通督活血汤治疗腰椎间盘突出症的临床研究

发布时间：2018-02-04 04:24

本文关键词： 通督活血汤腰椎间盘突出症　出处：《湖北中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:通过观察通督活血汤内服加腰椎牵引,中药熏洗,静脉滴注药物治疗腰椎间盘突出症与单纯行腰椎牵引,中药熏洗,静脉滴注药物治疗治疗腰椎间盘突出症的临床疗效对比,分析研究通督活血汤的临床疗效。方法:随机选取80例湖北省中医院骨科2014年4月到2015年4月收治的40岁至60岁以腰腿疼痛为主要症状的腰椎间盘突出症且住院天数大于或等于2周的住院非手术患者病例,选取以单纯行腰椎牵引,中药熏洗,静脉滴注药物治疗的病例组为对照组,选取在保守治疗的基础上接受通督活血汤汤内服治疗的病例组为治疗组,取对所有病例治前以及治疗2周后分别进行疼痛等级评分并进行相应的统计学分析。80例病例患者均伴有不同程度的腰部疼痛及下肢放射痛,所有病例年龄最低40岁最高60岁,平均年龄52.4岁,其中男性37例,女性43例,行腰椎X-ray,CT,MRI检查提示明确诊断为腰椎间盘突出症,对照组42例,其中男性19例,女性23例,平均年龄52.7岁,治疗组38例,其中男性18人,女性20例,平均年龄52.1岁,两组病例在年龄段分布行,性别比例,患者症状体征无显著差异具有可比性,分别对两组患者治疗前疼痛等级及治疗2周后的疼痛等级进行评分,以患者自觉疼痛症状为主要观察指标,采用世界卫生组织疼痛标准分别对患者治疗前,治疗2周后疼痛等级进行数据采集,以患者临床症状体征改善情况,参照《中医病症诊断疗效标准》,对患者治疗2周后治疗效果进行数据采集,收集整理数据资料并进行统计学分析,取p0.05具有统计学意义,分别对采集数据进行卡方检验,采用IBM SPSS Statistics 19统计软件进行统计学处理,对对照组和治疗组治疗前及治疗后分别进行统计学数据分析。结果:参照世界卫生组织疼痛标准,统计不同程度的病例数,治疗前2组行卡方检验得p0.05,提示治疗组与对照组治疗前不同疼痛程度病例分布无统计学意义,两组样本具有可比性,治疗后2组行数据检验得P0.05,治疗组与对照组治疗后不同疼痛程度病例分布具有显著性差异。参照按照国家中医药管理局颁布的《中医病证诊断疗效标准》。80例病例患者治疗后治愈12例,显效36例,好转29例,未愈3例;其中对照组治愈5例,显效18例,好转17例,未愈2例,总有效率:95%;高有效率:55%;治疗组治愈7例,显效18例,好转12例,未愈1例,总有效率:97%;高有效率:62%;行数据检验,总有效率检验得出p0.05,高有效率经检验得出P0.05,可认为2组总有效率无统计学差异,高有效率差异具有统计学意义,且治疗组高有效率高于对照组。结论:通过临床病例观察研究发现,通督活血汤加腰椎牵引,烫熨,中药熏洗,静脉滴注药物与单纯行腰椎牵引,烫熨,中药熏洗,静脉滴注药物治疗治疗腰椎间盘突出症的临床疗效更佳,通通督活血汤治疗腰椎键盘突出症疗效确切,值得临床应用。
[Abstract]:Objective: to observe the treatment of lumbar disc herniation by internal administration of Tongdu Huoxue decoction combined with lumbar traction, fumigation and washing of Chinese medicine, intravenous drip of medicine in the treatment of lumbar disc herniation and simple lumbar traction, fumigation and washing of traditional Chinese medicine. Comparison of clinical efficacy of intravenous drug infusion in the treatment of lumbar disc herniation. To analyze and study the clinical curative effect of Tongdu Huoxue decoction. 80 cases of lumbar intervertebral disc herniation between 40 and 60 years old with waist and leg pain were randomly selected from orthopedic department of Hubei traditional Chinese medicine hospital from April 2014 to April 2015, and the length of stay was longer than or equal to 2 weeks. Ten percent of the hospitalized non-operative patients. The patients with lumbar traction, traditional Chinese medicine fumigation and intravenous infusion of drugs were selected as the control group, and the patients treated with Tongdu Huoxue decoction on the basis of conservative treatment were selected as the treatment group. The pain grades were scored before treatment and 2 weeks after treatment. 80 cases were all accompanied with different degrees of lumbar pain and lower extremity radiation pain. The age of all cases was the lowest 40 years and the highest 60 years with an average age of 52.4 years. Among them 37 cases were male and 43 cases were female. X-rayCT was performed on lumbar vertebrae. MRI showed that 42 cases were diagnosed as lumbar disc herniation, including 19 males and 23 females, with an average age of 52.7 years. 38 cases were in the treatment group, among which 18 cases were males. The average age of 20 women was 52.1 years old. There was no significant difference between the two groups in terms of age distribution, sex ratio, symptoms and signs of the patients. The pain grades before and after 2 weeks of treatment were scored, and the patients' conscious pain symptoms were taken as the main observation index. The WHO pain standard was used to evaluate the patients before treatment. After 2 weeks of treatment, the pain grade was collected, and the clinical symptoms and signs of the patients were improved. According to the criteria for the diagnosis of TCM symptoms, the data were collected after 2 weeks of treatment. Collect and organize the data and carry on the statistical analysis, take p0.05 has the statistical significance, carry on the chi-square test to the collected data separately. Statistical software IBM SPSS Statistics 19 was used for statistical processing. Statistical data were analyzed before and after treatment in the control group and the treatment group. Results: according to the World Health Organization pain standard, the number of cases with different degrees was counted. Before treatment the two groups were tested by chi-square test p0.05 indicating that the treatment group and the control group before the treatment of different pain cases distribution is not statistically significant the two groups of samples are comparable. After treatment, the two groups were tested by data (P0.05). There was significant difference between the treatment group and the control group in the distribution of patients with different pain degree after treatment. According to the "criteria for diagnosis and curative effect of TCM Disease Syndrome" issued by the State Administration of traditional Chinese Medicine, 80 cases were cured 12 cases after treatment. ... There were 36 cases of remarkable effect, 29 cases of improvement and 3 cases of unrecovered. In the control group, 5 cases were cured, 18 cases were markedly effective, 17 cases were improved, and 2 cases were not recovered. The total effective rate was 9: 95; High efficiency: 55. In the treatment group, 7 cases were cured, 18 cases were markedly effective, 12 cases were improved, 1 case was not recovered, and the total effective rate was 97%. High efficiency: 62. Data test, total efficiency test to get p0.05, high effective rate after testing to get P0.05, we can think that the two groups of the total effective rate has no statistical difference, the high effective rate difference has statistical significance. The high effective rate of the treatment group was higher than that of the control group. Conclusion: through the clinical case observation study, we found that Tongdu Huoxue decoction lumbar traction, ironing, traditional Chinese medicine fumigation, intravenous infusion of drugs and simple lumbar traction, ironing. Traditional Chinese medicine fumigation, intravenous infusion of medicine in the treatment of lumbar disc herniation is better clinical efficacy, Tongtong du Huoxue decoction for lumbar keyboard herniation is effective and worthy of clinical application.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R274.9

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