除湿通痹汤联合牵引治疗腰椎间盘突出症的近期疗效观察

目的:观察除湿通痹汤联合牵引治疗湿热痹阻证腰椎间盘突出症(LDH)的近期临床疗效及生活质量。方法:将109例符合条件的患者,按就诊前后顺序随机分为对照组54例和观察组55例。对照组采用依托考昔片,1片/次,1次/d,和牵引治疗;观察组采用除湿通痹汤联合牵引治疗。两组疗程均为3周。采用简式麦吉尔Mc Gill疼痛问卷(MPQ)量表评价疼痛,采用Oswestry功能障碍指数(ODI)评价功能情况,测量腰椎关节活动度,进行主要症状、体征评分,进行日常生活活动能力(ADL)评分,以上指标治疗前后各评价1次。结果:观察组临床总有效为94.55%,高于对照组的81.48%(P0.05);治疗后观察组疼痛感觉评分(PRI A),疼痛情绪评分(PRI S),疼痛总分(PRI T),目测类比疼痛评分(VAS)和现在膝关节疼痛(PPI)评分均低于对照组(P0.01);治疗后观察组ODI总分、疼痛、单项和日常活动能力3个方面评分均低于对照组(P0.01);治疗后两组腰椎关节前屈与后伸关节活动度较治疗前增加(P0.01),观察组增加更为显著(P0.01);治疗后观察组ADL评分高于对照组,主要症状体征评分低于对照组(P0.01)。结论:除湿通痹汤联合牵引治疗LDH能减轻患者症状,改善腰椎关节的活动度,提高患者的生活质量。

Short-term Effect Observation of Chushi Tongbi Decoction Combined with Traction Treatment on Limbar Disc Herniation

Objective: To observe the clinical effect of Chushi Tongbi decoction combined with traction treatment in lumbar disc herniation(LDH)(moist heat arthralgia spasm syndrome) and observe the life quality. Method: One hundred and nine eligible patients were randomly divided into control group(54 cases) and observation group(55 cases) by visiting sequence. Patients in control group received etoricoxib tablets, 1tablet/time, 1 time/day, and combined with traction treatment. Patients in observation group received Chushi Tongbi decoction combined with traction treatment. Courses of treatment were 3 weeks in both groups. Pain was evaluated by McGill pain questionnaire(MPQ),function was evaluated by Oswestry disability index(ODI), activities of lumbar joints were measured;scores of activities of daily living(ADL) and main symptoms and sings were graded. The above indexes were evaluated once before and after treatment. Result: The total effective rate in observation group was 94.55%, superior to 81.48% in control group(P<0.05). After treatment, scores of pain feeling(PRI A), pain emotion(PRI S) and total scores of pain(PRI T), visual analogue scale(VAS) and present knee pain condition(PPI) in observation group were all lower than those in control group(P<0.01). After treatment, ODI total scores, scores of pain, single item scores and activities of daily living in observation group were all lower than those in control group(P<0.01). Compared with the conditions before treatment, both groups'' activities of flexion and extension of lumbar joints were increased(P<0.01), which was more significant in observation group(P<0.01). After treatment, score of ADL in observation group was higher than that in control group, and the scores of main symptoms and signs were lower than those in control group(P<0.01). Conclusion: Chushi Tongbi decoction combined with traction treatment can relieve patients'' symptoms, ameliorate activities of lumbar joints, and improve patients'' quality of life, with significant clinical effect.