加味补阳还五汤、甲钴胺联合手术治疗脊髓型颈椎病的临床效果观察

Observation of Clinical Effect of Modified Buyang Huanwu Decoction and Mecobalamin Combined with Surgery in Treatment of Cervical Spondylotic Myelopathy

目的:探讨加味补阳还五汤、甲钴胺联合手术治疗脊髓型颈椎病的临床效果。方法:选取2020年3月-2022年5月酒泉市中医院及甘肃省中医院收治的64例脊髓型颈椎病患者作为研究对象,按随机数字表法分为观察组和对照组,各32例。两组均行颈前路椎间盘切除减压融合术治疗,对照组术后给予甲钴胺治疗,观察组在对照组治基础上给予加味补阳还五汤治疗。比较两组治疗效果。结果:术前,两组日本骨科协会评估治疗分数比较,差异无统计学意义(P>0.05);术后1、2、4、6、12个月,两组日本骨科协会评估治疗分数高于术前,且观察组高于对照组,差异有统计学意义(P<0.05)。术前,两组颈椎功能障碍指数评分比较,差异无统计学意义(P>0.05);术后1、2、4、6、12个月,两组颈椎功能障碍指数评分低于术前,且观察组低于对照组,差异有统计学意义(P<0.05)。术前,两组视觉模拟评分法评分比较,差异无统计学意义(P>0.05);术后1、2、4、6、12个月,两组视觉模拟评分法评分低于术前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论:加味补阳还五汤、甲钴胺联合手术治疗脊髓型颈椎病的临床效果较好,能够缓解患者疼痛,改善患者颈椎功能、神经症状,促进患者恢复。

Objective:To explore the clinical effect of modified Buyang Huanwu decoction and mecobalamin combined with surgery in treatment of cervical spondylotic myelopathy.Methods:A total of 64 patients with cervical spondylotic myelopathy admitted to Jiuquan Hospital of Traditional Chinese Medicine and Gansu Provincial Hospital of Traditional Chinese Medicine from March 2020 to May 2022 were selected as the study subjects.They were divided into observation group and control group according to random number table method,with 32 cases in each group.Both groups were treated with anterior cervical discectomy,decompression and fusion surgery.The control group was treated with mecobalamin after surgery,and the observation group was treated with modified Buyang Huanwu decoction on the basis of the control group.The treatment effects were compared between the two groups.Results:Before surgery,there was no significant difference in the Japanese Orthopaedic Association scores between the two groups(P>0.05).At 1,2,4,6 and 12 months after surgery,the Japanese Orthopaedic Association scores in the two groups were higher than those before surgery,the scores in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).Before surgery,there was no significant difference in the Neck Disability Index scores between the two groups(P>0.05).At 1,2,4,6 and 12 months after surgery,the Neck Disability Index scores in the two groups were lower than those before surgery,the scores in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).Before surgery,there was no significant difference in the scores of Visual Analogue Scale between the two groups(P>0.05).At 1,2,4,6 and 12 months after surgery,the scores of Visual Analogue Scale in the two groups were lower than those before surgery,the scores in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).Conclusion:Modified Buyang Huanwu decoction and mecobalamin combined with surgery in treatment of cervical spondylotic myelopathy have good clinical effect,and can relieve pain,improve cervical function and neurological symptoms,and promote the recovery of patients.