本文選題：退變性腰椎管狹窄癥 + 身痛逐瘀湯　； 參考：《湖北中醫(yī)藥大學》2016年碩士論文

【摘要】：【目的】通過臨床使用身痛逐瘀湯,觀察其在腰椎管狹窄癥術后治療中對腰腿痛發(fā)生的防治作用。【方法】回顧性分析武漢市一醫(yī)院骨科2013年5月-2014年10月62例因腰椎管狹窄癥行全椎板減壓融合內固定手術患者,其中男34例,女28例,年齡50-80歲,平均63.03±7.89歲,門診隨訪6個月以上,平均7.36個月,隨機分為兩組,治療組與對照組,兩組均予以手術治療,治療組術后給予中藥身痛逐瘀湯治療,對照組給予常規(guī)抗炎鎮(zhèn)痛藥物塞來昔布和營養(yǎng)神經藥物甲鈷胺片口服治療,通過比較患者術前、術后一周、術后一月及末次隨訪的VAS、JOA及Oswestry功能障礙指數評分,評估患者的神經功能恢復、身體康復情況以及身痛逐瘀湯對腰椎術后患者身體恢復的影響。以JOA優(yōu)良率標準評價臨床治療效果�！窘Y果】本組62例患者均獲得隨訪,所有患者術后腰痛、下肢麻木、間歇性跛行等癥狀消失或顯著改善,恢復正常生活,兩組術后第2周及第4周VAS評分比值P0.05,具有統(tǒng)計學意義,說明身痛逐瘀湯在早期緩解術后疼痛的治療上效果顯著。兩組在術后第四周JOA評分上比較,P0.05,說明身痛逐瘀湯對患者神經功能康復、身體康復也具有顯著療效,治療組JOA評分優(yōu)良率:優(yōu)14例,良15例,中1例,差0例,優(yōu)良率86.23%;對照組JOA評分優(yōu)良率:優(yōu)13例,良17例,中2例,差0例,優(yōu)良率79.87%;通過治療患者癥狀得到明顯改善,治療組患者術后臨床療效優(yōu)良率明顯高于對照組,效果顯著�！窘Y論】身痛逐瘀湯辯證加減用于退變性腰椎管狹窄術后的治療,不僅可以預防和緩解術后腰腿部疼痛的發(fā)生,也對患者術后早期功能康復起到一定的促進作用,其活血化瘀、抗炎鎮(zhèn)痛的功效值得肯定,可于臨床推廣應用。
[Abstract]:[objective] to use Shentong Zhuyu decoction in clinic, To observe the preventive and therapeutic effect of Lumbar Spinal Stenosis on Lumbar and leg pain. [methods] A retrospective analysis was made on 62 cases of lumbar spinal stenosis treated with total laminar decompression fusion and internal fixation from May 2013 to October 2014 in Department of Orthopaedics, a hospital in Wuhan. Among them, 34 males and 28 females, aged 50-80 years (mean 63.03 鹵7.89 years), were followed up for more than 6 months (mean 7.36 months). They were randomly divided into two groups: treatment group and control group. The treatment group was treated with Shentong Zhuyu decoction, the control group was treated with the routine anti-inflammatory and analgesic drug celecoxib and the nutritional nerve drug Mecobalamin. The scores of VAS-JOA and Oswestry dysfunction index were evaluated to evaluate the recovery of nerve function, physical recovery and the effect of Zhentong Zhuyu decoction on the recovery of patients after lumbar vertebra operation. [results] all the 62 patients were followed up. All the patients' symptoms such as low back pain, numbness of lower extremity and intermittent claudication disappeared or improved significantly after operation. The ratio of VAS score at the 2nd and 4th week after operation in the two groups (P0.05) was statistically significant, which indicated that Shentong Zhuyu decoction had a significant effect on early relief of postoperative pain. The comparison of JOA scores between the two groups in the fourth week after operation showed that Shentong Zhuyu decoction had a significant effect on the rehabilitation of nerve function and physical recovery. The excellent and good rate of JOA score in the treatment group was excellent in 14 cases, good in 15 cases, fair in 1 case, and poor in 0 cases. The excellent and good rate was 86.23. The excellent and good rate of JOA score in the control group was excellent in 13 cases, good in 17 cases, fair in 2 cases, poor in 0 cases, excellent and good rate in 79.87.The clinical effect of the treatment group was significantly improved, and the excellent and good rate of the treatment group was significantly higher than that of the control group. [conclusion] Shentong Zhuyu decoction can be used to treat degenerative lumbar spinal stenosis after operation, which can not only prevent and relieve the pain in the waist and leg, but also promote the early functional rehabilitation of the patients. Its effect of promoting blood circulation and removing blood stasis and anti-inflammation and analgesia is worthy of affirmation and can be popularized and applied in clinic.
【學位授予單位】：湖北中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R274.9

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