加味补阳还五汤联合手法治疗退行性腰椎滑脱症

目的:观察加味补阳还五汤治疗退行性腰椎滑脱症的疗效,比较其联合手法在改善腰骶角、增强腰椎稳定性方面是否优于传统治疗方法。方法:将142例退行性腰椎滑脱症患者随机分为试验组68例与对照组74例,试验组采取加味补阳还五汤联合手法治疗,对照组给予塞来昔布胶囊200 mg每日1次口服,配合手法治疗,2周为1个疗程。治疗前及1个疗程后按腰椎功能(JOA)进行评分,采用Ferguson法测量腰骶角,比较治疗前后的评分变化及腰骶角变化。结果:试验组总有效率为95.59%,对照组总有效率为90.54%,两组比较有显著性差异(P<0.05)。试验组治疗前腰骶角为(46.45±1.21)°,治疗后为(41.24±1.14)°;对照组治疗前腰骶角为(46.29±1.18)°,治疗后为(43.17±1.01)°,两组比较有显著性差异(P<0.05)。结论:加味补阳还五汤治疗退行性腰椎滑脱症效果较好,其与手法联用在改善腰骶角、增强腰椎稳定性方面优于传统治疗方法,是治疗退行性腰椎滑脱症安全有效、副作用小的较好组合。

Curative Effect of Jiawei Buyang Huanwu Decoction Combined with Manipulation in Treating Degenerative Lumbar Spondylolisthesis

Objective: The aim of this study is to observe the curative effect of Jiawei Buyang Huanwu decoction in treating degenerative spondylolisthesis. And to compare whether it is superior to the traditional treatment method combined with manipulation in improving the lumbosacral angle or enhancing the stability of lumbar spine. Method: One hundred and forty-two cases of degenerative lumbar spondylolisthesis patients were randomly divided into experimental group of 68 cases and 74 cases in the control group, experimental group was treated with Jiawei Buyang Huanwu decoction combined with manipulation, while the control group was given celecoxib capsules 200 mg 1 times a day orally combined with manipulation, 2 weeks for 1 courses. Before treatment and after 1 courses of treatment, the patients' symptoms were scored by JOA and the lumbosacral angle was measured by Ferguson method. The rate of improvement was calculated according to the changes in the score and lumbosacral angle before and after treatment. Result: The total effective rate of experimental group was 95.59%, while the rate of the control group was 90.54%, there was significant difference between the two groups (P<0.05). Lumbosacral angle in the experimental group before treatment was (46.45±1.21)°, after treatment, the lumbosacral angle was (41.24±1.14)°.However, in the control group, lumbosacral angle was (46.29±1.18)° before treatment and (43.17±1.01)° after treatment. There was significant difference between two groups (P<0.05). Conclusion: Jiawei Buyang Huanwu decoction has good curative effect in treating degenerative lumbar spondylolisthesis,and it is superior to the traditional treatment method combined with manipulation in improving the lumbosacral angle and enhancing the stability of lumbar spine.It is a safe and effective treatment with less adverse reactions in treating the degenerative lumbar spondylolisthesis.