine,and restore their exercise tolerance.