中医优化诊疗方案治疗腰椎间盘突出症临床疗效验证

目的:按照国家中医药管理局对"十一五"专科专病建设主攻病种诊疗方案梳理的要求,形成并验证腰椎间盘突出症中医优化诊疗方案的临床疗效。方法:我院牵头分组单位在对腰椎间盘突出症诊疗方案梳理的基础上形成了全组共同认可的中医优化诊疗方案,并对方案进行验证。入组患者均严格按照中医优化诊疗方案进行治疗,按辨证分型后予以中药口服,结合"理筋正骨手法"手法、针灸、针刀松解和中药熏洗治疗,治疗时间20d左右。按照JOA标准进行疗效评估,对治疗前后主要症状体征、日常活动功能的改善进行评价,对治疗前后症状积分进行统计学处理;评价治疗方案的安全性与有效性。结果:经治疗,总有效率达98.52%;主要症状缓解,下腰痛、肢体疼痛/麻木、步态等指标评分优于治疗前(P<0.05);主要体征中直腿抬高试验、感觉障碍、运动障碍评分优于治疗前(P<0.05);日常活动评分结果中平卧翻身、站立、前屈、洗漱、行走、坐位等均优于治疗前(P<0.05),举重物较治疗前比较差异无统计学意义(P>0.05)。结论:该方案疗效确切,发挥了中医药"简、便、验、廉"的优势,适合在基层医院广泛推广。

Clinical Effect of Optimal Therapeutic Program of Traditional Chinese Medicine for Treating Lumbar Disc Herniation

Objective：To form and validate the clinical effect of optimal therapeutic program of traditional Chinese medicine （TCM） for treating lumbar disc herniation, according to the demand of ＂the Eleventh Five--year Plan＂ about special departments and diseases establishment by the state administration of TCM. Methods： We arranged and formed the optimal therapeutic program of TCM for treating LDH and then validated the clinical effect of this program. All the patients were strictly treated through the optimal therapeutic program of TCM for 20 days, and the curative effect and safety of the program were evaluated by JOA standard. Results： The total effective rate was 98. 52%. The main symptoms, such as low back pain, limbs pain/numbness, and the index of gait was superior after treating （P〈0.05）. The main signs, such as straight- leg raising test, scores of sensory disturbance and dyskinesia, and daily activities were better after treating too （P 〈0.05）. There was no difference in weight lifting after treating （P〉0.05）. Conclusion： This TCM program is simple, convenient, effective, and inexpensive. So it is suitable for wide application and promotion in basic-level hospital.