雷火灸联合加味芍药甘草汤对单开门颈椎管扩大椎板成形术后轴性症状的临床疗效

Clinical Efficacy of Thunder Fire Moxibustion Combined with Modified Shaoyao Gancao Decoction on Axial Symptoms after Single-door Cervical Expansive Laminoplasty

目的:探讨雷火灸联合加味芍药甘草汤治疗单开门颈椎管扩大椎板成形术后轴性症状的临床效果,探索治疗术后轴性症状新途径。方法:选取2021年10月—2023年10月于赣州市人民医院脊柱外科就诊的单开门颈椎管扩大椎板成形术后轴性症状且中医辨证属于气血不足症型的70例患者,通过随机数字表法将其分为试验组和对照组,各35例。试验组采用雷火灸联合加味芍药甘草汤内服的治疗方案,对照组采用常规西药治疗。采用视觉模拟评分法(visual analogue scale,VAS)、颈椎日本骨科协会(Japanese orthopaedic association,JOA)评分、C反应蛋白和红细胞沉降率评估治疗效果。结果:治疗前,两组VAS评分、颈椎JOA评分及C反应蛋白和红细胞沉降率比较,差异均无统计学意义(P>0.05);治疗后,试验组C反应蛋白和红细胞沉降率均低于对照组;治疗后2、4周,试验组VAS评分均低于对照组;治疗后4周,颈椎JOA评分高于对照组,差异有统计学意义(P<0.05)。结论:雷火灸配合加味芍药甘草汤治疗颈椎单开门椎管扩大成形术后轴性症状的效果较好,能够有效缓解疼痛,改善脊髓功能障碍,缓解轴性症状。

Objective:To explore the clinical efficacy of thunder fire moxibustion combined with modified Shaoyao Gancao Decoction in the treatment of axial symptoms after single-door cervical expansive laminoplasty,and to explore a new approach to the treatment of postoperative axial symptoms.Method:A total of 70 patients with axial symptoms after single-door cervical laminoplasty and classified as Qi and blood deficiency syndrome according to traditional Chinese medicine diagnosis at the Spinal Surgery Department of Ganzhou People's Hospital from October 2021 to October 2023 were selected and divided into an experimental group and a control group by random number table method,with 35 cases in each group.The experimental group was treated with a combination of thunder fire moxibustion and modified Shaoyao Gancao Decoction,while the control group was treated with conventional western medicine.Visual analogue scale(VAS),cervical Japanese orthopaedic association(JOA)scores,C reactive protein and erythrocyte sedimentation rate were used to assess the treatment effect.Result:Before treatment,VAS score,cervical JOA score and C reactive protein and erythrocyte sedimentation rate between the two groups were compared,the differences were not statistically significant(P>0.05);after treatment,C reactive protein and erythrocyte sedimentation rate of the experimental group were lower than those of the control group;at 2 and 4 weeks after treatment,VAS scores of the experimental group were lower than those of the control group;and at 4 weeks after treatment,the cervical JOA score was higher than that of the control group,the differences were statistically significant(P<0.05).Conclusion:The combination of thunder fire moxibustion and modified Shaoyao Gancao Decoction has a good therapeutic effect on axial symptoms after single-door cervical expansive laminoplasty,which can effectively alleviate pain,improve spinal cord dysfunction,and alleviate axial symptoms.