郑氏伤科治疗腰椎间盘突出症(脱出型)临床疗效观察

Clinical Curative Effect of Applying ZHENG's Department of Traumatology Treatment in the Treatment of Prolapse of Lumbar Intervertebral Disc Prolapse Type

目的:观察、对比郑氏伤科与手术治疗腰椎间盘突出症(脱出破裂型)的临床疗效,归纳总结中医药对腰椎间盘突出症(脱出破裂型)的疗效、适应症,进一步为临床提供依据。方法:采取回顾性队列研究的方法,随访2013年1月~2015年5月在我院住院治疗并符合研究条件的腰椎间盘突出症患者120例,按是否接受手术治疗分为非手术郑氏伤科综合疗法组(76例)及手术组(40例),其中男72例,女58例,年龄36~81岁,平均年龄55.3岁。入院后常规完善腰椎功能位、CT以及MRI资料,以调查问卷(SF一36量表)为测评工具,分别对两组患者治疗前后进行评分,研究郑氏伤科综合疗法与手术疗法对腰椎间盘突出症患者生存质量的影响,并比较两者对患者生存质量的改善程度、后期复发率及治疗费用。结果:其中120例均获随访,其中男性68例,女性52例,平均年龄46.4±5.45,随访时间9~12月,平均为10.4±0.7月。两组治疗后临床疗效有效率均达到100%,其中郑氏治疗组:显著5例(6.8%),有效69例(93.2%);手术组:显著4例(8.7%),有效42例(91.3%);两组对照无差异性(P>0.05);治疗前总得分:非手术治疗组(36.81±2.93),手术组(37.52±2.52),治疗前两组对比统计学无差异(P>0.05);治疗后改善率:非手术治疗组(61.29±5.81)%,手术组(65.13±8.04)%,手术组优于非手术组,且对照统计学有显著性差(P<0.05)。非手术组组内改善率相比,L5-S1节段优于L4~5、L4~5合并L5-S1节段,且对照统计学有显著性差(P<0.05)。结论:对于腰椎间盘脱出型临床治疗中郑氏伤科综合疗法对于改善患者临床症状总体均有效,费用及社会效应稍高于手术治疗,对腰椎间盘突出症(脱出型)患者,脱出髓核未对神经根形成嵌压性压迫,神经功能正常,体征、症状表现以炎性刺激为主的患者,可行非手术治疗。

Objective: To observe and contrast the clinical curative effect of ZHENG's department of Traumatology and surgical treatment for lumbar disc herniation(prolapse rupture),induction summary of traditional Chinese medicine on lumbar intervertebral disc herniation(prolapse rupture) efficacy,indications,further to provide the basis for clinical treatment. Methods:Retrospective cohort study was adopted to,follow-up January 2013 to May 2015 in our hospital hospitalization and conformed to the conditions of the lumbar disc herniation in 120 patients,according to whether or not to accept the surgical treatment for non operative ZHENG's department of traumatology comprehensive therapy group(76 cases) and operation group(40 cases). The 72 cases were male,58 cases of female,old age 36 ~ 81,average age 55. 3 years. After admission,conventional perfect lumbar function,CT and MRI data,questionnaire(SF 36 scale) were used as the evaluation tool,respectively before and after the treatment,the patients in the two groups score,study ZHENG's department of traumatology comprehensive therapy and surgical treatment of lumbar disc herniation patients quality of life impact and comparison on the quality of life of patients with improvement,the late recurrence rate and the cost of treatment. Results: 120 cases were followed up,including 68 males and 52 females,mean age 46. 4 ±5. 45,followed up from 9 to12 months,with an average of 0. 7 months and 10. 4 months. After treatment in the two groups clinical effective rate reached 100%,the ZHENG's treatment group was 5 cases(6. 8%),effective in 69 cases(93. 2%); The operation group: significantly in 4 cases(8. 7%),effective in 42 cases(91. 3%); the two groups of control had no significant difference(P>0. 05); Before treatment,the total score: non surgical treatment group(36. 81 ± 2. 93) and operation group(37. 52 ± 2. 52)treatment before the two groups statistically no difference(P>0. 05); After the treatment,to improve the rate: the non operative treatment group(61. 29±5. 81) %,the surgery group(65. 13±8. 04) %,the surgery group was better than that of the non operation group and control was statistically significant difference(P<0. 05). Compared with the improvement rate in the non operative group,the L5-S1 segment was better than L4 ~ 5,L4 ~ 5 and L5-S1 segment,and the control was statistically significant difference(P< 0. 05). Conclusion: For lumbar disc herniation clinical treatment in ZHENG's department of traumatology comprehensive therapy to improve clinical symptoms of the patients were generally effective,expense and the social effect is slightly higher than that of surgical treatment and on lumbar intervertebral disc herniation(extrusion) patients,prolapse of nucleus pulposus not on the nerve root formation of block pressure compression and normal nerve function,signs and symptoms to inflammatory stimulation patients and viable non-surgical treatment.