身痛逐瘀汤对退变性腰椎管狭窄症术后腰腿痛的近期临床疗效观察

发布时间：2018-05-18 21:43

本文选题：退变性腰椎管狭窄症 + 身痛逐瘀汤　；参考：《湖北中医药大学》2016年硕士论文

【摘要】：【目的】通过临床使用身痛逐瘀汤,观察其在腰椎管狭窄症术后治疗中对腰腿痛发生的防治作用。【方法】回顾性分析武汉市一医院骨科2013年5月-2014年10月62例因腰椎管狭窄症行全椎板减压融合内固定手术患者,其中男34例,女28例,年龄50-80岁,平均63.03±7.89岁,门诊随访6个月以上,平均7.36个月,随机分为两组,治疗组与对照组,两组均予以手术治疗,治疗组术后给予中药身痛逐瘀汤治疗,对照组给予常规抗炎镇痛药物塞来昔布和营养神经药物甲钴胺片口服治疗,通过比较患者术前、术后一周、术后一月及末次随访的VAS、JOA及Oswestry功能障碍指数评分,评估患者的神经功能恢复、身体康复情况以及身痛逐瘀汤对腰椎术后患者身体恢复的影响。以JOA优良率标准评价临床治疗效果。【结果】本组62例患者均获得随访,所有患者术后腰痛、下肢麻木、间歇性跛行等症状消失或显著改善,恢复正常生活,两组术后第2周及第4周VAS评分比值P0.05,具有统计学意义,说明身痛逐瘀汤在早期缓解术后疼痛的治疗上效果显著。两组在术后第四周JOA评分上比较,P0.05,说明身痛逐瘀汤对患者神经功能康复、身体康复也具有显著疗效,治疗组JOA评分优良率:优14例,良15例,中1例,差0例,优良率86.23%;对照组JOA评分优良率:优13例,良17例,中2例,差0例,优良率79.87%;通过治疗患者症状得到明显改善,治疗组患者术后临床疗效优良率明显高于对照组,效果显著。【结论】身痛逐瘀汤辩证加减用于退变性腰椎管狭窄术后的治疗,不仅可以预防和缓解术后腰腿部疼痛的发生,也对患者术后早期功能康复起到一定的促进作用,其活血化瘀、抗炎镇痛的功效值得肯定,可于临床推广应用。
[Abstract]:[objective] to use Shentong Zhuyu decoction in clinic, To observe the preventive and therapeutic effect of Lumbar Spinal Stenosis on Lumbar and leg pain. [methods] A retrospective analysis was made on 62 cases of lumbar spinal stenosis treated with total laminar decompression fusion and internal fixation from May 2013 to October 2014 in Department of Orthopaedics, a hospital in Wuhan. Among them, 34 males and 28 females, aged 50-80 years (mean 63.03 卤7.89 years), were followed up for more than 6 months (mean 7.36 months). They were randomly divided into two groups: treatment group and control group. The treatment group was treated with Shentong Zhuyu decoction, the control group was treated with the routine anti-inflammatory and analgesic drug celecoxib and the nutritional nerve drug Mecobalamin. The scores of VAS-JOA and Oswestry dysfunction index were evaluated to evaluate the recovery of nerve function, physical recovery and the effect of Zhentong Zhuyu decoction on the recovery of patients after lumbar vertebra operation. [results] all the 62 patients were followed up. All the patients' symptoms such as low back pain, numbness of lower extremity and intermittent claudication disappeared or improved significantly after operation. The ratio of VAS score at the 2nd and 4th week after operation in the two groups (P0.05) was statistically significant, which indicated that Shentong Zhuyu decoction had a significant effect on early relief of postoperative pain. The comparison of JOA scores between the two groups in the fourth week after operation showed that Shentong Zhuyu decoction had a significant effect on the rehabilitation of nerve function and physical recovery. The excellent and good rate of JOA score in the treatment group was excellent in 14 cases, good in 15 cases, fair in 1 case, and poor in 0 cases. The excellent and good rate was 86.23. The excellent and good rate of JOA score in the control group was excellent in 13 cases, good in 17 cases, fair in 2 cases, poor in 0 cases, excellent and good rate in 79.87.The clinical effect of the treatment group was significantly improved, and the excellent and good rate of the treatment group was significantly higher than that of the control group. [conclusion] Shentong Zhuyu decoction can be used to treat degenerative lumbar spinal stenosis after operation, which can not only prevent and relieve the pain in the waist and leg, but also promote the early functional rehabilitation of the patients. Its effect of promoting blood circulation and removing blood stasis and anti-inflammation and analgesia is worthy of affirmation and can be popularized and applied in clinic.
【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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