腰痹通胶囊联合椎间孔镜治疗腰椎间盘突出症疗效观察及对VAS、JOA评分的影响

Curative Effect of Yaobitong Capsules Combined with Endoscopic Lumbar Discectomy on Lumbar Disc Herniation and Its Effect on Scores of VAS and JOA

目的:观察腰痹通胶囊联合椎间孔镜治疗腰椎间盘突出症的疗效及对视觉模拟评分法(VAS)、日本骨科协会(JOA)评分的影响。方法:选取102例腰椎间盘突出症患者作为研究对象,按随机数字表法分为对照组及观察组各51例。2组均行经皮椎间孔镜下髓核摘除术,观察组在此基础上加用腰痹通胶囊。观察2组临床疗效及不良反应发生率,比较2组治疗前后中医证候评分的变化,比较2组治疗前后VAS、JOA评分的变化。结果:治疗后,2组腰腿痛如刺、痛有定处、腰部板硬、日轻夜重、舌暗紫或有瘀斑中医证候评分均较治疗前下降(P<0.05),观察组上述5项中医证候评分均低于对照组(P<0.05)。对照组临床疗效总有效率为80.39%,观察组总有效率为92.15%,2组比较,差异有统计学意义(P<0.05)。治疗后1个月、3个月、6个月,2组VAS评分均较治疗前下降(P<0.05);治疗后1个月、3个月、6个月观察组VAS评分均低于对照组(P<0.05)。治疗后1个月、3个月、6个月,2组JOA评分均较治疗前升高(P<0.05),观察组治疗后1个月、3个月、6个月JOA评分均高于对照组(P<0.05)。对照组不良反应发生率为11.76%,观察组不良反应发生率为3.92%,2组比较,差异有统计学意义(P<0.05)。结论:腰痹通胶囊联合椎间孔镜治疗腰椎间盘突出症能提高疗效,减轻疼痛,改善腰椎功能,降低不良反应发生率。

Objective:To observe the curative effect of the therapy of Yaobitong Capsules combined with endoscopic lumbar discectomy on lumbar disc herniation and its effect on the scores of Visual Analogue Scale(VAS)and Japanese Orthopaedic Association(JOA).Methods:A total of 102 patients with lumbar disc herniation were selected as the study objects,and divided into the control group and the observation group according to the random number table method,with 51 cases in each group.Both groups were given endoscopic lumbar discectomy,based on which the observation group was additionally treated with Yaobitong Capsules.The clinical effects and incidence of adverse reactions in both groups were observed;the changes of traditional Chinese medicine(TCM)syndrome scores before and after treatment and scores of VAS and JOA before and after treatment were compared between the two groups.Results:After treatment,the TCM syndrome scores of stabbing pain in the waist and lower extremities,fixedpain,board-like consistency of the waist,daily alleviating and night worsening pain,dark purple tongue or tongue with ecchymosis in both groups were decreased when compared with those before treatment(P<0.05),and the above five scores in the observation group were lower than those in the control group(P<0.05).The total clinical effective rate was 80.39%in the control group and 92.15%in the observation group,the difference being significant(P<0.05).One month,three months and six months after treatment,the VAS scores in both groups were decreased when compared with those before treatment(P<0.05),and the VAS scores in the observation group one month,three months and six months after treatment were respectively lower than those in the control group(P<0.05).One month,three months and six months after treatment,the JOA scores in both groups were increased when compared with those before treatment(P<0.05),and the JOA scores in the observation group at one month,three months and six months after treatment were respectively higher than those in the control group(P<0.05).The incidence of adverse reactions was 11.76%in the control group and 3.92%in the observation group,the difference being significant(P<0.05).Conclusion:The therapy of Yaobitong Capsules combined with endoscopic lumbar discectomy can enhance the curative effect on lumbar disc herniation,mitigate the pain,improve the lumbar vertebral function and decrease the incidence of adverse reactions.