搜风通络汤对脊髓型颈椎病术后脊髓功能恢复的临床观察

发布时间：2018-05-06 07:13

本文选题：搜风通络汤 + 脊髓型颈椎病　；参考：《南京中医药大学》2017年硕士论文

【摘要】：目的:观察周福贻教授搜风通络汤联合术后常规康复治疗对脊髓型颈椎病(CSM)术后脊髓功能恢复的临床疗效,探讨其临床价值,为CSM术后的康复治疗提供依据。方法:本研究所搜集的50名CSM患者均为2015年9月至2016年11月之间在江苏省中医院住院行颈前路手术者,将50名患者按照就诊时间顺序,随机分为试验组24例,采用术后常规康复治疗加搜风通络汤治疗,对照组26例,采用术后单纯常规康复治疗。试验组患者术后解除禁食后即开始服用中药煎剂,每日一剂,分为早晚两次口服,服用七天为一疗程,连续服用4疗程后停药。两组病患在术前和术后1周、2周、4周、3月分别进行随访,统计每名患者的JOA评分及VAS评分情况,并在术后3月随访中,根据《中医病证诊断疗效标准》评价两组患者的临床疗效及脊髓功能恢复情况。所得数据,使用软件SPSS 22.0进行统计学处理。结果:(1)一般资料比较:两组病患在年龄分布、性别情况、病程长短及术前的JOA评分、VAS评分等方面进行比较,P值均0.05,两组患者基线资料对比无明显统计学差异,具有可比性。(2)从JOA评分上看,组内比较:与术前相对比,术后各随访统计点JOA评分均得到持续提升,P0.05,比较具有明显统计学差别,说明两组脊髓功能均获得一定程度的提高,且均未出现明显反弹。组间比较:术后一周时,两组比较,P0.05,比较无明显统计学差别;术后两周、四周及三个月时,两组比较P值均0.05,比较具有统计学差别,试验组脊髓功能改善情况优于对照组。(3)从VAS评分上看,组内比较:与术前比较,术后各随访点VAS评分均得到持续改善,P0.05,比较具有统计学差别,说明两组疼痛均得到一定程度的缓解,均未出现明显反弹。组间比较:术后一周时,两组比较,P0.05,比较无明显统计学差异;术后两周、四周及三个月时,两组比较,P值均0.05,比较具有统计学差别,试验组患者疼痛改善状况优于对照组。(4)最后一次随访中,按《中医病证诊断疗效标准》比较两组的疗效,试验组总有效率为91.67%,对照组为76.92%,两组对比P0.05,比较具有统计学差别,试验组疗效改善优于对照组。结论:搜风通络汤联合术后常规康复治疗以及单纯术后常规康复治疗均可以促进CSM术后脊髓功能状态的恢复,减轻患者症状,提高临床疗效,且均无明显不良反应。但搜风通络汤联合术后常规康复治疗对改善CSM患者术后脊髓功能状态疗效更为显著,是脊髓型颈椎病术后治疗的有效治疗方法,值得临床推广。
[Abstract]:Objective: to observe the clinical effect of Professor Zhou Fuyi combined with conventional rehabilitation therapy on the recovery of spinal cord function after operation of cervical Spondylotic myelopathy (CSM), to explore its clinical value and to provide the basis for rehabilitation treatment after CSM. Methods: 50 CSM patients who were hospitalized in Jiangsu Provincial Hospital of traditional Chinese Medicine from September 2015 to November 2016 were randomly divided into two groups. 26 patients in the control group were treated with conventional rehabilitation therapy plus Soufeng Tongluo decoction, and 26 patients with the control group were treated with simple routine rehabilitation after operation. The patients in the test group began to take traditional Chinese medicine decoction once a day after relieving fasting after operation, divided into morning and evening oral twice, taking seven days as a course of treatment, continuously taking 4 courses of treatment and then stopped taking the medicine. The patients in the two groups were followed up before and after 1 week, 2 weeks, 4 weeks and 3 months, respectively. The JOA and VAS scores of each patient were calculated. To evaluate the clinical efficacy and spinal functional recovery of the two groups according to the criteria of diagnosis and treatment of TCM disease syndrome. The data were processed by software SPSS 22. 0. Results comparison of general data: there was no significant difference in baseline data between the two groups in terms of age distribution, sex, duration of disease, preoperative JOA score and VAS score. From the point of view of JOA score, comparison: compared with pre-operation, the JOA scores of all follow-up points were improved continuously (P0.05). The comparison showed that the spinal cord function of the two groups were improved to some extent. And did not appear obvious rebound. Comparison between the two groups: at one week after operation, there was no significant difference between the two groups (P 0.05), but at two weeks, four weeks and three months after operation, the P value of the two groups was 0.05, the difference was statistically significant. The improvement of spinal cord function in the trial group was better than that in the control group (P < 0.05). From the point of view of VAS score, comparison within the group: compared with pre-operation, the VAS score of all follow-up points after operation was improved continuously (P 0.05), the difference was statistically significant. It showed that the pain in both groups was relieved to a certain extent, and no obvious rebound appeared. Comparison between the two groups: at one week after operation, there was no significant difference between the two groups (P 0.05), but at two weeks, four weeks and three months after the operation, the P values of the two groups were all 0.05, with statistical difference. In the last follow-up, the total effective rate of the trial group was 91.67 and the control group 76.92. The difference was statistically significant (P0.05, P 0.05). The treatment group was better than the control group. Conclusion: Soufeng Tongluo decoction combined with conventional rehabilitation therapy and simple postoperative routine rehabilitation therapy can promote the recovery of spinal cord function after CSM, alleviate the symptoms of patients, improve the clinical efficacy, and have no obvious adverse reactions. But Soufeng Tongluo decoction combined with routine rehabilitation therapy is more effective in improving spinal cord function after CSM. It is an effective treatment method for cervical Spondylotic myelopathy and is worth popularizing.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R274.9

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