[1]唐向盛 谭明生△ 移平 杨峰 郝庆英.补阳还五汤结合手术治疗腰椎管狭窄症的临床观察[J].中国中医骨伤科杂志,2018,26(02):28-32.
　TANG Xiangsheng TAN Mingsheng YI Ping YANG Feng HAO Qingying.Effect of Operation Combined with Buyanghuanwu Decoction for Treating Lumbar Spinal Canal Stenosis[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2018,26(02):28-32.
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补阳还五汤结合手术治疗腰椎管狭窄症的临床观察()
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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:
28-32
栏目:
病证结合,从督论治
出版日期:
2018-01-15

文章信息/Info

Title:
Effect of Operation Combined with Buyanghuanwu Decoction for Treating Lumbar Spinal Canal Stenosis
文章编号:
1005-0205(2018)02-0028-05
作者:
唐向盛1 谭明生1△ 移平1 杨峰1 郝庆英1
1中日友好医院脊柱外科(北京,100029)
Author(s):
TANG Xiangsheng1 TAN Mingsheng1△ YI Ping1 YANG Feng1 HAO Qingying1
1Department of Spine Surgery,China-Japan Friendship Hospital,Beijing 100029,China.
关键词:
腰椎管狭窄症;  补阳还五汤;  督脉;  疗效
Keywords:
Keywords: lumbar spinal stenosis;  buyanghuanwu decoction;  Du meridian;  clinical efficacy
分类号:
R681.5
文献标志码:
A
摘要:
目的:比较手术联合补阳还五汤与单纯手术治疗腰椎管狭窄症的临床效果。方法:2015年1月至2015年12月,以随机数字表法将70例腰椎管狭窄症患者分为两组,每组35例,两组患者均行后路减压植骨内固定术治疗,治疗组术后加用补阳还五汤,观察术前、术后3个月及12个月的日本骨科协会(JOA)评分、疼痛视觉模拟评分(VAS)、Oswesty功能障碍指数(ODI)及中医证候评分,比较治疗后及随访期间两组患者的疗效差异。结果:所有手术均顺利完成,患者随访时间12～26个月(平均14个月)。治疗前两组患者的中医证候评分、ODI评分、JOA评分及VAS评分比较,差异无统计学意义(P>0.05); 治疗后3个月及12个月,两组患者的VAS,ODI及中医证候评分均较术前降低,JOA评分均较术前提高,差异有统计学意义(P<0.05)。治疗组VAS,ODI及中医证候评分显著低于对照组,差异有统计学意义(P<0.05); JOA评分高于对照组,差异有统计学意义(P<0.05)。固定节段均融合,融合器未见松动或下沉,椎弓根钉未见松动及断裂。结论:补阳还五汤结合手术治疗腰椎管狭窄症的临床疗效优于单纯手术。
Abstract:
Abstract Objective:To compare the therapeutic effect between operation combined with Buyanghuanwu decoction(BYHWD)and operation only for treating lumbar spinal canal stenosis.Methods:From January 2015 to December 2015,all 70 patients of our hospital were divided into two groups according to the random table method.Operation was performed for all the patients of the two groups.Surgical procedures include posterior decompression and fusion with using pedicular screw system and bone grafts,while the treatment group were added with BYHWD.Japanese orthopedic association(JOA)scores,Oswestry disability index(ODI),visual analogue scale(VAS)and traditional Chinese medicine(TCM)syndrome score of the patients in two groups were compared in preoperative and postoperative,3 months and 12 months follow-up respectively.The difference of curative effect between the two groups was compared after treatment and during follow-up.Results:All the operations were completed successfully.The mean follow-up time was 14 months(range 12 to 26 months).There was no statistically significant difference for the preoperative JOA,ODI,VAS scores and TCM syndrome score of the two groups(P>0.05).Postoperative JOA scores in two groups were significantly higher than that before operation,while ODI,VAS scores and TCM syndrome score were significantly lower than that(P<0.05).At the time of 3 months and 12 months follow-up,the JOA scores in the treatment group was significant higher than control group,while ODI,VAS scores,and TCM syndrome score were significant lower than that(P<0.05).The postoperative X-ray suggested no signs of loosening or sinking of the cage and the fixed levels were fused well.In addition,there were also no signs of breaking or loosing of screws.Conclusion:Compared to only operation group,the operation combined with BYHWD for treating lumbar spinal canal stenosis has better clinical effect.

