[1] ZHU Feng - feng, DONG Bo, LI Xiao - qun, et al. Clinical Observation of Percutaneous Transforaminal Endoscopic Discectomy Combined with Shentong Zhuyu Decoction in The Treatment of Lumbar Disc Herniation of Qi Stagnation and Blood Stasis Type [J]. Journal of Shaanxi University of Traditional Chinese Medicine, 2021, 44(02): 87-92. [doi: 10.13424/j.cnki.jsctcm.2021.02.018]
Clinical Observation of Percutaneous Transforaminal Endoscopic Discectomy Combined with Shentong Zhuyu Decoction in The Treatment of Lumbar Disc Herniation of Qi Stagnation and Blood Stasis Type
- Article number:
- 2096-1340(2021)02-0087-06
- Keywords:
- Percutaneous transforaminal endoscopic discectomy; Shentong Zhuyu Decoction; Qi stagnation and blood stasis type; Lumbar disc herniation; Clinical research
- ZTFLH:
- R681.5+3
- Code:
- A
- Abstract:
- Objective To observe the clinical efficacy of percutaneous transforaminal endoscopic discectomy combined with Shentong Zhuyu Decoction in the treatment of lumbar disc herniation of Qi stagnation and blood stasis type. Methods 70 patients with lumbar disc herniation were divided into treatment group and control group according to the order of treat-ment, 35 cases in each group. The treatment group was treated with percutaneous transforaminal endoscopic discectomy + Shentong Zhuyu Decoction, while the control group was treated with simple percutaneous transforaminal endoscopic discectomy. The VAS score, JOA score and TCM Syndrome improvement of the two groups were observed and compared after 1 month and 3 months of treatment statistical analysis. Results Before treatment, there was no significant difference in general information, VAS score and JOA score between the two groups (P > 0. 05); after 1 month of treatment, the VAS score and JOA score of the two groups were significantly improved (P < 0. 05), and the improvement of the treat-ment group was more obvious, the difference was statistically significant (P < 0. 05); after 3 months of treatment, there was no significant difference in VAS score between the treatment group and the control group (P > 0. 05), but the JOA score was significantly higher . The improvement of JOA score in the treatment group was still better than that in the con-trol group (P < 0. 05). After treatment, the total effective rate of TCM syndrome improvement was 94. 29% in the treat-ment group and 85. 71% in the control group, with significant difference between the two groups ( P < 0. 05). Conclusion Percutaneous transforaminal endoscopic discectomy combined with Shentong Zhuyu Decoction in the treatment of lumbar disc herniation of Qi stagnation and blood stasis type is significantly better than simple percutaneous transforami-nal endoscopic discectomy in relieving pain, improving clinical symptoms and improving postoperative functional recovery,which is worthy of clinical application.Objective To observe the clinical efficacy of percutaneous transforaminal endoscopic discectomy combined with Shentong Zhuyu Decoction in the treatment of lumbar disc herniation of Qi stagnation and blood stasis type. Methods 70 patients with lumbar disc herniation were divided into treatment group and control group according to the order of treat-ment, 35 cases in each group. The treatment group was treated with percutaneous transforaminal endoscopic discectomy + Shentong Zhuyu Decoction, while the control group was treated with simple percutaneous transforaminal endoscopic discectomy. The VAS score, JOA score and TCM Syndrome improvement of the two groups were observed and compared after 1 month and 3 months of treatment statistical analysis. Results Before treatment, there was no significant difference in general information, VAS score and JOA score between the two groups (P > 0. 05); after 1 month of treatment, the VAS score and JOA score of the two groups were significantly improved (P < 0. 05), and the improvement of the treat-ment group was more obvious, the difference was statistically significant (P < 0. 05); after 3 months of treatment, there was no significant difference in VAS score between the treatment group and the control group (P > 0. 05), but the JOA score was significantly higher . The improvement of JOA score in the treatment group was still better than that in the con-trol group (P < 0. 05). After treatment, the total effective rate of TCM syndrome improvement was 94. 29% in the treat-ment group and 85. 71% in the control group, with significant difference between the two groups ( P < 0. 05). Conclusion Percutaneous transforaminal endoscopic discectomy combined with Shentong Zhuyu Decoction in the treatment of lumbar disc herniation of Qi stagnation and blood stasis type is significantly better than simple percutaneous transforami-nal endoscopic discectomy in relieving pain, improving clinical symptoms and improving postoperative functional recovery,which is worthy of clinical application.
