[目的]探讨和营止痛颗粒能否缓解腰椎间盘突出症(lumbar intervertebral disc herniation,LIDH)患者的临床症状,改善活动能力和功能,提高生活质量。[方法]根据纳入和排除标准,收集在浙江中医药大学附属第一医院骨伤中心门诊或住院治疗的...[目的]探讨和营止痛颗粒能否缓解腰椎间盘突出症(lumbar intervertebral disc herniation,LIDH)患者的临床症状,改善活动能力和功能,提高生活质量。[方法]根据纳入和排除标准,收集在浙江中医药大学附属第一医院骨伤中心门诊或住院治疗的120例LIDH患者的临床资料。将患者分为3组,观察组、治疗组和对照组,每组40例。观察组口服和营止痛颗粒治疗;治疗组口服塞来昔布胶囊、甲钴胺片和盐酸乙哌立松片,联合和营止痛颗粒治疗;对照组口服塞来昔布胶囊、甲钴胺片和盐酸乙哌立松片治疗。以4周为1个疗程。治疗前、治疗1个疗程后、1个疗程结束后1个月分别进行随访,记录每组患者的疼痛视觉模拟(visual analogue scale,VAS)评分、日本骨科协会(Japanese Orthopaedic Association,JOA)评估治疗评分和SF-36健康调查量表(36-item Short Form Health Survey,SF-36)评分。对3组患者的数据进行对照分析,明确和营止痛颗粒治疗LIDH的临床疗效。[结果]各组患者在性别组成、年龄构成、体质量指数(body mass index,BMI)、病程长短、影像学检查突出节段以及治疗前的VAS评分、JOA评分、SF-36评分等方面差异无统计学意义(P>0.05),提示各组患者基线一致,具有可比性。治疗1个疗程后,与治疗前比较,3组患者的VAS评分均降低(P<0.001),JOA评分均升高(P<0.001),SF-36评分均上升(P<0.001)。对照组VAS评分低于观察组,治疗组低于对照组和观察组(P<0.001);对照组JOA评分高于观察组,治疗组高于对照组和观察组(P<0.001);对照组的SF-36评分高于观察组,治疗组高于对照组和观察组(P<0.001)。1个疗程治疗结束后1个月,与治疗前比较,三组患者的VAS评分均降低(P<0.001),JOA评分均升高(P<0.001),SF-36评分均上升(P<0.001)。对照组VAS评分低于观察组,治疗组低于对照组和观察组(P<0.001);对照组JOA评分高于观察组,治疗组高于对照组和观察组(P<0.001);对照组SF-36评分高于观察组,治疗组高于对照组和观察组(P<0.001)。[结论]和营止痛颗粒能有效缓解LIDH患者的临床症状,改善活动能力和功能,提高生活质量,与西药联用时,能提高西药的临床疗效,是临床治疗LIDH的良好中药制剂。展开更多
BACKGROUND Ankylosing spondylitis at total hip arthroplasty(THA)has significant hip stiffness with flexion deformity,restricted mobility,and function.Range of movement(ROM)improvement with good functional outcome is s...BACKGROUND Ankylosing spondylitis at total hip arthroplasty(THA)has significant hip stiffness with flexion deformity,restricted mobility,and function.Range of movement(ROM)improvement with good functional outcome is seen following THA in these hips.The modified Hardinge approach without abductor compromise is helpful in these stiff hips with associated flexion deformity.AIM To assess improvement in ROM and functional outcomes with a modified lateral approach THA in ankylosing spondylitis with stiff hips.METHODS A total of 69 hips that underwent THA with a modified Hardinge approach in 40 patients were evaluated at a mean follow-up of 38.33 mo.All individuals ambulated with weight-bearing as tolerated and ROM exercises from the 1st postoperative day.Modified Harris hip score and ROM were assessed during follow-up.Quality of life assessments using the 36-item and 12-item short form health surveys were done along with clinical and functional outcomes at followup.SPSS 22.0 was used for statistical analysis.The correlation of ROM and functional score change was performed using Pearson’s correlation coefficient.RESULTS Sixty-nine hips with a significant decrease in ROM preoperatively with 32 clinically fused hips showed significant improvement in flexion range.The mean flexion in 69 hips improved from 29.35±31.38 degrees to 102.17±10.48 degrees.The mean difference of 72.82 with a P value<0.0001 was significant.In total,45 out of 69 hips had flexion deformity,with 13 hips having a deformity above 30 degrees.The flexion during the follow-up was below 90 degrees in 3 hips.Eleven hips had flexion of 90 degrees at follow-up,while the remaining 55 hips had flexion above 100 degrees.Modified Harris hip score improved from 17.03±6.02 to 90.66±7.23(P value<0.0001).The 36-item short form health survey at the follow-up indicated health status in 40 patients as excellent in 11,very good in 20,good in 5,fair in 3,and poor in 1.The mean mental health score was 84.10±11.58.Pain relief was good in all 69 hips.Altogether,28/40 patients(70%)had no pain,9 patients(22%)had occasional pain,and 3 patients(8%)had mild to moderate pain with unusual activity.Heterotopic ossification was seen in 21 hips with Brooker class 1 in 14 hips.CONCLUSION Modified Hardinge approach THA in ankylosing spondylitis with stiff hips with flexion deformity significantly improved ROM,Harris hip score,and quality of life indicated by the 36-item and 12-item short form health surveys.展开更多
