补阳还五汤对急性脊髓损伤患者血清MBP含量影响的临床研究

发布时间：2018-01-16 09:05

本文关键词：补阳还五汤对急性脊髓损伤患者血清MBP含量影响的临床研究　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:应用补阳还五汤于急性脊髓损伤患者术后,通过探究补阳还五汤对急性脊髓损伤患者术后血清中MBP含量影响,并结合对比患者ASIA感觉、运动评分及等级同步变化,进一步探讨补阳还五汤在血清中MBP含量与神经功能改善状况的关系,为急性脊髓损伤患者术后功能恢复寻找新的治疗方案与临床参考指标。方法:将2015年3月至2016年5月期间河南省洛阳正骨医院医院脊柱外科收治的60例急性脊髓损伤患者以入院时间为序随机分为试验组和对照组,所有纳入研究对象入院后均在创伤72h内于急诊或亚急诊下行切开复位减压内固定手术。术后所有受试者均给予脱水、激素、抗炎和神经营养类药物常规治疗。试验组在上述常规治疗基础上自术后第一天起开始服用补阳还五汤,每日一剂,持续服用12周。所有受试者在院期间均进行常规康复训练,术后4*5周出院后继续坚持相关康复治疗。采用ASIA评分量表分别于术前、术后4周、术后12周对所有受试者的感觉运动功能及生活自理能力进行评估,同期运用酶联免疫吸附法对受试者血清中MBP含量进行测定。数据分析采用SPSS20.0统计数据软件进行,全部测定数据以均数±标准差(X±S)格式记录;两组的性别、年龄、损伤节段、病程、损伤程度均进行差异性分析,采用t检验和方差分析计量资料,采用秩和检验对不符合正态分布的计量资料分析;采用X2检验分析计数资料。P0.05示差异有统计学意义。结果:组内比较:术后12与术前、术后4周ASIA感觉评分比较:实验组有统计学意义(P0.05),对照组无统计学意义(P0.05);术后12与术前、术后4周ASIA运动评分及血清中MBP含量比较:两组均有统计学意义(P0.05)。术后4周与术前ASIA感觉评分比较:两组均无统计学意义(P0.05);术后4周与术前ASIA运动评分及血清中MBP含量比较:两组均有统计学意义(P0.05)。组间比较:术前的ASIA感觉运动评分及血清中MBP含量比较:两组差异无统计学意义(P0.05),具有可比性。术后4周及术后12周患者ASIA感觉评分比较:两组差异无统计学意义(P0.05),ASIA运动评分比较差异有统计学意义(P0.05);血清中MBP含量比较:术后4周两组差异有统计学意义(P0.05),术后12周两组差异性比较无统计学意义(P0.05)。两组治疗前与术后12周ASIA分级比较:两组差异有统计学意义(P0.05)。结论:1.补阳还五汤对急性脊髓损伤术后患者的感觉运动功能评分以及ASIA等级有改善作用。2.补阳还五汤的应用可以在早期明显降低患者血清中的MBP含量。3.早期血清中MBP含量的变化程度与急性脊髓损伤患者术后功能恢复程度有相关性。
[Abstract]:Objective: to investigate the effect of Buyang Huanwu decoction (BHD) on serum MBP content in patients with acute spinal cord injury (sci) after operation, and to compare patients' ASIA sensation. To explore the relationship between the content of MBP in serum and the improvement of nerve function in the serum of Buyang Huanwu decoction. To find a new treatment plan and clinical reference index for postoperative functional recovery of patients with acute spinal cord injury (Asci). Methods:. From March 2015 to May 2016, 60 patients with acute spinal cord injury admitted in Department of Spine surgery, Luoyang Zhenggu Hospital, Henan Province, were randomly divided into experimental group and control group. All subjects were treated with open reduction and decompression and internal fixation within 72 hours of trauma. All subjects were given dehydration and hormone after operation. Routine treatment of anti-inflammatory and neurotrophic drugs. On the basis of the above routine treatment, the experimental group began to take Buyang Huanwu decoction once a day from the first day after operation. All subjects received routine rehabilitation training during the hospital and continued to adhere to the related rehabilitation treatment after 4 weeks of discharge. The ASIA scale was used before operation and 4 weeks after the operation. Sensory motor function and self-care ability of all subjects were evaluated 12 weeks after operation. At the same time, the content of MBP in serum was determined by enzyme-linked immunosorbent assay (Elisa). The data were analyzed by SPSS20.0 statistical data software. All the measured data were recorded in the format of mean 卤standard deviation X 卤S; Sex, age, injury segment, course of disease and degree of injury were all analyzed. T test and variance analysis were used to measure the data, and rank sum test was used to analyze the non-normal distribution data. X2 test was used to analyze the counting data. P0.05 showed statistical significance. Results: intragroup comparison: postoperative 12 and preoperative. Comparison of ASIA sensory scores at 4 weeks after operation: the experimental group had statistical significance (P 0.05), while the control group had no statistical significance (P 0.05). Postoperative 12 and preoperative. Comparison of ASIA motor score and serum MBP content at 4 weeks after operation: there was significant difference between the two groups (P 0.05), and ASIA sensory score at 4 weeks after operation was not statistically significant in both groups (P < 0.05). P0.05; 4 weeks after operation compared with preoperative ASIA motor score and serum MBP content: there was significant difference between the two groups (P 0.05). Group comparison: preoperative ASIA sensory motor score and serum MBP content comparison: there was no significant difference between the two groups (P 0.05). Comparison of ASIA sensory scores at 4 weeks and 12 weeks after operation: there was no significant difference between the two groups (P 0.05). The difference of ASIA motor score was statistically significant (P 0.05). Comparison of serum MBP levels: there was a significant difference between the two groups at 4 weeks after operation (P 0.05). There was no significant difference between the two groups at 12 weeks after operation (P 0.05). Comparison of ASIA grading before treatment and 12 weeks after operation: the difference between the two groups was statistically significant (P 0.05). ... conclusion:. 1. Buyang Huanwu decoction can improve the sensory and motor function score and ASIA grade of patients after acute spinal cord injury .2.The application of Buyang Huanwu decoction can obviously reduce the MBP content in patients' serum at the early stage. The level of serum MBP was correlated with the degree of postoperative functional recovery in patients with acute spinal cord injury (Asci).
【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】：R651.2

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