老年退变性腰椎管狭窄症的非手术治疗  

Clinical outcome of non-surgical treatment of senile people with degenerative lumbar spinal canal stenosis

作　　者：许建文[1] 钟远鸣[1] 黄荣[2] 雷龙鸣[3] 陈锋[4] 黄民锋[4] 

机构地区：[1]广西中医学院第一附属医院脊柱外科,南宁530023 [2]广西中医学院骨伤研究所,南宁530001 [3]广西中医学院第一附属医院推拿科,南宁530023 [4]广西中医学院附属瑞康医院骨腰骶科,南宁530011

出　　处：《中国矫形外科杂志》2008年第11期829-832,共4页Orthopedic Journal of China

基　　金：广西医疗卫生重点科研课题(课题号:桂卫科教重200642);广西卫生厅立项课题(课题号:桂卫科教Z2005078)

摘　　要：[目的]探讨老年退变性腰椎管狭窄症患者非手术治疗的疗效。[方法]2000年11月～2005年10月收治的60岁以上退变性腰椎管狭窄症患者176例,随机分为中医组、西医组及中西医结合组,组间性别、年龄、病程及并发症比较差异无统计学意义(P>0.05),具有可比性。分别予中医、西医及中西医结合非手术方法治疗并采用日本矫形外科协会JOA评分标准评定疗效。[结果]157例获2～7年随访,平均随访3.5年,三组患者治疗前JOA分值比较差异无统计学意义(P>0.05),出院及随访时中医组与西医组患者JOA分值比较差异无统计学意义(P>0.05),但中医组或西医组与中西医结合组间JOA分值以及疗效比较差异有统计学意义(P<0.05),中西医结合组疗效优于中医组和西医组。[结论]对于无急诊手术指征老年退变性腰椎管狭窄症患者,在积极治疗并存内科疾病的同时,选择合理的非手术治疗,可取得较好疗效,但中西医结合疗法与单纯中医或西医疗法比较,疗效更持久及稳定。[ Objective ] To investigate the clinical effect of non-surgical treatment of senile people with degenerative lum- bar spinal canal stenosis. [ Method] Totally 176 cases of degenerative lumbar spinal canal stenosis from November 2000 to October 2005 were randomly divided into traditional Chinese medicine group （53 cases）, western medicine group （ 57 cases） , traditional Chinese medicine- western medicine group （ 66 cases） . And the treating effects were evaluatd by using JOA 29 grading system, and improving rate was analysed statistically. [ Result] Totally 157 cases acquired a follow - up of 2 - 7 years. The JOA score of cases in three groups had no obvious difference before treatment （P 〉 0.05 ）, the symptoms and activities of daily living were improved significantly in three groups after treatment （ P 〈 0. 05 ） , there was no obvious difference be- tween traditional Chinese medicine and western medicine group （ P 〉 0. 05 ） , but the clinical effect had obvious difference be- tween traditional Chinese medicine group and traditional Chinese medicine - western medicine group or western medicine group and traditional Chinese medicine - western medicine group （ P 〈 0. 05 ） . [ Conclusion ] In condition of controlling concomitant internal disease, degenerative lumbar canal stenosis cases were satisfied with nonoperation outcomes, comparing with other two groups, the traditional Chinese medicine - western medicine group guarrenteed better therapeutic effect.

关 键 词：腰椎 椎管狭窄症 退变性 老年 非手术/保守/中西医结合治疗 

分 类 号：R681.53[医药卫生—骨科学]