口服益气化瘀汤联合功能锻炼治疗腰椎退行性疾病术后残留腰腿痛的临床研究  

Clinical study on oral application of Yiqi Huayu Tang( 益气化瘀汤) combined with functional exercise for the treatment of postoperative residual lumbocrural pain in patients with lumbar degenerative disease

作　　者：万宏波[1] 马海燕 蒋云霞[3] 莫文[1] 姚若愚 邬学群[1] 

机构地区：[1]上海中医药大学附属龙华医院,上海200032 [2]上海黄浦区中西医结合医院,上海200010 [3]上海中医药大学附属龙华医院(分院),上海200123

出　　处：《中医正骨》2015年第6期1-5,共5页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：上海市教委预算内课题项目(736)

摘　　要：目的:观察口服益气化瘀汤联合功能锻炼治疗腰椎退行性疾病术后残留腰腿痛的临床疗效。方法:将132例因腰椎退行性疾病接受手术治疗后残留腰腿痛的患者(腰椎间盘突出症85例,腰椎管狭窄症47例)随机分为2组,联合治疗组69例、功能锻炼组63例。联合治疗组采用口服益气化瘀汤结合五点支撑锻炼治疗,功能锻炼组仅进行五点支撑锻炼。采用疼痛视觉模拟评分(visual analogue score,VAS)、Oswestry功能障碍指数(Oswestry dability index,ODI)问卷表、JOA腰痛疾患疗效评分标准、简明健康状况调查表(short form 36 health survey questionnaire,SF-36)评定临床疗效。结果:治疗前后不同时间疼痛VAS评分的差异有统计学意义,即存在时间效应(F=1759.038,P=0.000)。2组疼痛VAS评分比较总体上有统计学意义,即存在分组效应(F=11.431,P=0.001)。治疗前和治疗14 d后2组评分比较,组间差异均无统计学意义(t=0.590,P=0.557;t=-1.676,P=0.096);治疗7 d、21 d后联合治疗组的评分均低于功能锻炼组(t=-3.913,P=0.000;t=-8.822,P=0.000)。时间因素与分组因素存在交互效应(F=26.623,P=0.000)。治疗前后不同时间ODI评分的差异有统计学意义,即存在时间效应(F=634.277,P=0.000)。2组ODI评分比较总体上有统计学意义,即存在分组效应(F=4.067,P=0.046);除治疗前外,治疗7 d、14 d、21 d后联合治疗组的评分均低于功能锻炼组(t=0.455,P=0.650;t=-2.044,P=0.043;t=-2.224,P=0.028;t=-5.658,P=0.000)。时间因素与分组因素存在交互效应(F=9.217,P=0.000)。治疗前后不同时间JOA评分的差异有统计学意义,即存在时间效应(F=1054.688,P=0.000)。2组JOA评分比较总体上有统计学意义,即存在分组效应(F=173.613,P=0.000);除治疗前外,治疗7 d、14 d、21 d后联合治疗组的评分均高于功能锻炼组(t=-0.149,P=0.882;t=5.944,P=0.000;t=12.636,P=0.000;t=9.774,P=0.000)。时间因素与分组因素存在交互效应(F=30.428,P=0.000)。治疗前2组患者的SObjective： To observe the clinical curative effects of oral application of Yiqi Huayu Tang（ 益气化瘀汤） 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 14 th 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 21 th 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 g

关 键 词：椎管狭窄 椎间盘移位 腰椎 腰腿痛 益气化瘀汤 功能锻炼 治疗 临床研究性 

分 类 号：R274.9[医药卫生—中西医结合]