文摘[目的]探讨和营止痛颗粒能否缓解腰椎间盘突出症(lumbar intervertebral disc herniation,LIDH)患者的临床症状,改善活动能力和功能,提高生活质量。[方法]根据纳入和排除标准,收集在浙江中医药大学附属第一医院骨伤中心门诊或住院治疗的120例LIDH患者的临床资料。将患者分为3组,观察组、治疗组和对照组,每组40例。观察组口服和营止痛颗粒治疗;治疗组口服塞来昔布胶囊、甲钴胺片和盐酸乙哌立松片,联合和营止痛颗粒治疗;对照组口服塞来昔布胶囊、甲钴胺片和盐酸乙哌立松片治疗。以4周为1个疗程。治疗前、治疗1个疗程后、1个疗程结束后1个月分别进行随访,记录每组患者的疼痛视觉模拟(visual analogue scale,VAS)评分、日本骨科协会(Japanese Orthopaedic Association,JOA)评估治疗评分和SF-36健康调查量表(36-item Short Form Health Survey,SF-36)评分。对3组患者的数据进行对照分析,明确和营止痛颗粒治疗LIDH的临床疗效。[结果]各组患者在性别组成、年龄构成、体质量指数(body mass index,BMI)、病程长短、影像学检查突出节段以及治疗前的VAS评分、JOA评分、SF-36评分等方面差异无统计学意义(P>0.05),提示各组患者基线一致,具有可比性。治疗1个疗程后,与治疗前比较,3组患者的VAS评分均降低(P<0.001),JOA评分均升高(P<0.001),SF-36评分均上升(P<0.001)。对照组VAS评分低于观察组,治疗组低于对照组和观察组(P<0.001);对照组JOA评分高于观察组,治疗组高于对照组和观察组(P<0.001);对照组的SF-36评分高于观察组,治疗组高于对照组和观察组(P<0.001)。1个疗程治疗结束后1个月,与治疗前比较,三组患者的VAS评分均降低(P<0.001),JOA评分均升高(P<0.001),SF-36评分均上升(P<0.001)。对照组VAS评分低于观察组,治疗组低于对照组和观察组(P<0.001);对照组JOA评分高于观察组,治疗组高于对照组和观察组(P<0.001);对照组SF-36评分高于观察组,治疗组高于对照组和观察组(P<0.001)。[结论]和营止痛颗粒能有效缓解LIDH患者的临床症状,改善活动能力和功能,提高生活质量,与西药联用时,能提高西药的临床疗效,是临床治疗LIDH的良好中药制剂。
文摘BACKGROUND Ankylosing spondylitis at total hip arthroplasty(THA)has significant hip stiffness with flexion deformity,restricted mobility,and function.Range of movement(ROM)improvement with good functional outcome is seen following THA in these hips.The modified Hardinge approach without abductor compromise is helpful in these stiff hips with associated flexion deformity.AIM To assess improvement in ROM and functional outcomes with a modified lateral approach THA in ankylosing spondylitis with stiff hips.METHODS A total of 69 hips that underwent THA with a modified Hardinge approach in 40 patients were evaluated at a mean follow-up of 38.33 mo.All individuals ambulated with weight-bearing as tolerated and ROM exercises from the 1st postoperative day.Modified Harris hip score and ROM were assessed during follow-up.Quality of life assessments using the 36-item and 12-item short form health surveys were done along with clinical and functional outcomes at followup.SPSS 22.0 was used for statistical analysis.The correlation of ROM and functional score change was performed using Pearson’s correlation coefficient.RESULTS Sixty-nine hips with a significant decrease in ROM preoperatively with 32 clinically fused hips showed significant improvement in flexion range.The mean flexion in 69 hips improved from 29.35±31.38 degrees to 102.17±10.48 degrees.The mean difference of 72.82 with a P value<0.0001 was significant.In total,45 out of 69 hips had flexion deformity,with 13 hips having a deformity above 30 degrees.The flexion during the follow-up was below 90 degrees in 3 hips.Eleven hips had flexion of 90 degrees at follow-up,while the remaining 55 hips had flexion above 100 degrees.Modified Harris hip score improved from 17.03±6.02 to 90.66±7.23(P value<0.0001).The 36-item short form health survey at the follow-up indicated health status in 40 patients as excellent in 11,very good in 20,good in 5,fair in 3,and poor in 1.The mean mental health score was 84.10±11.58.Pain relief was good in all 69 hips.Altogether,28/40 patients(70%)had no pain,9 patients(22%)had occasional pain,and 3 patients(8%)had mild to moderate pain with unusual activity.Heterotopic ossification was seen in 21 hips with Brooker class 1 in 14 hips.CONCLUSION Modified Hardinge approach THA in ankylosing spondylitis with stiff hips with flexion deformity significantly improved ROM,Harris hip score,and quality of life indicated by the 36-item and 12-item short form health surveys.
