【摘要】：目的：觀察活血止痛湯加減配合頸前路減壓治療脊髓型頸椎病的療效,評價術后單純手術組與活血止痛湯+手術組的短期的療效。方法：按照脊髓型頸椎病(下頸椎)的診斷標準,選取來源于福建中醫(yī)藥大學附屬人民醫(yī)院骨科于2014年1月至2014年12月期間住院治療的病人,共60例,其中男性38例,女性22例,隨機化分組,將60例病人隨機分為實驗組：活血止痛湯+手術30例；對照組：單純手術30例。觀察點選擇在術后第3天及術后服用活血止痛湯后第1周、第2周、第3周、第3個月各隨訪一次；觀察時間為3個月。采用JOA脊髓型頸椎病的治療成績評定標準量表、肌電圖及《中醫(yī)病證診斷療效標準》進行評價。從性別、年齡、病程、頸椎病變累及節(jié)段四個方面比較是否存在差異,術前及術后3天JOA評分,確定可比性,進行兩組對照比較,觀察兩組在術后服用活血止痛湯后第1周、2周、3周、第3個月治療效果及JOA評分、肌電圖、《中醫(yī)病證診斷療效標準》評價的差異。結果：兩組病例在性別、年齡、病程、頸椎病變累及節(jié)段評分等無顯著性差異(p0.05),具有可比性。術前及術后第3天JOA評分無明顯差別,具有可比性；通過服用活血止痛湯后第1周、第2周、第3周、第3個月的JOA評分、肌電圖、《中醫(yī)病證診斷療效標準》評價,分別在術后第2周、第3個月、第3個月開始有臨床意義(p0.05)、有統(tǒng)計學差異。結論：活血止痛湯在脊髓型頸椎病病人經(jīng)頸前路減壓鈦網(wǎng)植骨內(nèi)固定術后能夠改善其殘留床癥狀,促進病人術后的脊髓功能恢復,提高生活質(zhì)量。
[Abstract]:Aim: to observe the efficacy of Huoxue Zhitong decoction (Huoxue Zhitong decoction) in the treatment of cervical Spondylotic myelopathy (CSM), and to evaluate the short-term curative effect of operation group and Huoxue Zhitong decoction group. Methods: according to the diagnostic criteria of cervical Spondylotic myelopathy (lower cervical vertebra), 60 patients (38 males) from the Department of Orthopaedics, affiliated people's Hospital of Fujian University of traditional Chinese Medicine from January 2014 to December 2014 were selected. Twenty-two female patients were randomly divided into experimental group (n = 60) and control group (n = 30): operation with Huoxue Zhitong decoction (n = 30); Control group: 30 cases underwent simple operation. The observation points were followed up on the 3rd day after operation and on the 1st week, 2nd week, 3rd week and 3rd month after taking Huoxue Zhitong decoction, and the observation time was 3 months. The JOA scale, electromyography (EMG) and therapeutic effect standard for diagnosis of cervical Spondylotic myelopathy (CSM) were used to evaluate the therapeutic performance of cervical spondylotic myelopathy. Whether there were differences in sex, age, course of disease, involvement of cervical vertebra, JOA score before and 3 days after operation were compared between the two groups, and the two groups were observed at the first week after taking Huoxue Zhitong decoction after operation, and compared with each other in the first week after taking Huoxue Zhitong decoction (Huoxue Zhitong decoction). The difference of therapeutic effect, JOA score, electromyography (EMG), < criteria for diagnosis and curative effect of TCM syndrome > were observed in 2 weeks, 3 weeks and 3 months. Results: there was no significant difference between the two groups in sex, age, course of disease and score of cervical involvement (p0.05). There was no significant difference in JOA scores before operation and on the 3rd day after operation, and it was comparable. After taking Huoxue Zhitong decoction, the JOA score, electromyogram (EMG) and the diagnostic efficacy standard of TCM syndrome were evaluated at week 1, week 2, week 3, and month 3 after operation, respectively, at the 2nd week and 3rd month after operation, respectively. The third month began to have clinical significance (p0.05), there was statistical difference. Conclusion: Huoxue Zhitong decoction can improve the residual bed symptoms, promote the recovery of spinal cord function and improve the quality of life of patients with cervical Spondylotic myelopathy after anterior cervical decompression and titanium mesh internal fixation.
【學位授予單位】：福建中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R687.3

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