本文關(guān)鍵詞： 通督活血湯 腰椎間盤突出癥　出處：《湖北中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:通過(guò)觀察通督活血湯內(nèi)服加腰椎牽引,中藥熏洗,靜脈滴注藥物治療腰椎間盤突出癥與單純行腰椎牽引,中藥熏洗,靜脈滴注藥物治療治療腰椎間盤突出癥的臨床療效對(duì)比,分析研究通督活血湯的臨床療效。方法:隨機(jī)選取80例湖北省中醫(yī)院骨科2014年4月到2015年4月收治的40歲至60歲以腰腿疼痛為主要癥狀的腰椎間盤突出癥且住院天數(shù)大于或等于2周的住院非手術(shù)患者病例,選取以單純行腰椎牽引,中藥熏洗,靜脈滴注藥物治療的病例組為對(duì)照組,選取在保守治療的基礎(chǔ)上接受通督活血湯湯內(nèi)服治療的病例組為治療組,取對(duì)所有病例治前以及治療2周后分別進(jìn)行疼痛等級(jí)評(píng)分并進(jìn)行相應(yīng)的統(tǒng)計(jì)學(xué)分析。80例病例患者均伴有不同程度的腰部疼痛及下肢放射痛,所有病例年齡最低40歲最高60歲,平均年齡52.4歲,其中男性37例,女性43例,行腰椎X-ray,CT,MRI檢查提示明確診斷為腰椎間盤突出癥,對(duì)照組42例,其中男性19例,女性23例,平均年齡52.7歲,治療組38例,其中男性18人,女性20例,平均年齡52.1歲,兩組病例在年齡段分布行,性別比例,患者癥狀體征無(wú)顯著差異具有可比性,分別對(duì)兩組患者治療前疼痛等級(jí)及治療2周后的疼痛等級(jí)進(jìn)行評(píng)分,以患者自覺疼痛癥狀為主要觀察指標(biāo),采用世界衛(wèi)生組織疼痛標(biāo)準(zhǔn)分別對(duì)患者治療前,治療2周后疼痛等級(jí)進(jìn)行數(shù)據(jù)采集,以患者臨床癥狀體征改善情況,參照《中醫(yī)病癥診斷療效標(biāo)準(zhǔn)》,對(duì)患者治療2周后治療效果進(jìn)行數(shù)據(jù)采集,收集整理數(shù)據(jù)資料并進(jìn)行統(tǒng)計(jì)學(xué)分析,取p0.05具有統(tǒng)計(jì)學(xué)意義,分別對(duì)采集數(shù)據(jù)進(jìn)行卡方檢驗(yàn),采用IBM SPSS Statistics 19統(tǒng)計(jì)軟件進(jìn)行統(tǒng)計(jì)學(xué)處理,對(duì)對(duì)照組和治療組治療前及治療后分別進(jìn)行統(tǒng)計(jì)學(xué)數(shù)據(jù)分析。結(jié)果:參照世界衛(wèi)生組織疼痛標(biāo)準(zhǔn),統(tǒng)計(jì)不同程度的病例數(shù),治療前2組行卡方檢驗(yàn)得p0.05,提示治療組與對(duì)照組治療前不同疼痛程度病例分布無(wú)統(tǒng)計(jì)學(xué)意義,兩組樣本具有可比性,治療后2組行數(shù)據(jù)檢驗(yàn)得P0.05,治療組與對(duì)照組治療后不同疼痛程度病例分布具有顯著性差異。參照按照國(guó)家中醫(yī)藥管理局頒布的《中醫(yī)病證診斷療效標(biāo)準(zhǔn)》。80例病例患者治療后治愈12例,顯效36例,好轉(zhuǎn)29例,未愈3例;其中對(duì)照組治愈5例,顯效18例,好轉(zhuǎn)17例,未愈2例,總有效率:95%;高有效率:55%;治療組治愈7例,顯效18例,好轉(zhuǎn)12例,未愈1例,總有效率:97%;高有效率:62%;行數(shù)據(jù)檢驗(yàn),總有效率檢驗(yàn)得出p0.05,高有效率經(jīng)檢驗(yàn)得出P0.05,可認(rèn)為2組總有效率無(wú)統(tǒng)計(jì)學(xué)差異,高有效率差異具有統(tǒng)計(jì)學(xué)意義,且治療組高有效率高于對(duì)照組。結(jié)論:通過(guò)臨床病例觀察研究發(fā)現(xiàn),通督活血湯加腰椎牽引,燙熨,中藥熏洗,靜脈滴注藥物與單純行腰椎牽引,燙熨,中藥熏洗,靜脈滴注藥物治療治療腰椎間盤突出癥的臨床療效更佳,通通督活血湯治療腰椎鍵盤突出癥療效確切,值得臨床應(yīng)用。
[Abstract]:Objective: to observe the treatment of lumbar disc herniation by internal administration of Tongdu Huoxue decoction combined with lumbar traction, fumigation and washing of Chinese medicine, intravenous drip of medicine in the treatment of lumbar disc herniation and simple lumbar traction, fumigation and washing of traditional Chinese medicine. Comparison of clinical efficacy of intravenous drug infusion in the treatment of lumbar disc herniation. To analyze and study the clinical curative effect of Tongdu Huoxue decoction. 80 cases of lumbar intervertebral disc herniation between 40 and 60 years old with waist and leg pain were randomly selected from orthopedic department of Hubei traditional Chinese medicine hospital from April 2014 to April 2015, and the length of stay was longer than or equal to 2 weeks. Ten percent of the hospitalized non-operative patients. The patients with lumbar traction, traditional Chinese medicine fumigation and intravenous infusion of drugs were selected as the control group, and the patients treated with Tongdu Huoxue decoction on the basis of conservative treatment were selected as the treatment group. The pain grades were scored before treatment and 2 weeks after treatment. 80 cases were all accompanied with different degrees of lumbar pain and lower extremity radiation pain. The age of all cases was the lowest 40 years and the highest 60 years with an average age of 52.4 years. Among them 37 cases were male and 43 cases were female. X-rayCT was performed on lumbar vertebrae. MRI showed that 42 cases were diagnosed as lumbar disc herniation, including 19 males and 23 females, with an average age of 52.7 years. 