溶髓方联合腰椎牵引治疗腰椎间盘突出症气滞血瘀证疗效观察

发布时间：2018-04-19 08:17

  本文选题：溶髓方 + 腰椎牵引　； 参考：《广西中医药大学》2017年硕士论文

【摘要】：目的:重点观察评价溶髓方联合腰椎牵引与西药双氯芬酸钠缓释片联合腰椎牵引综合治疗的疗效比较,以及溶髓方联合腰椎牵引在本病中治疗中发挥的作用,为指导中医药治疗腰椎间盘突出症气滞血瘀证提供理论依据和指导。方法:本研究主要从大学附属医院骨科门诊及住院部就诊的患者中,收集符合腰椎间盘突出症气滞血瘀证诊断标准、纳入标准的患者68例,按就诊时间先后顺序用随机数字法随机分成治疗组和对照组,每组34例。治疗组予以应用导师在临床中常用的经验方溶髓方,每日服用剂量为30g,疗程为4周;对照组予以双氯芬酸钠缓释片口服,每日服用75mg,共治疗4周,两组都联合腰椎牵引进行治疗。并观察治疗前与治疗后2周、4周,通过应用JOA评分、VAS评分、ODI评分、临床疗效综合评价、肝肾功能等安全性观察指标及计算不良反应发生率,以判定临床疗效。所得试验研究数据使用SPSS22.0统计软件进行处理,用均数±标准差表示,P0.05则证明具有统计学意义。结果:(1)JOA评分:(1)经过2周时间治疗,与治疗前同组比较,两组患者都有小幅提高的JOA评分差异有统计学意义(P0.05),但两组间JOA评分差异无统计学意义(P0.05);(2)经过4周时间治疗,与同组治疗2周时JOA评分差异有统计学意义(P0.05),而经过4周时间治疗,两组间获取的JOA评分差异有统计学意义(P0.05)。(2)ODI评分:(1)经过2周时间治疗,与治疗前同组比较,两组均有小幅降低的ODI评分差异有统计学意义(P0.05),但获取的两组间ODI评分差异无统计学意义(P0.05);(2)经过4周时间治疗,与同组治疗2周时的ODI评分差异有统计学意义(P0.05),而两组间获取的ODI评分差异有统计学意义(P0.05)。(3)VAS评分:(1)两组患者在治疗2周时,与治疗前同组比较,获取的两组VAS评分均有降低,差异有统计学意义(P0.05),而两组间获取的VAS评分差异无统计学意义(P0.05);(2)治疗4周时,与同组治疗2周时的VAS评分差异有统计学意义(P0.05);而两组间降低的VAS评分差异也有统计学意义(P0.05)。(4)临床疗效:两组患者经过为期4周时间的治疗,治疗组31例患者中,治疗总有效率为90.3%;而对照组29例患者中,治疗总有效率为79.3%,两组临床疗效有统计学意义(P0.05)。(5)安全性观察:两组患者治疗前与经过4周时间治疗所获得的肝、肾功能等安全性指标差异均无统计学意义(P0.05);治疗期间治疗组的不良反应率为6.5%,对照组的不良反应率为17.2%,两组的不良反应率差异具有统计学意义(P0.05)。结论:溶髓方联合腰椎牵引及口服双氯芬酸钠缓释片联合腰椎牵引治疗腰椎间盘突出症(LDH)气滞血瘀证都有一定的疗效,患者在治疗期间腰腿部疼痛等症状及功能活动都有了一定程度的改善,但溶髓方联合腰椎牵引对腰椎间盘突出症气滞血瘀证的治疗,在对临床症状的改善及机体功能恢复等整体方面上较口服双氯芬酸钠缓释片联合腰椎牵引更有优势。
[Abstract]:Objective: To compare the curative effect observation on Evaluation of spinal cord combined with lumbar traction and Western medicine combined with lumbar traction Diclofenac Sodium Sustained Release Tablets comprehensive treatment, and the dissolution of marrow decoction combined with lumbar traction in the treatment of this disease in the play the role of providing theoretical basis and guidance for the guidance of Chinese medicine for the treatment of lumbar disc herniation of qi stagnation and blood stasis syndrome. Methods: This study mainly from the patients of Department of orthopedics affiliated hospital outpatient and inpatient medical university, collect with lumbar disc herniation with qi stagnation and blood stasis syndrome diagnostic criteria, 68 patients were included in the standard, according to the visiting time sequence with random digital method randomly divided into treatment group and control group, 34 cases in each group. The treatment group to be applied in clinical tutor in the experience of the common solution marrow side, the daily dose is 30g, for 4 weeks; the control group was given oral daily doses of 75mg, Diclofenac Sodium Sustained Release Tablets, a total of 4 weeks of treatment, the two groups are linked Combined lumbar traction treatment. And observation and treatment after 2 weeks before treatment, 4 weeks, through the application of JOA score, VAS score, ODI score, clinical evaluation, liver and kidney function and other safety observation index and calculate the incidence of adverse reactions, to determine the clinical efficacy. The experimental research data using statistical software SPSS22.0 processing, represented by the standard deviation, P0.05 is proved to have statistical significance. Results: (1) JOA score: (1) after 2 weeks of treatment, and the treatment group compared with before, two groups of patients had slightly increased JOA score difference was statistically significant (P0.05), but the difference was not statistically significant the JOA score between the two groups (P0.05); (2) after 4 weeks of treatment, and the treatment in the same group was statistically significant difference in JOA score at week 2 (P0.05), and after 4 weeks of treatment, there are statistically significant differences in JOA scores between the two groups (P0.05). The ODI score: ((2) 1) after 2 weeks 鏃堕棿娌荤枟,涓庢不鐤楀墠鍚岀粍姣旇緝,涓ょ粍鍧囨湁灏忓箙闄嶄綆鐨凮DI璇勫垎宸�寮傛湁缁熻�″�︽剰涔�(P0.05),浣嗚幏鍙栫殑涓ょ粍闂碠DI璇勫垎宸�寮傛棤缁熻�″�︽剰涔�(P0.05);(2)缁忚繃4鍛ㄦ椂闂存不鐤，

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