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[1]萬宏波,馬海燕,蔣云霞,等.口服益氣化瘀湯聯(lián)合功能鍛煉治療腰椎退行性疾病 術(shù)后殘留腰腿痛的臨床研究[J].中醫(yī)正骨,2015,27(06):1-5.
　WAN Hongbo,MA Haiyan,JIANG Yunxia,et al.Clinical study on oral application of Yiqi Huayu Tang(益氣化瘀湯)combined with functional exercise for the treatment of postoperative residual lumbocrural pain in patients with lumbar degenerative disease[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(06):1-5.
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口服益氣化瘀湯聯(lián)合功能鍛煉治療腰椎退行性疾病 術(shù)后殘留腰腿痛的臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第27卷
期數(shù):
2015年06期
頁碼:
1-5
欄目:
臨床研究
出版日期:
2015-06-30

文章信息/Info

Title:
Clinical study on oral application of Yiqi Huayu Tang(益氣化瘀湯)combined with functional exercise for the treatment of postoperative residual lumbocrural pain in patients with lumbar degenerative disease
作者:
萬宏波1; 馬海燕2; 蔣云霞3; 莫文1; 姚若愚1; 鄔學(xué)群1
1.上海中醫(yī)藥大學(xué)附屬龍華醫(yī)院,上海 200032;
2.上海黃浦區(qū)中西醫(yī)結(jié)合醫(yī)院,上海 200010;
3.上海中醫(yī)藥大學(xué)附屬龍華醫(yī)院(分院),上海 200123
Author(s):
WAN Hongbo1; MA Haiyan2; JIANG Yunxia3; MO Wen1; YAO Ruoyu1; WU Xuequn1
1.Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China 2.Huangpu District combinational hospital of traditional Chinese medicine and Western medicine in Shanghai,Shanghai 200010,China 3.Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Pudong branch,Shanghai 200123,China
關(guān)鍵詞:
椎管狹窄;  椎間盤移位;  腰椎;  腰腿痛;  益氣化瘀湯;  功能鍛煉;  治療; 臨床研究性
Keywords:
spinal stenosis;  intervertebral disc displacement;  lumbar vertebrae;  lumbago-leg pain;  Yiqi Huayu Tang;  functional exercise;  therapies; investigational
摘要:
目的:觀察口服益氣化瘀湯聯(lián)合功能鍛煉治療腰椎退行性疾病術(shù)后殘留腰腿痛的臨床療效。方法:將132例因腰椎退行性疾 病接受手術(shù)治療后殘留腰腿痛的患者(腰椎間盤突出癥85例,腰椎管狹窄癥47例)隨機(jī)分為2組,聯(lián)合治療組69例、功能鍛煉組63例 。聯(lián)合治療組采用口服益氣化瘀湯結(jié)合五點(diǎn)支撐鍛煉治療,功能鍛煉組僅進(jìn)行五點(diǎn)支撐鍛煉。采用疼痛視覺模擬評分(visual analogue score,VAS)、Oswestry功能障礙指數(shù)(Oswestry dability index,ODI)問卷表、JOA腰痛疾患療效評分標(biāo)準(zhǔn)、簡明健康 狀況調(diào)查表(short form 36 health survey questionnaire,SF-36)評定臨床療效。結(jié)果:治療前后不同時(shí)間疼痛VAS評分的差異 有統(tǒng)計(jì)學(xué)意義,即存在時(shí)間效應(yīng)(F=1759.038,P=0.000)。2組疼痛VAS評分比較總體上有統(tǒng)計(jì)學(xué)意義,即存在分組效應(yīng) (F=11.431,P=0.001)。治療前和治療14 d后2組評分比較,組間差異均無統(tǒng)計(jì)學(xué)意義(t=0.590,P=0.557; t=-1.676,P=0.096); 治 療7 d、21 d后聯(lián)合治療組的評分均低于功能鍛煉組(t=-3.913,P=0.000; t=-8.822,P=0.000)。時(shí)間因素與分組因素存在交互效 應(yīng)(F=26.623,P=0.000)。治療前后不同時(shí)間ODI評分的差異有統(tǒng)計(jì)學(xué)意義,即存在時(shí)間效應(yīng)(F=634.277,P=0.000)。2組ODI評分比 較總體上有統(tǒng)計(jì)學(xué)意義,即存在分組效應(yīng)(F=4.067,P=0.046); 除治療前外,治療7 d、14 d、21 d后聯(lián)合治療組的評分均低于功 能鍛煉組(t=0.455,P=0.650; t=-2.044,P=0.043; t=-2.224,P=0.028; t=-5.658,P=0.000)。時(shí)間因素與分組因素存在交互效應(yīng) (F=9.217,P=0.000)。治療前后不同時(shí)間JOA評分的差異有統(tǒng)計(jì)學(xué)意義,即存在時(shí)間效應(yīng)(F=1054.688,P=0.000)。2組JOA評分比較 總體上有統(tǒng)計(jì)學(xué)意義,即存在分組效應(yīng)(F=173.613,P=0.000); 除治療前外,治療7 d、14 d、21 d后聯(lián)合治療組的評分均高于功 能鍛煉組(t=-0.149,P=0.882; t=5.944,P=0.000; t=12.636,P=0.000; t=9.774,P=0.000)。時(shí)間因素與分組因素存在交互效應(yīng) (F=30.428,P=0.000)。治療前2組患者的SF-36評分比較,組間差異無統(tǒng)計(jì)學(xué)意義[(58.277±10.552)分, (58.857±8.640)分,t=-0.344,P=0.732]; 治療21 d后2組患者的SF-36評分均增加(t=-10.030,P=0.000; t=- 10.492,P=0.000); 治療21 d后2組患者的SF-36評分比較,差異無統(tǒng)計(jì)學(xué)意義[(64.582±11.162)分,(62.452±8.935)分 ,t=-1.203,P=0.310]。結(jié)論:口服益氣化瘀湯聯(lián)合功能鍛煉對于腰椎術(shù)后患者神經(jīng)功能的恢復(fù)及疼痛的改善有明顯促進(jìn)作用,對 患者整體健康狀況的改善效果明顯,可提高患者的生活質(zhì)量。
Abstract:
Objective:To observe the clinical curative effects of oral application of Yiqi Huayu Tang(益氣化瘀湯) combined with functional exercise in the treatment of postoperative residual lumbocrural pain in patients with lumbar degenerative disease.Methods:One hundred and thirty-two patients with residual lumbocrural pain after surgery for lumbar degenerative disease were randomly divided into combination treatment group(69 cases)and functional exercise group(63 cases).A total of 85 patients were diagnosed as lumbar disc herniation and 47 patients were diagnosed as lumbar spinal stenosis.The patients in combination treatment group were treated with oral application of Yiqi Huayu Tang combined with five-point weight-support exercise,while the others in the functional exercise group were merely treated with five-point weight-support exercise.The curative effect were evaluated by using visual analogue score(VAS),Oswestry dability index(ODI)questionnaire,JOA scores for low back pain and short form 36 health survey questionnaire(SF-36).Results:There was statistical difference in VAS scores between different time points,in other words,there was time effect(F=1759.038,P=0.000).In general,there was statistical difference in VAS scores between the 2 groups,in other words,there was grouping effect(F=11.431,P=0.001).There was no statistical difference in VAS scores between the 2 groups before the treatment and at the 14th day after the beginning of the treatment(t=0.590,P=0.557; t=-1.676,P=0.096).The VAS scores were lower in combination treatment group compared to functional exercise group at the 7th and 21th day after the beginning of the treatment(t=-3.913,P=0.000; t=-8.822,P=0.000).There was interaction between time factor and grouping factor (F=26.623,P=0.000).There was statistical difference in ODI scores between different time points,in other words,there was time effect(F=634.277,P=0.000).In general,there was statistical difference in ODI scores between the 2 groups,in other words,there was grouping effect(F=4.067,P=0.046).The ODI scores were lower in combination treatment group compared to functional exercise group at the 7th,14th and 21th day after the beginning of the treatment(t=0.455,P=0.650; t=-2.044,P=0.043; t=-2.224,P=0.028; t=-5.658,P=0.000).There was interaction between time factor and grouping factor(F=9.217,P=0.000).There was statistical difference in JOA scores between different time points,in other words,there was time effect(F=1054.688,P=0.000).In general,there was statistical difference in JOA scores between the 2 groups,in other words,there was grouping effect (F=173.613,P=0.000).The JOA scores were higher in combination treatment group compared to functional exercise group at the 7th,14th and 21th day after the beginning of the treatment(t=-0.149,P=0.882; t=5.944,P=0.000; t=12.636,P=0.000; t=9.774,P=0.000).There was interaction between time factor and grouping factor (F=30.428,P=0.000).There was no statistical difference in SF-36 scores between the 2 groups before the treatment(58.277+/-10.552 vs 58.857+/-8.640 points,t=-0.344,P=0.732).The SF-36 scores increased at 21th day after the beginning of the treatment in both of the groups(t=-10.030,P=0.000; t=-10.492,P=0.000).There was no statistical difference in SF-36 scores between the 2 groups at 21th day after the beginning of the treatment (64.582+/-11.162 vs 62.452+/-8.935 points,t=-1.203,P=0.310).Conclusion:The combination therapy of oral application of Yiqi Huayu Tang and functional exercise can obviously promote the recovery of neural function and relieve postoperative residual lumbocrural pain after lumbar vertebrae surgery,meanwhile,patient's health and quality of life can be greatly improved.

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備注/Memo

備注/Memo:
2014-11-20收稿 2015-01-22修回
基金項(xiàng)目:上海市教委預(yù)算內(nèi)課題項(xiàng)目(736)
通訊作者:莫文 E-mail:[email protected]
更新日期/Last Update: 2015-06-30