References:
[1]胡有谷. 腰椎间盘突出症[M]. 3 版. 北京:人民卫生出版社,2004:362.
[2] Kim YK,Kang D,Lee I,et al. Differences in the incidence of symptomatic cervical and lumbar disc herniation accord-ing to age,sex and national health insurance eligibility:a pilot study on the disease’s association with work [J]. International Journal of Environmental Research and Public Health,2018,15(10):2094.
[3] 张德元. 腰椎间盘突出症的中西医康复医疗技术[J].现代康复,1998,2(11):3 -5.
[4] Wang Y,Yan YQ,Yang J,et al. Outcomes of percutaneous endoscopic trans - articular discectomy for huge central or paracentral lumbar disc herniation[J]. International Ortho-paedics,2019,43(4):939 -945.
[5] Jiang C,Li YY,Guo MM,et al. Acupotomy therapy for lumbar disc herniation:Protocol for a systematic review and meta - analysis[J]. Medicine,2018,97(40):e12624.
[6] 宋丹,张耀巍,杨璐. 推拿配合运动疗法治疗腰椎间盘突出症患者的疗效[J]. 医疗装备,2018,31(20):56-57.
[7] 陈霞,范玉江. 针灸治疗腰椎间盘突出症疼痛的临床疗效观察[J]. 湖北中医药大学学报,2018,20(5):83-85.
[8] 吴晓飞,陈锋,刘宁,等. 腰椎间盘突出症中西医治疗方法选择[J]. 辽宁中医药大学学报,2018,20(11):163-167.
[9]禚汉杰,周英杰,柴旭斌,等. 身痛逐瘀汤治疗血瘀型腰椎间盘突出症的临床报道[J]. 中国中医骨伤科杂志,2018,26(10):52 -53.
[10]宋晓平. 药物配合火疗及电针治疗腰椎间盘突出症 96例疗效分析[J]. 陕西中医药大学学报,2018,41(5):83-85.
[11]张扬. 中医正骨疗法联合温针灸治疗腰椎间盘突出症的临床疗效[J]. 中国康复,2018,33(4):327 -329.
[12] Komori H,Shinomiya K,Nakai O,et al. The natural his-tory of herniated nucleus pulposus with radiculopathy[J].Spine,1996,21(2):225 -229.
[13] 国家中医药管理局. 中华人民共和国中医药行业标准(中医病证诊断疗效标准)[M]. 南京:南京大学出版社,1994.
[14] 周仲瑛. 中医内科学[M]. 2 版. 北京:中国中医药出版社,2007.
[15] Huskisson EC. Measurement of pain[J]. Lancet,1974,2(7889):1127 -1131.[16]井上骏一,片冈治. 腰腿疾患治疗成绩制定基准[J].日本整形骨科学会杂志,1983,60(2):391
-394.
[17]周贝,刘亚琳,唐健元. 我国中药新药临床研究技术指导原则体系发布概况[J]. 中国临床药理学杂志,2017,33(18):1850 -1852.
[18] 王洪伟,李长青,周跃. 腰椎间盘突出症疼痛发生机制的研究进展[J]. 中国矫形外科杂志,2011,19(7):568-571.
[19] 徐奎,覃正仕,赵权. 腰椎间盘突出症微创治疗研究进展[J]. 现代中西医结合杂志,2016,25(1):109 -112.
[20] 王国军,尹佩玉,韩庭良,等. 导杆导引在经皮椎间孔脊柱内镜技术中的应用[J]. 中国中医骨伤科杂志,2018,26(11):51 -54.
[21] 崔长信,胡迎光. 经皮椎间孔镜治疗腰椎间盘突出症的探究[J]. 中国实用医药,2014,9(27):54 -55.
[22] Jasper GP,Francisco GM,Telfeian A. Outpatient,awake,ultra - minimally invasive endoscopic treatment of lumbar disc herniations [ J ]. Rhode Island Medical Journal (2013),2014,97(6):47 -49.
Memo
基金项目:国家自然科学基金项目(81574006);国家中管局科研专项(JDZX2015280);陕西省自然科学计划项目(2018JM7132);陕西省重点科技创新团队项目(2013KJT -26); 陕西省三秦学者创新团队支持计划;刘德玉名老中医药专家传承工作室项目;关中李氏骨伤流派传承工作室项目
通讯作者:董博,主任医师。 E - mail:297065203@ qq. Com