活血止痛汤加减配合颈前路减压钛网植骨内固定治疗脊髓型脊椎病的疗效研究

发布时间：2019-04-07 18:01

【摘要】：目的：观察活血止痛汤加减配合颈前路减压治疗脊髓型颈椎病的疗效,评价术后单纯手术组与活血止痛汤+手术组的短期的疗效。方法：按照脊髓型颈椎病(下颈椎)的诊断标准,选取来源于福建中医药大学附属人民医院骨科于2014年1月至2014年12月期间住院治疗的病人,共60例,其中男性38例,女性22例,随机化分组,将60例病人随机分为实验组：活血止痛汤+手术30例；对照组：单纯手术30例。观察点选择在术后第3天及术后服用活血止痛汤后第1周、第2周、第3周、第3个月各随访一次；观察时间为3个月。采用JOA脊髓型颈椎病的治疗成绩评定标准量表、肌电图及《中医病证诊断疗效标准》进行评价。从性别、年龄、病程、颈椎病变累及节段四个方面比较是否存在差异,术前及术后3天JOA评分,确定可比性,进行两组对照比较,观察两组在术后服用活血止痛汤后第1周、2周、3周、第3个月治疗效果及JOA评分、肌电图、《中医病证诊断疗效标准》评价的差异。结果：两组病例在性别、年龄、病程、颈椎病变累及节段评分等无显著性差异(p0.05),具有可比性。术前及术后第3天JOA评分无明显差别,具有可比性；通过服用活血止痛汤后第1周、第2周、第3周、第3个月的JOA评分、肌电图、《中医病证诊断疗效标准》评价,分别在术后第2周、第3个月、第3个月开始有临床意义(p0.05)、有统计学差异。结论：活血止痛汤在脊髓型颈椎病病人经颈前路减压钛网植骨内固定术后能够改善其残留床症状,促进病人术后的脊髓功能恢复,提高生活质量。
[Abstract]:Aim: to observe the efficacy of Huoxue Zhitong decoction (Huoxue Zhitong decoction) in the treatment of cervical Spondylotic myelopathy (CSM), and to evaluate the short-term curative effect of operation group and Huoxue Zhitong decoction group. Methods: according to the diagnostic criteria of cervical Spondylotic myelopathy (lower cervical vertebra), 60 patients (38 males) from the Department of Orthopaedics, affiliated people's Hospital of Fujian University of traditional Chinese Medicine from January 2014 to December 2014 were selected. Twenty-two female patients were randomly divided into experimental group (n = 60) and control group (n = 30): operation with Huoxue Zhitong decoction (n = 30); Control group: 30 cases underwent simple operation. The observation points were followed up on the 3rd day after operation and on the 1st week, 2nd week, 3rd week and 3rd month after taking Huoxue Zhitong decoction, and the observation time was 3 months. The JOA scale, electromyography (EMG) and therapeutic effect standard for diagnosis of cervical Spondylotic myelopathy (CSM) were used to evaluate the therapeutic performance of cervical spondylotic myelopathy. Whether there were differences in sex, age, course of disease, involvement of cervical vertebra, JOA score before and 3 days after operation were compared between the two groups, and the two groups were observed at the first week after taking Huoxue Zhitong decoction after operation, and compared with each other in the first week after taking Huoxue Zhitong decoction (Huoxue Zhitong decoction). The difference of therapeutic effect, JOA score, electromyography (EMG), < criteria for diagnosis and curative effect of TCM syndrome > were observed in 2 weeks, 3 weeks and 3 months. Results: there was no significant difference between the two groups in sex, age, course of disease and score of cervical involvement (p0.05). There was no significant difference in JOA scores before operation and on the 3rd day after operation, and it was comparable. After taking Huoxue Zhitong decoction, the JOA score, electromyogram (EMG) and the diagnostic efficacy standard of TCM syndrome were evaluated at week 1, week 2, week 3, and month 3 after operation, respectively, at the 2nd week and 3rd month after operation, respectively. The third month began to have clinical significance (p0.05), there was statistical difference. Conclusion: Huoxue Zhitong decoction can improve the residual bed symptoms, promote the recovery of spinal cord function and improve the quality of life of patients with cervical Spondylotic myelopathy after anterior cervical decompression and titanium mesh internal fixation.
【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】：2015
【分类号】：R687.3

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