【摘要】：目的：觀察補(bǔ)陽還五湯對(duì)脊髓型頸椎病(Cervical Spondylotic Myelopathy, CSM)術(shù)后脊髓功能康復(fù)的臨床療效,探討其臨床應(yīng)用價(jià)值。方法：選取2014年11月至2015年12月在南京軍區(qū)福州總醫(yī)院骨一科行頸前路減壓植骨融合內(nèi)固定術(shù)的CSM患者60例,按就診時(shí)間順序,隨機(jī)分成試驗(yàn)組和對(duì)照組,各30例。試驗(yàn)組采用補(bǔ)陽還五湯聯(lián)合CSM術(shù)后常規(guī)康復(fù)療法；對(duì)照組采用CSM術(shù)后常規(guī)康復(fù)療法。共4療程,每個(gè)療程7d,療程間隔為2d。采用脊髓JOA評(píng)分和改良的Barthel指數(shù)評(píng)分在術(shù)前、術(shù)后7d和術(shù)后36d分別對(duì)兩組患者進(jìn)行脊髓功能評(píng)定,并采用《中醫(yī)病癥診斷療效標(biāo)準(zhǔn)》評(píng)價(jià)兩組患者術(shù)后7d及術(shù)后36d脊髓功能康復(fù)情況。所得數(shù)據(jù),使用軟件SPSS18.0進(jìn)行統(tǒng)計(jì)學(xué)處理。結(jié)果：1.一般資料分析：兩組CSM患者在性別、年齡、脊髓病變節(jié)段及病程上比較,均無統(tǒng)計(jì)學(xué)差異(P0.05)。2.脊髓JOA評(píng)分：術(shù)前試驗(yàn)組、對(duì)照組的脊髓JOA評(píng)分分別為(9.03±1.33)、(9.17±1.11)分,術(shù)后7d兩組的脊髓JOA評(píng)分分別為(13.26±1.56)、(12.37±1.58)分,術(shù)后36d兩組的脊髓JOA評(píng)分分別為(15.05±1.58)、(13.74±1.73)分。術(shù)前試驗(yàn)組的脊髓JOA評(píng)分同對(duì)照組比較無統(tǒng)計(jì)學(xué)差異(P0.05)。與術(shù)前比較,兩組在術(shù)后7d、術(shù)后36d的脊髓JOA評(píng)分均有不同程度改善,均有顯著性差異(P0.01)。術(shù)后7d,試驗(yàn)組與對(duì)照組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)；術(shù)后36d,試驗(yàn)組與對(duì)照組比較,有顯著性差異(P0.01)。3.日常生活能力：術(shù)前試驗(yàn)組、對(duì)照組改良Barthel指數(shù)評(píng)分分別為(50.87±6.27)、(53.80±5.60)分,術(shù)后7d兩組的改良Barthel指數(shù)評(píng)分分別為(77.70±7.40)、(73.01±8.12)分,術(shù)后36d兩組的改良Barthel指數(shù)評(píng)分分別為(89.03±7.13)、(81.70±8.11)分。術(shù)前試驗(yàn)組的日常生活能力改良Barthel指數(shù)同對(duì)照組比較無統(tǒng)計(jì)學(xué)差異(P0.05)。與術(shù)前比較,兩組在術(shù)后7d、術(shù)后36d的日常生活能力改良Barthel指數(shù)均有不同程度改善,均有顯著性差異(P0.01)。術(shù)后7d,試驗(yàn)組與對(duì)照組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)；術(shù)后36d,試驗(yàn)組與對(duì)照組比較,有顯著性差異(P0.01)。4.中醫(yī)病癥診斷療效標(biāo)準(zhǔn)：試驗(yàn)組、對(duì)照組CSM患者經(jīng)治療后,在《中醫(yī)病癥診斷療效標(biāo)準(zhǔn)》評(píng)價(jià)方面上比較。術(shù)后7d,試驗(yàn)組總有效率83.3%,對(duì)照組總有效率76.7%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)；術(shù)后36d,試驗(yàn)組總有效率93.3%,對(duì)照組總有效率86.70%,有顯著性差異(P0.01)。結(jié)論：補(bǔ)陽還五湯可以促進(jìn)CSM術(shù)后脊髓功能康復(fù),具有良好的臨床療效。
[Abstract]:Objective: to observe the clinical effect of Buyang Huanwu decoction on the rehabilitation of spinal cord function after (Cervical Spondylotic Myelopathy, CSM) for cervical Spondylotic myelopathy. Methods: from November 2014 to December 2015, 60 patients with CSM who were treated with anterior cervical decompression, bone grafting and internal fixation in Department of Bone of Fuzhou General Hospital of Nanjing military region were randomly divided into experimental group and control group, 30 cases in each group. The experimental group was treated with Buyang Huanwu decoction combined with conventional rehabilitation therapy after CSM and the control group with routine rehabilitation therapy after CSM. A total of 4 courses of treatment, each course of 7 days, the interval of 2 days. Spinal cord function was evaluated by spinal cord JOA score and modified Barthel index score before operation, 7 days after operation and 36 days after operation, respectively. The recovery of spinal cord function was evaluated 7 days after operation and 36 days after operation. The data were processed by software SPSS18.0. Results: 1. General data analysis: two groups of CSM patients in sex, age, spinal cord disease segment and course of comparison, there was no statistical difference (P0.05). Spinal cord JOA score: the spinal cord JOA score of the experimental group and the control group was (9.03 鹵1.33), (9.17 鹵1.11) before operation, and the JOA score of spinal cord in the two groups was (13.26 鹵1.56), (12.37 鹵1.58 on the 7th day after operation. The JOA score of spinal cord in the two groups was (15.05 鹵1.58), () 13.74 鹵1.73 on the 36th day after operation. There was no significant difference in JOA score between the experimental group and the control group (P0.05). Compared with pre-operation, the spinal cord JOA scores of the two groups were improved in different degrees on the 7th day and 36th day after operation, and there were significant differences between the two groups (P0.01). On the 7th day after operation, the difference between the experimental group and the control group was statistically significant (P0.05), and at 36 days after operation, there was a significant difference between the experimental group and the control group (P0.01). Activity of daily living (ADL): the scores of modified Barthel index in preoperative group and control group were (50.87 鹵6.27), (鹵5.60) and (77.70 鹵7.40), (, 73.01 鹵8.12), respectively. The scores of modified Barthel index were (89.03 鹵7.13), (, 81.70 鹵8.11), respectively. There was no significant difference in ADL Barthel index between the experimental group and the control group (P0.05). Compared with before operation, the improved Barthel index of ADL in the two groups were improved in different degree on the 7th day and 36th day after operation, and there was significant difference between the two groups (P0.01). At 7 days after operation, the difference between the experimental group and the control group was statistically significant (P0.05), and at 36 days after operation, there was a significant difference between the experimental group and the control group (P0.01). Criteria for the diagnosis of TCM symptoms: the patients in the experimental group and the control group were compared in the evaluation of the criteria for the diagnosis of TCM symptoms after treatment. At 7 days after operation, the total effective rate of the trial group was 83.3%, while that of the control group was 76.70.The difference was statistically significant (P0.05). At 36 days after operation, the total effective rate was 93.3 in the experimental group and 86.70 in the control group, with significant difference (P0.01). Conclusion: Buyang Huanwu decoction can promote the recovery of spinal cord function after CSM and has good clinical effect.
【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】：2016
【分類號(hào)】：R274.9

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