[1]邓强△ 李军杰 张彦军 李中锋 杨镇源 彭冉东 徐浩军.从督脉论治胸腰椎结核并不全瘫的临床观察[J].中国中医骨伤科杂志,2018,26(02):23-27.
　DENG Qiang LI Junjie ZHANG Yanjun LI Zhongfeng YANG Zhenyuan PENG Randong XU Haojun.Clinical Observation on the Treatment of Thoracic and Lumbar Vertebral Tuberculosis with Incomplete Paralysis Based on the Theory of Du Meridian[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2018,26(02):23-27.
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从督脉论治胸腰椎结核并不全瘫的临床观察()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第26卷
期数:
2018年02期
页码:
23-27
栏目:
病证结合,从督论治
出版日期:
2018-01-15

文章信息/Info

Title:
Clinical Observation on the Treatment of Thoracic and Lumbar Vertebral Tuberculosis with Incomplete Paralysis Based on the Theory of Du Meridian
文章编号:
1005-0205(2018)02-0023-05
作者:
邓强1△ 李军杰2 张彦军1 李中锋1 杨镇源1 彭冉东2 徐浩军2
1甘肃省中医院(兰州,730050) 2甘肃中医药大学
Author(s):
DENG Qiang1△ LI Junjie2 ZHANG Yanjun1 LI Zhongfeng1 YANG Zhenyuan1 PENG Randong2 XU Haojun2
1Gansu Hospital of Traditional Chinese Medicine,Lanzhou 730050,China; 2Gansu University of Chinese Medicine,Lanzhou 730000,China.
关键词:
从督论治;  椎管减压;  胸腰椎结核;  杜仲腰痛丸
Keywords:
Keywords: Du meridian treatment;  decompression of vertebral canal;  thoracic and lumbar vertebral tuberculosis;  Duzhongyaotong pill
分类号:
R681.5
文献标志码:
A
摘要:
目的:探讨基于从督论治思想运用陇中杜仲腰痛丸联合椎管减压手术对胸腰椎结核并不全瘫的临床疗效。方法:选取本院2014年1月至2017年1月收住的28例胸腰椎结核患者随机分为两组。28例患者根据病灶不同的累及位置,采用经胸或胸腹前路、后路或后路联合前外侧入路(治疗组14例、对照组14例),均行一期病灶清除取自体骨植骨内固定术,对照组在术后采用单纯抗结核治疗,治疗组在此基础上给予补肾强督的陇中杜仲腰痛丸干预治疗。治疗后观察患者治疗前后VAS评分、Oswestry残疾指数与神经功能Frankel分级的变化,并行X线检查,观察植骨融合情况。结果:治疗前后,两组患者的VAS评分、Oswestry残疾指数与神经功能Frankel分级变化情况比较,差异均有统计学意义(P<0.01); 治疗后治疗组各项指标显著优于对照组,差异有统计学意义(P<0.05),28例患者病灶清除、植骨、内固定术治疗均成功,切口一期愈合。所有患者均获得(32.1±5.5)个月随访,植骨融合时间为3～9个月,平均4.5个月,末次随访时植骨全部融合,椎间隙全部融合,内固定位置良好,无松动发生,后凸畸形明显改善。结论:基于从督脉论治思想运用补肾强督杜仲腰痛丸并联合手术对椎管减压,对胸腰椎结核并不全瘫患者能有效缓解术后疼痛,并且以强督补肾,改善患者功能障碍,行早期的椎管减压利于术后脊髓神经功能的康复,疗效可靠、满意。
Abstract:
Abstract Objective:Based on the theory of Du meridian treatment,to explore the clinical efficacy of Duzhongyaotong pill of Longzhong combined with decompression of vertebral canal for treating thoracic and lumbar vertebral tuberculosis with incomplete paralysis.Methods:28 patients with thoracic and lumbar vertebral tuberculosis admitted from January 2014 to January 2017 in our hospital were randomly divided into two groups:treatment group(14 cases)and control group(14 cases).28 patients were treated with phase I debridement and internal fixation by autogenously bone grafting via anterior,posterior transthoracic or thoracoabdominal approaches or posterior transthoracic or thoracoabdominal combined with anterolateral approach.The control group was treated with simple anti-tuberculosis treatment after operation,and the treatment group was given the intervention treatment of Duzhongyaotong pill of Longzhong to reinforce kidney and strengthen spine additionally.The changes of VAS score,Oswestry disability index,and Frankel grade of neurological function were observed before and after treatment.The X-ray examination was performed to observe the fusion of bone grafting.Results:Before and after treatment,the difference of VAS score,Oswestry disability index,and Frankel grading between two groups were significantly different(P<0.01).After treatment,the indexes in the treatment group were significantly better than those in the control group(P<0.05).All 28 patients underwent successful lesion removal,bone grafting,internal fixation,incision primarily healing.All the patients were followed up for(32.1 ± 5.5)months.The fusion time ranged from 3 to 9 months(average 4.5 months).All the patients got the fusion at the last follow-up,all the intervertebral space fused.The internal fixation was good,no loosening occurred,and the kyphosis deformity was obviously improved.Conclusion:Based on the theory of Du meridian treatment,using Duzhongyaotong pill combined with decompression of vertebral canal can effectively alleviate postoperative pain in patients with incomplete paralysis of thoracic and lumbar tuberculosis,reinforce kidney and strengthen spine,and improve the dysfunction.The early decompression of spinal canal is conducive to the recovery of spinal nerve function after operation,with reliable and satisfactory results.

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备注/Memo

备注/Memo:
基金项目:兰州市科技计划项目(2016-3-114) △通信作者 E-mail:1007692436@qq.com
更新日期/Last Update: 2018-02-15