通痹片治疗脊髓型颈椎病术后轴性症状的疗效观察

发布时间：2018-01-06 00:08

本文关键词：通痹片治疗脊髓型颈椎病术后轴性症状的疗效观察　出处：《福建中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过对照研究通痹片治疗脊髓型颈椎病术后轴性症状的临床观察。方法:采用前瞻性研究的方法,对来自于中国人民解放军第175医院2015年9月至2016年9月,因脊髓型颈椎病入院需行颈后路手术(包括颈后路单开门椎管成形术和颈后路双开门椎管成形术)治疗且术后1个月门诊随访出现轴性症状的患者,符合纳入标准、排除标准,共40例,随机分为两组,分别为治疗组(口服通痹片+艾瑞昔布)及对照组(口服艾瑞昔布),同时进行颈部功能锻炼(每天早中晚各3组,每组5次)。分别在患者术后第1个月记录患者一般资料,同时记录患者此时的视觉模拟评分(VAS)、颈椎JOA评分及颈椎活动度(ROM),同时定期监测患者肝肾功。分别在术后第1个月、第2个月、第3个月、第4个月及第6个月随访记录患者VAS评分、颈椎J0A评分、颈部活动度(ROM)及Tsuji评分,随访期限为6个月,分别对比两组各项指标观察疗效。计量资料用X±S表示,采用t检验,应用统计学软件SSPS20.0对所有数据进行统计分析。观察两组病人治疗前后差异(以P0.05为无显著差异,P0.05为有显著差异)。结果:2例病人因外出无法提供完整资料予以剔除,又补充2例病人进行随访,随访期间实验组的患者无明显药物不良反应,且治疗组与对照组在年龄、性别、手术节段等一般资料,两组数据无统计学差异(P0.05),具有可比性。1、治疗组和对照组在术后1个月随访得到的VAS评分、JOA评分、颈椎活动度及Tsuji评分无统计学差异(P0.05)具有可比性。2、治疗组和对照组经治疗后,随访2、3、4、6个月,治疗组的VAS评分均低于对照组(P0.05),治疗组优于对照组。3、治疗组和对照组经治疗后,随访2、3、4、6个月,治疗组的JOA评分与对照组相仿(P＜0.05),不具备统计学差异。4、治疗组和对照组经治疗后,随访2、3、4、6个月,其中术后2、3、4月份的治疗组的颈椎活动度(屈伸、旋转)较对照组明显改善(P0.05),治疗组优于对照组,而术后6个月的治疗组颈椎活动度(屈伸、旋转)较对照组无明显差异,P0.05;术后2、3个月的治疗组颈椎活动度(侧弯)较对照组明显改善(P0.05),术后4、6个月的治疗组颈椎活动度(侧弯)较对照组无明显改善,P0.05。5、治疗组和对照组经治疗后,术后2、3个月随访Tsuji评分,P＞0.05,不具有统计学差异;术后4、6个月随访Tsuji评分,P0.05,具有统计学差异,治疗组优于对照组。结论:通痹片在治疗脊髓型颈椎病术后轴性症状具有显著疗效,有利于改善患者疼痛及短期内恢复患者的正常颈椎活动度。
[Abstract]:Objective: to study the clinical effect of Tongbi tablet on axial symptoms of cervical Spondylotic myelopathy after operation. Yes, from September 2015 to September 2016 at the 175th Hospital of the Chinese people's Liberation Army. Patients with cervical Spondylotic myelopathy underwent posterior cervical surgery (including posterior cervical open door spinal canal angioplasty and posterior cervical open door laminoplasty) and were followed up 1 month after operation for axial symptoms of cervical Spondylotic myelopathy. 40 patients were randomly divided into two groups: the treatment group (oral administration of Tongbi tablet) and the control group (oral administration of alexib). At the same time, cervical functional exercise (3 groups each morning, midnight, 5 times in each group. The patients were recorded in the first month after the operation of general data, while recording the visual analogue scores of patients at this time VAS.). JOA score of cervical spine and cervical motion were measured regularly. The liver and kidney function were monitored at the first month, the second month, and the third month after operation, respectively. The VAS score, cervical J0A score, cervical mobility score and Tsuji score were recorded at the 4th and 6th months. The follow-up period was 6 months. The data were expressed as X 卤S and t-test were used. The statistical software SSPS20.0 was used to analyze all the data. The difference between the two groups before and after treatment was observed (P0.05 as no significant difference). Results 2 cases of patients were not able to provide complete information to be eliminated, and 2 cases were followed up. There was no obvious adverse drug reaction in the patients of the experimental group during the follow-up period. And the treatment group and the control group in the age, sex, surgical segment and other general data, there is no statistical difference between the two groups (P 0.05), there is comparable .1. There was no significant difference in VAS score, cervical mobility and Tsuji score between the treatment group and the control group after 1 month follow-up (P 0.05). The VAS scores of the treatment group and the control group were lower than that of the control group (P 0.05), and that of the treatment group was better than that of the control group. The JOA score of the treatment group was similar to that of the control group (P < 0.05), and there was no significant difference between the treatment group and the control group (P < 0.05). The treatment group and the control group were followed up after treatment. After 6 months, the cervical movement (flexion, extension, rotation) of the treatment group was significantly improved than that of the control group in 2 and 3 months postoperatively, and the treatment group was superior to the control group. However, there was no significant difference in cervical movement (flexion, extension, rotation) between the treatment group and the control group 6 months after operation (P 0.05). The cervical movement (lateral curvature) in the treatment group was significantly improved than that in the control group at 2 and 3 months postoperatively, but the cervical movement (lateral curvature) in the treatment group at 4 and 6 months after operation was not significantly improved compared with that in the control group. After treatment, the Tsuji scores of the treatment group and the control group were followed up 2 and 3 months after operation (P > 0.05), there was no significant difference between the treatment group and the control group. The Tsuji score of the treatment group was better than that of the control group (P 0.05). Conclusion: Tongbi tablet has a significant effect in the treatment of postoperative axial symptoms of cervical Spondylotic myelopathy. It is beneficial to improve the pain and restore the normal cervical movement in a short time.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R274.9

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