独活寄生汤治疗腰椎间盘突出症术后腰腿痛的临床研究

发布时间：2018-01-19 15:11

本文关键词： 独活寄生汤腰椎间盘突出症腰腿痛　出处：《安徽中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:观察比较实验中两组腰椎间盘突出症患者的术后恢复情况,论证独活寄生汤对增强腰椎间盘突出症患者的手术后疗效的作用,以便为临床提高腰椎间盘突出症患者手术治疗效果提供相应的理论和实践依据。方法:对进入临床试验的60例患者病例依照就诊的先后顺序,按照随机数据表法将其分为治疗组(30例)以及对照组(30例),各病例均行单侧椎板间开窗减压加髓核摘除手术治疗,术后常规预防感染、镇痛及对症治疗。对照组术后三天给予氟比诺酚酯50毫克+0.9%氯化钠注射液100毫升静脉滴注,每日一次;治疗组病例在此基础上给予服用独活寄生汤中药汤剂治疗一周,每日一剂,早晚两次分服。采用视觉模拟评分系统评分和以下腰痛评分系统进行评分比较两组患者年龄、性别、术后第一天评估是否存在差异,确定可比性。观察手术后两组患者第3天、第7天及第14天的临床表现以及肌电图等检查项目。计量资料使用均数土标准差方式表示,使用统计分析方法,其中P0.05为有显著性差异,而P0.05为没有显著性差异。结果:治疗组患者与对照组患者对比,治疗前以及手术后患者的相关因素(如年龄、病程、性别、VAS评分及JOA评分等)未见显著性差异(P0.05),两组病例具有可比性。术后当天的VAS评分与JOA评分方面无统计学差异;术后第三天的VAS评分与JOA评分方面无统计学差异;观察术后第七天的VAS评分无统计学差异,但是JOA评分两两比较,存在统计学差异;比较术后十四天对照组与治疗组,JOA与VAS评分均有统计学差异(P0.05),治疗组均值优于对照组。术后14天肌电图结果显示治疗组纤颤波的好转程度优于对照组(P0.05),正相波好转程度指标差异不明显(P0.05)。用药研究期间,各病例均未见其他特殊药物不良反应。结论:中药汤剂独活寄生汤可以有效缓解腰椎间盘突出症患者术后存在的腰腿痛以及肢体麻木和肢体无力等症状,能较明显地改善腰椎间盘突出导致的神经电生理的病理变化,加速了神经功能恢复,是与腰椎间盘突出症手术治疗同步进行的一种安全而有效的治疗手段。
[Abstract]:Objective: to observe and compare the postoperative recovery of the two groups of patients with lumbar disc herniation, and to demonstrate the effect of Duhuozheng decoction on enhancing the post-operative effect of the patients with lumbar disc herniation. In order to provide a theoretical and practical basis for clinical treatment of lumbar disc herniation patients. Methods: 60 patients who entered the clinical trial according to the order of treatment. It was divided into treatment group (n = 30) and control group (n = 30) according to random data table. All cases were treated with unilateral interlaminar fenestration and nucleus pulposus extirpation. Analgesia and symptomatic treatment. The control group received 50 mg of florbinol ester 50 mg 0.9% sodium chloride injection 100ml intravenously once a day three days after operation. The cases in the treatment group were treated with the traditional Chinese medicine decoction of Duhuozhongtang once a week and once a day on this basis. Using visual analogue scoring system and the following low back pain scoring system to compare the two groups of patients age, sex, the first day after surgery to assess whether there is a difference. To determine comparability. Observe the clinical manifestations and electromyography of the two groups on the 3rd, 7th and 14th day after operation. Results: compared with the control group, the treatment group and the control group, before and after the treatment of patients with relevant factors (such as age, course of disease). There was no significant difference (P 0.05) between the two groups. There was no significant difference in VAS score and JOA score between the two groups on the day after operation. There was no significant difference between VAS score and JOA score on the third day after operation. There was no statistical difference in VAS scores at 7th days after operation, but there was statistical difference in JOA scores. The scores of JOA and VAS in the control group and the treatment group were significantly different 14 days after operation (P 0.05). The average value of the treatment group was better than that of the control group. The results of electromyography 14 days after operation showed that the improvement of fibrillation wave in the treatment group was better than that in the control group (P 0.05). There was no significant difference in the improvement degree of positive phase wave (P 0.05). No other special adverse drug reactions were found in each case. Conclusion: Duhuozheng decoction can effectively relieve the symptoms of lumbago and leg pain, limb numbness and limb weakness in patients with lumbar disc herniation after operation. It can obviously improve the pathological changes of nerve electrophysiology caused by lumbar intervertebral disc herniation and accelerate the recovery of nerve function. It is a safe and effective treatment method to synchronize the surgical treatment of lumbar disc herniation.
【学位授予单位】：安徽中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R274.9

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