本文選題：搜風(fēng)通絡(luò)湯 + 脊髓型頸椎病��； 參考：《南京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:觀察周福貽教授搜風(fēng)通絡(luò)湯聯(lián)合術(shù)后常規(guī)康復(fù)治療對(duì)脊髓型頸椎病(CSM)術(shù)后脊髓功能恢復(fù)的臨床療效,探討其臨床價(jià)值,為CSM術(shù)后的康復(fù)治療提供依據(jù)。方法:本研究所搜集的50名CSM患者均為2015年9月至2016年11月之間在江蘇省中醫(yī)院住院行頸前路手術(shù)者,將50名患者按照就診時(shí)間順序,隨機(jī)分為試驗(yàn)組24例,采用術(shù)后常規(guī)康復(fù)治療加搜風(fēng)通絡(luò)湯治療,對(duì)照組26例,采用術(shù)后單純常規(guī)康復(fù)治療。試驗(yàn)組患者術(shù)后解除禁食后即開始服用中藥煎劑,每日一劑,分為早晚兩次口服,服用七天為一療程,連續(xù)服用4療程后停藥。兩組病患在術(shù)前和術(shù)后1周、2周、4周、3月分別進(jìn)行隨訪,統(tǒng)計(jì)每名患者的JOA評(píng)分及VAS評(píng)分情況,并在術(shù)后3月隨訪中,根據(jù)《中醫(yī)病證診斷療效標(biāo)準(zhǔn)》評(píng)價(jià)兩組患者的臨床療效及脊髓功能恢復(fù)情況。所得數(shù)據(jù),使用軟件SPSS 22.0進(jìn)行統(tǒng)計(jì)學(xué)處理。結(jié)果:(1)一般資料比較:兩組病患在年齡分布、性別情況、病程長(zhǎng)短及術(shù)前的JOA評(píng)分、VAS評(píng)分等方面進(jìn)行比較,P值均0.05,兩組患者基線資料對(duì)比無明顯統(tǒng)計(jì)學(xué)差異,具有可比性。(2)從JOA評(píng)分上看,組內(nèi)比較:與術(shù)前相對(duì)比,術(shù)后各隨訪統(tǒng)計(jì)點(diǎn)JOA評(píng)分均得到持續(xù)提升,P0.05,比較具有明顯統(tǒng)計(jì)學(xué)差別,說明兩組脊髓功能均獲得一定程度的提高,且均未出現(xiàn)明顯反彈。組間比較:術(shù)后一周時(shí),兩組比較,P0.05,比較無明顯統(tǒng)計(jì)學(xué)差別;術(shù)后兩周、四周及三個(gè)月時(shí),兩組比較P值均0.05,比較具有統(tǒng)計(jì)學(xué)差別,試驗(yàn)組脊髓功能改善情況優(yōu)于對(duì)照組。(3)從VAS評(píng)分上看,組內(nèi)比較:與術(shù)前比較,術(shù)后各隨訪點(diǎn)VAS評(píng)分均得到持續(xù)改善,P0.05,比較具有統(tǒng)計(jì)學(xué)差別,說明兩組疼痛均得到一定程度的緩解,均未出現(xiàn)明顯反彈。組間比較:術(shù)后一周時(shí),兩組比較,P0.05,比較無明顯統(tǒng)計(jì)學(xué)差異;術(shù)后兩周、四周及三個(gè)月時(shí),兩組比較,P值均0.05,比較具有統(tǒng)計(jì)學(xué)差別,試驗(yàn)組患者疼痛改善狀況優(yōu)于對(duì)照組。(4)最后一次隨訪中,按《中醫(yī)病證診斷療效標(biāo)準(zhǔn)》比較兩組的療效,試驗(yàn)組總有效率為91.67%,對(duì)照組為76.92%,兩組對(duì)比P0.05,比較具有統(tǒng)計(jì)學(xué)差別,試驗(yàn)組療效改善優(yōu)于對(duì)照組。結(jié)論:搜風(fēng)通絡(luò)湯聯(lián)合術(shù)后常規(guī)康復(fù)治療以及單純術(shù)后常規(guī)康復(fù)治療均可以促進(jìn)CSM術(shù)后脊髓功能狀態(tài)的恢復(fù),減輕患者癥狀,提高臨床療效,且均無明顯不良反應(yīng)。但搜風(fēng)通絡(luò)湯聯(lián)合術(shù)后常規(guī)康復(fù)治療對(duì)改善CSM患者術(shù)后脊髓功能狀態(tài)療效更為顯著,是脊髓型頸椎病術(shù)后治療的有效治療方法,值得臨床推廣。
[Abstract]:Objective: to observe the clinical effect of Professor Zhou Fuyi combined with conventional rehabilitation therapy on the recovery of spinal cord function after operation of cervical Spondylotic myelopathy (CSM), to explore its clinical value and to provide the basis for rehabilitation treatment after CSM. Methods: 50 CSM patients who were hospitalized in Jiangsu Provincial Hospital of traditional Chinese Medicine from September 2015 to November 2016 were randomly divided into two groups. 26 patients in the control group were treated with conventional rehabilitation therapy plus Soufeng Tongluo decoction, and 26 patients with the control group were treated with simple routine rehabilitation after operation. The patients in the test group began to take traditional Chinese medicine decoction once a day after relieving fasting after operation, divided into morning and evening oral twice, taking seven days as a course of treatment, continuously taking 4 courses of treatment and then stopped taking the medicine. The patients in the two groups were followed up before and after 1 week, 2 weeks, 4 weeks and 3 months, respectively. The JOA and VAS scores of each patient were calculated. To evaluate the clinical efficacy and spinal functional recovery of the two groups according to the criteria of diagnosis and treatment of TCM disease syndrome. The data were processed by software SPSS 22. 0. Results comparison of general data: there was no significant difference in baseline data between the two groups in terms of age distribution, sex, duration of disease, preoperative JOA score and VAS score. From the point of view of JOA score, comparison: compared with pre-operation, the JOA scores of all follow-up points were improved continuously (P0.05). The comparison showed that the spinal cord function of the two groups were improved to some extent. And did not appear obvious rebound. Comparison between the two groups: at one week after operation, there was no significant difference between the two groups (P 0.05), but at two weeks, four weeks and three months after operation, the P value of the two groups was 0.05, the difference was statistically significant. The improvement of spinal cord function in the trial group was better than that in the control group (P < 0.05). From the point of view of VAS score, comparison within the group: compared with pre-operation, the VAS score of all follow-up points after operation was improved continuously (P 0.05), the difference was statistically significant. It showed that the pain in both groups was relieved to a certain extent, and no obvious rebound appeared. Comparison between the two groups: at one week after operation, there was no significant difference between the two groups (P 0.05), but at two weeks, four weeks and three months after the operation, the P values of the two groups were all 0.05, with statistical difference. In the last follow-up, the total effective rate of the trial group was 91.67 and the control group 76.92. The difference was statistically significant (P0.05, P 0.05). The treatment group was better than the control group. Conclusion: Soufeng Tongluo decoction combined with conventional rehabilitation therapy and simple postoperative routine rehabilitation therapy can promote the recovery of spinal cord function after CSM, alleviate the symptoms of patients, improve the clinical efficacy, and have no obvious adverse reactions. But Soufeng Tongluo decoction combined with routine rehabilitation therapy is more effective in improving spinal cord function after CSM. It is an effective treatment method for cervical Spondylotic myelopathy and is worth popularizing.
【學(xué)位授予單位】：南京中醫(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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