宣气活血方对腰椎间盘突出症单侧双通道脊柱内镜术后疗效的影响

Study on curative effect of Xuanqi Huoxue prescription in treatment of lumbar disc herniation after unilateral double-channel spinal endoscopy

目的:观察宣气活血方治疗腰椎间盘突出症单侧双通道脊柱内镜(UBE)术后患者疼痛递质及腰背肌生物力学性能的影响。方法:选取130例腰椎间盘突出症患者为对象,采用随机数字表法分为两组。两组均接受UBE治疗,常规组术后给予常规处理。方剂组术后在常规处理基础上给予宣气活血方辅助治疗。检测两组血清疼痛递质、腰背肌生物力学性能差异,评估两组视觉模拟(VAS)评分、Oswestry(ODI)评分、日本骨科协会(JOA)评分、中医证候评分变化,记录两组并发症和疗效。结果:与本组术前比较,两组术后2周血清疼痛递质明显下降,且方剂组低于常规组(P<0.05)。与本组术前比较,两组术后12周腰背屈伸比明显下降,且方剂组低于常规组(P<0.05)。与本组术前比较,两组术后12周前降力距、平均功率明显升高,且方剂组高于常规组(P<0.05)。与本组术前比较,两组术后2、12周VAS评分、ODI评分、中医证候评分明显下降,且方剂组低于常规组(P<0.05)。治疗后两组术后2、12周JOA评分升高,且方剂组高于常规组(P<0.05)。方剂组并发症率低于常规组(P>0.05)。结论:宣气活血方治疗腰椎间盘突出症UBE术后可抑制血清疼痛递质表达,减轻疼痛,改善腰椎功能,提高优良率。

Objective:To observe the effects of Xuanqi Huoxue formula on pain transmitters and biomechanical properties of lumbar muscle after unilateral double channel spinal endoscopy(UBE)in patients with lumbar disc herniation.Methods:130 patients with lumbar disc herniation were selected and divided into two groups by random number method.Both groups received UBE treatment,and the conventional group received routine treatment after surgery.The prescription group was given Xuanqi Huoxue adjuvant treatment on the basis of routine treatment.The differences of serum pain transmitters and the biomechanical properties of lumbar and back muscles between the two groups were detected,the changes of visual analogue scale(VAS)score,Oswestry(ODI) score,Japanese Orthopaedic Association(JOA)score and TCM syndrome score between the two groups were evaluated,and the complications and curative effects of the two groups were recorded.Results:Compared to preoperative,the serum pain transmitter in the two groups was significantly decreased 2 weeks after surgery,and the prescription group was lower than the conventional.group(P<0.05).Compared to preoperative,the lumbar and back flexion and extension ratio of the two groups was significantly decreased 12 weeks after surgery,and the prescription group was lower than the conventional group(P<0.05).Compared to preoperative,the descending pitch and average power of the two groups were significantly increased 12 weeks after surgery,and the prescription group was higher than the conventional group(P<0.05).Compared to preoperative,V AS score,ODI score and TCM syndrome score of 2 and 12 weeks after surgery were sig-nificantly decreased,and the prescription group was lower than the conventional group(P<0.05).After treatment,the JOA score of 2 and 12 weeks after surgery was significantly increased,and the prescription group was higher than the conventional group(P<0.05).The complication rate of the prescription group was lower than that of the conventional group,and there was no statistical difference between the good and good rate and the convetional group(P>0.05).Conclusion:Xuanqi Huoxue formula can inhibit the expression of pain transmitter in serum,relieve pain,improve lumbar function and increase the good and good rate after UBE.