38 cases were in the treatment group, among which 18 cases were males. The average age of 20 women was 52.1 years old. There was no significant difference between the two groups in terms of age distribution, sex ratio, symptoms and signs of the patients. The pain grades before and after 2 weeks of treatment were scored, and the patients' conscious pain symptoms were taken as the main observation index. The WHO pain standard was used to evaluate the patients before treatment. After 2 weeks of treatment, the pain grade was collected, and the clinical symptoms and signs of the patients were improved. According to the criteria for the diagnosis of TCM symptoms, the data were collected after 2 weeks of treatment. Collect and organize the data and carry on the statistical analysis, take p0.05 has the statistical significance, carry on the chi-square test to the collected data separately. Statistical software IBM SPSS Statistics 19 was used for statistical processing. Statistical data were analyzed before and after treatment in the control group and the treatment group. Results: according to the World Health Organization pain standard, the number of cases with different degrees was counted. Before treatment the two groups were tested by chi-square test p0.05 indicating that the treatment group and the control group before the treatment of different pain cases distribution is not statistically significant the two groups of samples are comparable. After treatment, the two groups were tested by data (P0.05). There was significant difference between the treatment group and the control group in the distribution of patients with different pain degree after treatment. According to the "criteria for diagnosis and curative effect of TCM Disease Syndrome" issued by the State Administration of traditional Chinese Medicine, 80 cases were cured 12 cases after treatment. ... There were 36 cases of remarkable effect, 29 cases of improvement and 3 cases of unrecovered. In the control group, 5 cases were cured, 18 cases were markedly effective, 17 cases were improved, and 2 cases were not recovered. The total effective rate was 9: 95; High efficiency: 55. In the treatment group, 7 cases were cured, 18 cases were markedly effective, 12 cases were improved, 1 case was not recovered, and the total effective rate was 97%. High efficiency: 62. Data test, total efficiency test to get p0.05, high effective rate after testing to get P0.05, we can think that the two groups of the total effective rate has no statistical difference, the high effective rate difference has statistical significance. The high effective rate of the treatment group was higher than that of the control group. Conclusion: through the clinical case observation study, we found that Tongdu Huoxue decoction lumbar traction, ironing, traditional Chinese medicine fumigation, intravenous infusion of drugs and simple lumbar traction, ironing. Traditional Chinese medicine fumigation, intravenous infusion of medicine in the treatment of lumbar disc herniation is better clinical efficacy, Tongtong du Huoxue decoction for lumbar keyboard herniation is effective and worthy of clinical application.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R274.9

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