补肾壮骨方联合椎间孔镜技术治疗腰椎间盘突出症的疗效观察

发布时间：2018-05-14 17:54

本文选题：补肾壮骨方 + 腰椎间盘突出症　；参考：《福建中医药大学》2016年硕士论文

【摘要】：目的：观察中药方剂补肾壮骨方联合椎间孔镜技术治疗腰椎间盘突出症的临床疗效,为提高椎问孔镜技术治疗腰椎间盘突出症的临床疗效提供一定的参考依据。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2014年2月至2015年7月,因腰椎问盘突出症致腰腿疼痛入院需行椎间孔镜技术手术治疗的患者,共60例,按照手术先后顺序完全随机分为两组,即常规治疗组(对照组,30例)、常规治疗补肾壮骨方组(治疗组,30例)。观察点为术前最后1天、术后第1个月、第3个月、第6个月各随访1次,观察随访期限为6个月。采用视觉模拟评分(VAS)、腰腿痛评价量表(JOA)、Oswestry腰椎功能障碍指数(ODI)评分问卷量表测定,比较两组在治疗腰椎间盘突出症的临床效果评价。计量资料用x±S表示,应用统计学软件SSPS18.0对所有数据进行统计分析。观察两组手术前后治疗效果及两组间手术治疗前后差异(以P0.05为无显著差异,P0.05为有显著差异)。结果：1、对照组与治疗组在性别、年龄、病程时间、节段分布、手术时间、术中失血量,两组数据的差异无统计学意义(P0.05),两组病例具有可比性。2、对照组与治疗组在两组术后较术前的VAS评分、JOA评分、ODI评分,均有不同程度的改善；术后两组间第1个月观察点, 两组间VAS评分、JOA评分、ODI评分数据无统计学差异(P0.05)。3、术后3个月VAS疼痛评分下降至对照组为3.03±0.765,治疗组为2.30±0.651,PO.05,两组具有统计学差异,治疗组优于对照组；JOA上升至对照组评分15.70±0.907,治疗组16.90±1.398,P0.05, 两组具有统计学差异,治疗组优J于对照组；ODI评分下降至对照组24.10±1.373,治疗组22.60±1.354,P0.05,两组具有统计学差异,治疗组优于对照组。4、术后6个月VAS疼痛评分下降至对照组为1.13±0.507,治疗组为0.67±0.479,P0.05,两组具有统计学差异,治疗组优于对照组；JOA上升至对照组评分17.70±1.055,治疗组19.90±0.845,P0.05,两组具有统计学差异,治疗组优于对照组；ODI评分下降至对照组14.37±1.691,治疗组11.17±1.510,P0.05,两组具有统计学差异,治疗组优于对照组。结论：补肾壮骨方可以提高椎问孔镜技术治疗腰椎间盘突出症的临床疗效,有利于患者术后腰椎功能的恢复。
[Abstract]:Objective: to observe the clinical effect of Bushen Zhuanggu prescription combined with intervertebral foramen endoscopy in the treatment of lumbar disc herniation, and to provide a certain reference for improving the clinical effect of intervertebral disc herniation. Methods: from February 2014 to July 2015, 60 patients with lumbar herniation caused by lumbar disc herniation and lumbar leg pain were treated by intervertebral foramen endoscopy, a prospective study was carried out in the 175 Hospital of the Chinese people's Liberation Army. According to the sequence of operation, they were randomly divided into two groups: the routine treatment group (control group, 30 cases) and the routine treatment group (Bushen Zhuanggu prescription group, 30 cases). The observation point was the last day before operation, the first month, the third month and the sixth month after operation. The follow-up period was 6 months. Visual analogue scale (VASA), low back pain evaluation scale (JOAA) and Oswestry Lumbar Disorder Index (Oswestry) scale were used to evaluate the clinical efficacy of the two groups in the treatment of lumbar disc herniation. The measurement data were expressed as x 卤S, and all the data were analyzed by statistical software SSPS18.0. To observe the treatment effect before and after operation and the difference between the two groups before and after operation (P0.05 as no significant difference). Results: 1. Sex, age, duration of disease, segmental distribution, operative time, blood loss during operation, There was no significant difference in data between the two groups (P 0.05). The two groups were comparable. The VAS scores of the control group and the treatment group were improved in different degrees compared with those before operation. At the first month after operation, there was no significant difference in VAS scores between the two groups. The VAS pain score decreased to 3.03 卤0.765 in the control group and 2.30 卤0.651 to PO .05 in the treatment group at 3 months after operation. There was statistical difference between the two groups. The scores of JOA in the treatment group increased to 15.70 卤0.907 in the control group and 16.90 卤1.398g / P 0.05 in the treatment group. The ODI score of the treatment group decreased to 24.10 卤1.373 in the control group, and 22.60 卤1.354 to the control group (P 0.05). There was statistical difference between the two groups. The pain score of VAS in the treatment group decreased to 1.13 卤0.507 in 6 months after operation, and that in the treatment group was 0.67 卤0.479, P 0.05. There was statistical difference between the two groups. The score of VAS in the treatment group increased to 17.70 卤1.055 in the control group, and 19.90 卤0.845 in the treatment group. There was statistical difference between the two groups. The ODI score in the treatment group decreased to 14.37 卤1.691in the control group, and 11.17 卤1.510p 0.05 in the treatment group. The difference between the two groups was statistically significant, and that in the treatment group was better than that in the control group. Conclusion: Bushen Zhuanggu prescription can improve the clinical curative effect of intervertebral disc herniation with intervertebral foramen technique, and is beneficial to the recovery of lumbar vertebrae function after operation.
【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】：2016
【分类号】：R687.3

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