摘要
目的观察独活寄生汤加减治疗腰椎间盘突出症(LDH)患者椎间孔镜髓核摘除术后残余痛的临床疗效。方法将60例椎间孔镜髓核摘除术后残余痛患者按随机数字表法分为2组。对照组30例予术后常规康复治疗;治疗组30例在对照组的基础上加用独活寄生汤加减治疗。2组均治疗28 d后统计疗效,并比较2组治疗前后疼痛视觉模拟评分法(VAS)评分、日本骨科协会评估治疗分数(JOA)评分、腰椎Oswetry功能障碍指数(ODI)评分、症状评分(包括腰腿痠痛、肢体麻木、椎体旁压痛及下肢放射痛)及简明健康状况量表(SF-36)评分(包括生理职能、生理功能、情感职能、生命活力、社会功能、心理健康、总体健康及躯体疼痛)变化情况。结果治疗组总有效率96.7%,对照组总有效率80.0%,治疗组疗效优于对照组(P<0.05)。与本组治疗前比较,2组治疗后疼痛VAS评分及ODI评分均明显降低(P<0.05),JOA评分明显升高(P<0.05),且治疗组治疗后对各评分改善均优于对照组(P<0.05)。2组治疗后腰腿痠痛、肢体麻木、椎体旁压痛及下肢放射痛评分与本组治疗前比较均明显降低(P<0.05),且治疗组治疗后各症状评分均低于对照组(P<0.05)。2组治疗后SF-36生理职能、生理功能、情感职能、生命活力、社会功能、心理健康、总体健康及躯体疼痛评分与本组治疗前比较均明显升高(P<0.05),且治疗组治疗后SF-36各项评分均高于对照组(P<0.05)。结论独活寄生汤加减治疗LDH患者椎间孔镜髓核摘除术后残余痛疗效确切,可明显缓解疼痛,改善腰椎功能及相关症状,提高生活质量。
Objective To observe the clinical efficacy of modified Duhuo Jisheng decoction in the treatment of residual pain after vertebral nucleus pulposus removal in patients with lumbar disc herniation(LDH).Methods 60 patients with residual pain after vertebral nucleus pulposus removal were divided into two groups according to the random number table method.30 cases in control group were treated by routine rehabilitation after operation.30 cases in treatment group were treated by modified Duhuo Jisheng decoction on the basis of the control group.The curative effect was evaluated after 28 days of treatment in both groups.The Visual analogue score of pain(VAS)scores,Japanese orthopaedic association assessment of treatment scores(JOA)scores,lumbar oswetry dysfunction index(ODI)scores,symptom scores(including lumbago and leg pain,limb numbness,paravertebral tenderness and radiation pain of lower extremity)and concise health status(SF-36)scores(including physiological function,physiological function,emotional function,life vitality,social function,mental health,general health and physical pain)were compared between the two groups before and after treatment.Results The total effective rate was 96.7%in treatment group and 80.0%in control group.The clinical curative effect of the treatment group was better than that of the control group(P<0.05).Compared with the group before treatment,the VAS score and ODI score in the two groups were significantly lower(P<0.05),JOA score was significantly higher(P<0.05),and the improvement of each score in the treatment group was better than that in the control group(P<0.05).The scores of lumbago and leg pain,limb numbness,paravertebral tenderness and lower extremity radiation pain in the two groups were significantly lower than those in the group before treatment(P<0.05),and the scores of symptoms in the treatment group were lower than those in the control group(P<0.05).The scores of SF-36 physiological function,physiological function,emotional function,life vitality,social function,mental health,general health and physical pain in the two groups were significantly higher than those in the group before treatment(P<0.05),and each item scores in the treatment group were lower than those in the control group(P<0.05).Conclusion Duhuo Jisheng decoction is effective in the treatment of residual pain after vertebral nucleus pulposus removal in LDH patients.It can obviously relieve the pain,improve the lumbar function and related symptoms,and improve the quality of life.
作者
邓小磊
侯德才
DENG Xiaolei;HOU Decai(The Second department of Orthopaedics and Traumatology,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang,Liaoning 110000)
出处
《河北中医》
2019年第8期1213-1217,1249,共6页
Hebei Journal of Traditional Chinese Medicine
基金
沈阳市科学技术局科技人才应用技术研究计划(编号:18-014-4-05)
关键词
椎间盘移位
腰椎
疼痛
手术后
中药疗法
独活寄生汤
Intervertebral disc displacement
Lumbar vertebrae
Pain
after operation
Chinese medicine therapy
Duhuo Jisheng decoction