参考文献/References:

[1] Tomkinslane C,Melloh M,Lurie J,et al.Consensus on the clinical diagnosis of lumbar spinal stenosis:results of an international delphi study[J].Spine(Phila Pa 1976),2016,41(15):1239-1246.
[2] 林一峰,牛维.脊柱退行性疾病从督脉论治探讨[J].安微中医学院学报,2002,21(5):4-6.
[3] 唐汉武,林一峰,原超,等.温通督脉法治疗退行性腰椎管狭窄症的临床研究[J].时珍国医国药,2016,27(5):1148-1150.
[4] 张贺民.督脉论治治疗老年退行性腰椎管狭窄症256例[J].中国中医骨伤科杂志,2013,21(6):14-15.
[5] 移平,谭明生,吕国华,等.督脉瘀阻型寰枢椎脱位手术联合中药治疗的临床研究[J].中国中医骨伤科杂志,2017,25(1):14-18.
[6] 国家中医药管理局.ZY/T001.1-94中医病症诊断疗效标准[S].南京:南京大学出版社,1994.
[7] 王和鸣,葛继荣,沈冯君,等.丹鹿通督片治疗腰椎管狭窄症临床试验总结[J].中国中医骨伤科杂志,2010,18(7):13-16.
[8] Huskisson EC.Measurement of pain [J].Lancet,1974,2(7889):1127-1131.
[9] Roland M,Fairbank J.The roland-mirrors disability questionnaire and the oswestry questionnaire [J].Spine(Phila Pa 1976),2000,25(24):3115-3124.
[10] 倪菁琳,口锁堂,陆伟峰.温通针法治疗腰椎管狭窄症临床疗效观察[J].中华中医药学刊,2012,30(3):612-614.
[11] 柴俊飞,袁幸芳.通督调脊手法结合中药、牵引治疗老年退行性腰椎管狭窄症61例[J].福建中医药,2012,43(2):24-25.
[12] 李晋文,李建仲.通督正脊术治疗腰椎管狭窄症的临床研究[J].世界中西医结合杂志,2014,9(9):954-955.
[13] 刘太红.壮骨通督汤治疗腰椎管狭窄症的体会[J].中国医药指南,2012,10(26):244.
[14] 吴平辉.自拟补肾通督壮腰汤治疗腰椎管狭窄25例临床观察[J].四川中医,2007,25(10):97.
[15] 宋聚才,毛书歌,毛天东.通督汤对治疗腰椎管狭窄症的临床观察[J].中医临床研究,2015,7(25):116-117.
[16] 梁平,周绍稳.通督活血汤治疗退行性腰椎管狭窄症112例[J].中国中医骨伤科杂志,2014,21(8):55-56.
[17] 彭博文,董晓俊.益督通痹汤结合中药离子低频导入治疗肾虚血瘀型退行性腰椎管狭窄症疗效观察[J].现代中西医结合杂志,2015,24(7):699-701.
[18] 张继平,王志彬,林爱华,等.补阳还五汤对脊髓损伤大鼠脊髓组织血小板活化因子含量的影响[J].中国中医药信息杂志,2011,18(11):46-48.
[19] 刘国军.针刺结合补阳还五汤加减对腰椎管狭窄症患者血清中炎性因子水平的影响[J].针灸临床杂志,2016,32(2):18-21.
[20] 石继祥,曹成福,纪斌,等.补阳还五汤对急性脊髓损伤大鼠神经功能康复作用的研究[J].临床和实验医学杂志,2012,11(21):1684.
[21] 薛金伟,姜志刚,韩冬,等.补阳还五汤药浴对大鼠周围神经再生组织形态学的影响[J].中国老年学杂志,2008,28(6):523.
[22] 陈伯健,王爱明,王昭佩,等.补阳还五汤促进腰椎术后下肢麻痹恢复的临床疗效[J].四川中医,2008,26(3):93-94.
[23] 李佑飞,危致芊,吴芳,等.补阳还五汤加味配合中药离子定向导入治疗腰椎术后疼痛30例[J].湖南中医杂志,2016,32(12):76-78. (收稿日期:2017-10-01)

备注/Memo

备注/Memo:
基金项目:首都临床特色应用研究与成果推广项目 (Z161100000516009) △通信作者 E-mail:zrtanms@sina.com
更新日期/Last Update: 2018-02-15