摘要
目的观察益气活血方对腰椎间盘突出合并椎管狭窄患者经皮椎间盘切除术疗效和血清炎性因子水平的影响。方法选取2020年3月至2021年6月在周口骨科医院诊治的腰椎间盘突出合并椎管狭窄患者90例,按照随机对照原则分为对照组(45例)和观察组(45例)。两组均采用经皮椎间孔镜椎间盘切除术治疗,对照组术后口服西乐葆胶囊、弥可保片治疗,观察组在对照组治疗的基础上联合益气活血方口服治疗。比较两组临床疗效、治疗前后日本骨科学会腰痛评价量表(Japanese Orthopaedic Association scores,JOA)评分、Oswestry功能障碍指数(Oswestry dysfunction index,ODI)评分、视觉模拟量表(visual analogue scale,VAS)评分、血清前列腺素E_(2)(prostaglandin E_(2),PGE_(2))水平、5-羟色胺(5-hydroxytryptamine,5-HT)水平、白细胞介素6(interleukin-6,IL-6)水平、白细胞介素1β(interleukin-1β,IL-1β)水平、超敏C反应蛋白(hypersensitivity C-reactive protein,hs-CRP)水平,统计两组用药不良反应发生情况。结果观察组和对照组总有效率分别为91.1%和68.9%,差异有统计学意义(P<0.05);两组治疗后JOA评分均升高(P<0.05),且观察组JOA评分高于对照组(P<0.05);两组治疗后ODI评分、VAS评分均降低(P<0.05),且观察组ODI评分、VAS评分均低于对照组(P<0.05);两组治疗后PGE_(2)、5-HT、IL-6、IL-1β、hs-CRP水平均降低(P<0.05),且观察组PGE_(2)、5-HT、IL-6、IL-1β、hs-CRP水平均低于对照组(P<0.05);两组治疗期间均未出现明显的全身或局部不良反应。结论将益气活血方应用到腰椎间盘突出合并椎管狭窄经皮椎间盘切除术中,能够提高手术疗效,抑制疼痛介质和炎性因子表达,有助于缓解患者临床症状,改善腰椎功能。
Objective To observe the effect of Yiqi Huoxue decoction on the efficacy of percutaneous discectomy and serum inflammatory factors in patients with lumbar disc herniation combined with spinal stenosis.Methods 90 patients with lumbar disc herniation combined with spinal stenosis treated in zhoukou Orthopedic Hospital from March 2020 to June 2021 were selected and divided into a control group(45 cases)and a observation group(45 cases)according to the basic principles of randomized controlled study.Both groups were treated with percutaneous transforaminal endoscopic discectomy.The control group was treated with oral Celecoxib capsule and Mecobao tablet,and the observation group was treated with Yiqi Huoxue decoction on the basis of the treatment of the control group.Compare two groups of clinical curative effect,Japanese Orthopaedic Association scores(JOA)score before and after the treatment,Oswestry disability index(ODI)score,visual analogue scale(VAS)score,serum levels of prostaglandin E_(2)(PGE_(2)),5-hydroxytryptamine(5-HT),interleukin-6(IL-6),interleukin-1β(IL-1β),and high-sensitivity C-reactive protein(hs-CRP)were recorded.The incidence of adverse drug reactions in the two groups was statistically analyzed.Results The observation group and control group total effective rate were 91.1%and 68.9%respectively,the difference was statistically significant(P<0.05).The JOA scores of the two groups were increased after treatment(P<0.05),and the JOA score of the observation group was higher than that of the control group(P<0.05).The ODI and VAS scores of the two groups were decreased after treatment(P<0.05),and the ODI and VAS scores of the observation group were lower than those of the control group(P<0.05).After treatment,the levels of PGE_(2),5-HT,IL-6,IL-1βand hs-CRP in the two groups were decreased(P<0.05),and the levels of PGE_(2),5-HT,IL-6,IL-1βand hs-CRP in the observation group were lower than those in the control group(P<0.05).There were no obvious systemic or local adverse reactions in the two groups during the treatment.Conclusions Yiqi Huoxue decoction can improve the curative effect,inhibit the expression of pain mediators and inflammatory factors,help to relieve the clinical symptoms of patients,and improve the function of lumbar spine,which is worthy of clinical promotion.Conclusion The application of Yiqi Huoxue recipe in percutaneous discectomy for lumbar disc herniation combined with spinal stenosis can improve the surgical efficacy,inhibit the expression of pain mediators and inflammatory factors,help to relieve the clinical symptoms of patients,and improve the function of lumbar spine.
作者
刘培培
贾露露
张欲翔
王孝文
刘堃
LIU Pei-pei;JIA Lu-lu;ZHANG Yu-xiang;WANG Xiao-wen;LIU Kun(Department of Neurospinal Center,Zhoukou Orthopedic Hospital,Zhoukou,Henan 466000,China;不详)
出处
《慢性病学杂志》
2023年第9期1289-1292,共4页
Chronic Pathematology Journal
基金
河北省中医药管理局课题(2016108)
关键词
腰椎间盘突出
椎管狭窄
经皮椎间盘切除术
中药
炎性因子
Lumbar disc herniation
Spinal canal stenosis
Percutaneous discectomy
Traditional Chinese Medicine
Inflammatory factors
