本文關(guān)鍵詞：通痹片治療脊髓型頸椎病術(shù)后軸性癥狀的療效觀察　出處：《福建中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

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【摘要】：目的:通過對(duì)照研究通痹片治療脊髓型頸椎病術(shù)后軸性癥狀的臨床觀察。方法:采用前瞻性研究的方法,對(duì)來自于中國人民解放軍第175醫(yī)院2015年9月至2016年9月,因脊髓型頸椎病入院需行頸后路手術(shù)(包括頸后路單開門椎管成形術(shù)和頸后路雙開門椎管成形術(shù))治療且術(shù)后1個(gè)月門診隨訪出現(xiàn)軸性癥狀的患者,符合納入標(biāo)準(zhǔn)、排除標(biāo)準(zhǔn),共40例,隨機(jī)分為兩組,分別為治療組(口服通痹片+艾瑞昔布)及對(duì)照組(口服艾瑞昔布),同時(shí)進(jìn)行頸部功能鍛煉(每天早中晚各3組,每組5次)。分別在患者術(shù)后第1個(gè)月記錄患者一般資料,同時(shí)記錄患者此時(shí)的視覺模擬評(píng)分(VAS)、頸椎JOA評(píng)分及頸椎活動(dòng)度(ROM),同時(shí)定期監(jiān)測(cè)患者肝腎功。分別在術(shù)后第1個(gè)月、第2個(gè)月、第3個(gè)月、第4個(gè)月及第6個(gè)月隨訪記錄患者VAS評(píng)分、頸椎J0A評(píng)分、頸部活動(dòng)度(ROM)及Tsuji評(píng)分,隨訪期限為6個(gè)月,分別對(duì)比兩組各項(xiàng)指標(biāo)觀察療效。計(jì)量資料用X±S表示,采用t檢驗(yàn),應(yīng)用統(tǒng)計(jì)學(xué)軟件SSPS20.0對(duì)所有數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析。觀察兩組病人治療前后差異(以P0.05為無顯著差異,P0.05為有顯著差異)。結(jié)果:2例病人因外出無法提供完整資料予以剔除,又補(bǔ)充2例病人進(jìn)行隨訪,隨訪期間實(shí)驗(yàn)組的患者無明顯藥物不良反應(yīng),且治療組與對(duì)照組在年齡、性別、手術(shù)節(jié)段等一般資料,兩組數(shù)據(jù)無統(tǒng)計(jì)學(xué)差異(P0.05),具有可比性。1、治療組和對(duì)照組在術(shù)后1個(gè)月隨訪得到的VAS評(píng)分、JOA評(píng)分、頸椎活動(dòng)度及Tsuji評(píng)分無統(tǒng)計(jì)學(xué)差異(P0.05)具有可比性。2、治療組和對(duì)照組經(jīng)治療后,隨訪2、3、4、6個(gè)月,治療組的VAS評(píng)分均低于對(duì)照組(P0.05),治療組優(yōu)于對(duì)照組。3、治療組和對(duì)照組經(jīng)治療后,隨訪2、3、4、6個(gè)月,治療組的JOA評(píng)分與對(duì)照組相仿(P＜0.05),不具備統(tǒng)計(jì)學(xué)差異。4、治療組和對(duì)照組經(jīng)治療后,隨訪2、3、4、6個(gè)月,其中術(shù)后2、3、4月份的治療組的頸椎活動(dòng)度(屈伸、旋轉(zhuǎn))較對(duì)照組明顯改善(P0.05),治療組優(yōu)于對(duì)照組,而術(shù)后6個(gè)月的治療組頸椎活動(dòng)度(屈伸、旋轉(zhuǎn))較對(duì)照組無明顯差異,P0.05;術(shù)后2、3個(gè)月的治療組頸椎活動(dòng)度(側(cè)彎)較對(duì)照組明顯改善(P0.05),術(shù)后4、6個(gè)月的治療組頸椎活動(dòng)度(側(cè)彎)較對(duì)照組無明顯改善,P0.05。5、治療組和對(duì)照組經(jīng)治療后,術(shù)后2、3個(gè)月隨訪Tsuji評(píng)分,P＞0.05,不具有統(tǒng)計(jì)學(xué)差異;術(shù)后4、6個(gè)月隨訪Tsuji評(píng)分,P0.05,具有統(tǒng)計(jì)學(xué)差異,治療組優(yōu)于對(duì)照組。結(jié)論:通痹片在治療脊髓型頸椎病術(shù)后軸性癥狀具有顯著療效,有利于改善患者疼痛及短期內(nèi)恢復(fù)患者的正常頸椎活動(dòng)度。
[Abstract]:Objective: to study the clinical effect of Tongbi tablet on axial symptoms of cervical Spondylotic myelopathy after operation. Yes, from September 2015 to September 2016 at the 175th Hospital of the Chinese people's Liberation Army. Patients with cervical Spondylotic myelopathy underwent posterior cervical surgery (including posterior cervical open door spinal canal angioplasty and posterior cervical open door laminoplasty) and were followed up 1 month after operation for axial symptoms of cervical Spondylotic myelopathy. 40 patients were randomly divided into two groups: the treatment group (oral administration of Tongbi tablet) and the control group (oral administration of alexib). At the same time, cervical functional exercise (3 groups each morning, midnight, 5 times in each group. The patients were recorded in the first month after the operation of general data, while recording the visual analogue scores of patients at this time VAS.). JOA score of cervical spine and cervical motion were measured regularly. The liver and kidney function were monitored at the first month, the second month, and the third month after operation, respectively. The VAS score, cervical J0A score, cervical mobility score and Tsuji score were recorded at the 4th and 6th months. The follow-up period was 6 months. The data were expressed as X 鹵S and t-test were used. The statistical software SSPS20.0 was used to analyze all the data. The difference between the two groups before and after treatment was observed (P0.05 as no significant difference). Results 2 cases of patients were not able to provide complete information to be eliminated, and 2 cases were followed up. There was no obvious adverse drug reaction in the patients of the experimental group during the follow-up period. And the treatment group and the control group in the age, sex, surgical segment and other general data, there is no statistical difference between the two groups (P 0.05), there is comparable .1. There was no significant difference in VAS score, cervical mobility and Tsuji score between the treatment group and the control group after 1 month follow-up (P 0.05). The VAS scores of the treatment group and the control group were lower than that of the control group (P 0.05), and that of the treatment group was better than that of the control group. The JOA score of the treatment group was similar to that of the control group (P < 0.05), and there was no significant difference between the treatment group and the control group (P < 0.05). The treatment group and the control group were followed up after treatment. After 6 months, the cervical movement (flexion, extension, rotation) of the treatment group was significantly improved than that of the control group in 2 and 3 months postoperatively, and the treatment group was superior to the control group. However, there was no significant difference in cervical movement (flexion, extension, rotation) between the treatment group and the control group 6 months after operation (P 0.05). The cervical movement (lateral curvature) in the treatment group was significantly improved than that in the control group at 2 and 3 months postoperatively, but the cervical movement (lateral curvature) in the treatment group at 4 and 6 months after operation was not significantly improved compared with that in the control group. After treatment, the Tsuji scores of the treatment group and the control group were followed up 2 and 3 months after operation (P > 0.05), there was no significant difference between the treatment group and the control group. The Tsuji score of the treatment group was better than that of the control group (P 0.05). Conclusion: Tongbi tablet has a significant effect in the treatment of postoperative axial symptoms of cervical Spondylotic myelopathy. It is beneficial to improve the pain and restore the normal cervical movement in a short time.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R274.9

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