【摘要】：目的:分析搜風(fēng)通絡(luò)湯對(duì)腰椎間盤(pán)突出癥經(jīng)皮椎間孔鏡技術(shù)(PTED)術(shù)后神經(jīng)根癥狀恢復(fù)情況的影響,并與肌松藥鹽酸乙哌立松功效作比較。方法:選擇腰椎間盤(pán)突出癥PTED術(shù)后患者60例,隨機(jī)分成基礎(chǔ)組、實(shí)驗(yàn)組、對(duì)照組各20例,基礎(chǔ)組予地塞米松5mg靜滴qd抗炎止痛+20%甘露醇250m1靜滴脫水治療,實(shí)驗(yàn)組基礎(chǔ)治療+搜風(fēng)通絡(luò)湯口服,對(duì)照組基礎(chǔ)治療+鹽酸乙哌立松50mg 口服tid,分別在術(shù)后3天、術(shù)后1周、術(shù)后4周三個(gè)時(shí)間點(diǎn)用腰椎JOA評(píng)分和視覺(jué)疼痛評(píng)分VAS評(píng)價(jià)三組治療效果。結(jié)果:術(shù)后4周時(shí)三組JOA評(píng)分顯效率分別為:基礎(chǔ)組40%,治療組85%,對(duì)照組75%;術(shù)后3天,三組JOA評(píng)分分別為:基礎(chǔ)組17.40±1.88,治療組18.70±2.25,對(duì)照組18.05±2.19,VAS評(píng)分分別為:基礎(chǔ)組4.0(2.0),治療組4.0(1.0),對(duì)照組3.5(1.0),三組之間JOA及VAS評(píng)分較術(shù)前明顯改善,但此時(shí)組間沒(méi)有明顯差別(P0.05);術(shù)后1周,三組JOA評(píng)分分別為:基礎(chǔ)組19.55±1.10,治療組21.45±1.97,對(duì)照組20.85±2.52,VAS評(píng)分分別為:基礎(chǔ)組3.0(1.0),治療組2.0(1.0),對(duì)照組2.0(1.0),三組JOA評(píng)分和VAS評(píng)分較術(shù)后3天改善明顯,治療組和對(duì)照組療效優(yōu)于基礎(chǔ)組;術(shù)后4周,三組JOA評(píng)分分別為:基礎(chǔ)組19.80± 1.54,治療組25.15±2.03,對(duì)照組23.85±2.25,VAS評(píng)分分別為:基礎(chǔ)組1.0(1.0),治療組0.5(1.0),對(duì)照組1.0(0.0),三組臨床療效較術(shù)后1周有所改善,治療組和對(duì)照組優(yōu)于基礎(chǔ)組,且治療組優(yōu)于對(duì)照組。結(jié)論:搜風(fēng)通絡(luò)湯對(duì)腰椎間盤(pán)突出癥PTED術(shù)后遺留神經(jīng)根癥狀有持續(xù)改善效果,并且臨床療效優(yōu)于鹽酸乙哌立松。
[Abstract]:Objective: to analyze the effect of Soufeng Tongluo decoction on the recovery of nerve root symptoms after percutaneous intervertebral foramen technique (PTED) in lumbar disc herniation and compare with the effect of muscle relaxant Epiperidone hydrochloride. Methods: sixty patients with lumbar disc herniation after PTED were randomly divided into basic group (n = 20), experimental group (n = 20) and control group (n = 20). The basic group was treated with dexamethasone 5mg intravenous drip of qd for anti-inflammatory and analgesic 20% mannitol 250m1 dehydration. The experimental group was treated by oral administration of Soufeng Tongluo decoction, while the control group was treated with 50mg on 3 days and 1 week after operation, respectively. The three groups were evaluated with lumbar JOA score and visual pain score (VAS) at 4 weeks after operation. Results: at 4 weeks after operation, the effective rates of JOA scores in the three groups were as follows: 40 in the basic group, 85 in the treatment group and 75 in the control group; 3 days after operation, the JOA scores of the three groups were 17.40 鹵1.88 in the basic group, 18.70 鹵2.25 in the treatment group, and 18.05 鹵2.19 in the control group, respectively: 4.0 (2.0) in the basic group and 4.0 (1.0) in the treatment group. In the control group (3.5 (1.0), the scores of JOA and VAS in the three groups were significantly improved compared with those before operation, but there was no significant difference between the three groups at this time (P0.05). 1 week after operation, the JOA scores of the three groups were 19.55 鹵1.10 in the basic group, 21.45 鹵1.97 in the treatment group and 20.85 鹵2.52 in the control group, respectively. In the control group (2.0), the JOA score and VAS score of the three groups were significantly improved compared with the 3 days after operation. The curative effect of the treatment group and the control group was better than that of the basic group. 4 weeks after operation, the JOA scores of the three groups were 19.80 鹵1.54 in the basic group, 25.15 鹵2.03 in the treatment group and 23.85 鹵2.25 in the control group, respectively. In control group 1.0 (0.0), the clinical efficacy of the three groups was improved 1 week after operation, the treatment group and the control group were superior to the basic group, and the treatment group was better than the control group. Conclusion: Soufeng Tongluo decoction can improve the nerve root symptom of lumbar intervertebral disc herniation after PTED, and the clinical effect is better than Epipraxone hydrochloride.
【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(lèi)號(hào)】：R274.9

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