[1]杨辉宝,龙大伟△,李春峰,等.单侧双通道脊柱内镜治疗不同证型腰椎间盘突出症术后疗效差异分析[J].中国中医骨伤科杂志,2025,33(11):24-27+33.[doi:10.20085/j.cnki.issn1005-0205.251105]
　YANG Huibao,LONG Dawei,LI Chunfeng,et al.Analysis of the Differences in Postoperative Efficacy of Unilateral Biportal Endoscopic Discectomy in Different Syndrome Types of Lumbar Disc Herniation[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2025,33(11):24-27+33.[doi:10.20085/j.cnki.issn1005-0205.251105]
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单侧双通道脊柱内镜治疗不同证型腰椎间盘突出症术后疗效差异分析()

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第33卷
期数:
2025年11期
页码:
24-27+33
栏目:
临床研究
出版日期:
2025-11-15

文章信息/Info

Title:
Analysis of the Differences in Postoperative Efficacy of Unilateral Biportal Endoscopic Discectomy in Different Syndrome Types of Lumbar Disc Herniation
文章编号:
1005-0205(2025)11-0024-04
作者:
杨辉宝1; 龙大伟1△; 李春峰1; 王烁1; 邝雪傲1
1安徽中医药大学附属太和中医院(安徽 太和,236600)
Author(s):
YANG Huibao1; LONG Dawei1△; LI Chunfeng1; WANG Shuo1; KUANG Xueao1
1Taihe Traditional Chinese Medicine Hospital Affiliated to Anhui University of Chinese Medicine,Taihe 236600,Anhui China.
关键词:
腰椎间盘突出症;  单侧双通道脊柱内镜;  肝肾亏虚;  血瘀证;  寒湿证;  湿热证
Keywords:
lumbar disc herniation;  unilateral biportal endoscopic discectomy;  deficiency of liver and kidney;  blood stasis syndrome;  cold-dampness syndrome;  damp-heat syndrome
分类号:
R681.5
DOI:
10.20085/j.cnki.issn1005-0205.251105
文献标志码:
A
摘要:
目的:探讨单侧双通道脊柱内镜(UBE)手术对不同证型腰椎间盘突出症(LDH)患者的临床疗效。方法:纳入2020年1月至2025年1月行单侧双通道脊柱内镜手术的腰椎间盘突出症患者400例,根据中医辨证诊断,将其分为血瘀证组(162例)、湿热证组(74例)、寒湿证组(49例)、肝肾阴虚证组(69例)及肝肾阳虚证组(46例)。术后3 d评估视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)评分及中医证候评分,计算主证(腰痛)及次证的缓解率; 术后3个月采用MacNab标准评定疗效,分析单侧双通道脊柱内镜治疗各证型腰椎间盘突出症患者的疗效差异。结果:术后3 d,血瘀证组患者的主证缓解率最高(87.65%),显著高于其他组,差异有统计学意义(P<0.05),寒湿证组、肝肾阴虚证组及肝肾阳虚证组患者缓解率较低,分别为57.14%,57.97%和56.52%。次证缓解率血瘀证组(79.01%)和湿热证组(63.51%)显著高于寒湿证组、肝肾阴虚证组及肝肾阳虚证组(10.20%,11.59%,10.87%),差异有统计学意义(P<0.05); 术后各组患者VAS评分、ODI评分、中医证候评分均较术前改善,其中血瘀证组改善最为显著。术后3个月MacNab标准优良率为92.75%,血瘀证组最高(96.91%),寒湿证组最低(85.71%),组间差异有统计学意义(P<0.05)。结论:单侧双通道脊柱内镜手术治疗各证型腰椎间盘突出症疗效显著,其中血瘀证型疗效最佳,寒湿证和肝肾阴虚证及肝肾阳虚证型患者单侧双通道脊柱内镜手术后容易残留次证,建议术后结合中医辨证论治予以中药干预,以进一步改善整体疗效。
Abstract:
Objective:To explore the clinical efficacy of unilateral biportal endoscopic discectomy(UBE)in patients with lumbar disc herniation(LDH)of different syndrome types.Methods:A total of 400 patients with LDH who underwent UBE from January 2020 to January 2025 were included.According to the diagnosis of traditional Chinese medicine(TCM)syndrome differentiation,they were divided into the blood stasis syndrome group(162 cases),damp-heat syndrome group(74 cases),cold-dampness syndrome group(49 cases),liver-kidney Yin deficiency syndrome group(69 cases),and liver-kidney Yang deficiency syndrome group(46 cases).The visual analogue scale(VAS),Oswestry disability index(ODI),and TCM syndrome scores were evaluated 3 d after surgery,and the remission rates of the main symptoms(low back pain)and secondary symptoms were calculated.The efficacy was evaluated using the MacNab criteria 3 months after surgery,and the differences in the efficacy of UBE in patients with different syndrome types of LDH were analyzed.Results:Three days after surgery,the remission rate of the main symptoms in the blood stasis syndrome group was the highest(87.65%),significantly higher than that in the other groups(P<0.05).The remission rates in the cold-dampness syndrome,liver-kidney Yin deficiency,and liver-kidney Yang deficiency groups were relatively low,at 57.14%,57.97%,and 56.52%,respectively.The remission rates of secondary symptoms in the blood stasis syndrome group(79.01%)and the damp-heat syndrome group(63.51%)were significantly higher than those in the cold-dampness syndrome,liver-kidney Yin deficiency,and liver-kidney Yang deficiency groups(10.20%,11.59%,and 10.87%,respectively),and the differences were statistically significant(P<0.05).The VAS score,ODI score,and TCM syndrome score were all improved compared with those before surgery,with the most significant improvement in the blood stasis syndrome group.Three months after surgery,the total MacNab excellent and good rate was 92.75%,with the highest rate in the blood stasis syndrome group(96.91%)and the lowest rate in the cold-dampness syndrome group(85.71%),and the differences between the groups were significant(P<0.05).Conclusion:UBE surgery has a significant therapeutic effect on LDH of different syndrome types,with the best efficacy in the blood stasis syndrome type.The cold-dampness syndrome and liver-kidney Yin deficiency and liver-kidney Yang deficiency syndrome types are prone to residual secondary symptoms after UBE surgery.It is recommended to combine TCM syndrome differentiation and treatment with TCM intervention after surgery to further improve the overall therapeutic effect.

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(收稿日期:2025-06-09)

备注/Memo

备注/Memo:
基金项目:安徽中医药大学临床科研项目(2023LCTH25)
△通信作者 E-mail:275250091@qq.com
更新日期/Last Update: 2025-11-15