硬膜外封闭联合身痛逐瘀汤治疗腰椎间盘突出伴继发性椎管狭窄症临床研究  

Clinical Study on Secondary Spinal Stenosis of Lumbar Disc Herniation Treated by Extradural Blocking Combined with Shentong Zhuyu Decoction

作　　者：冀海源 徐佳 

机构地区：[1]河南省驻马店市第二中医院,河南驻马店463000

出　　处：《实用中医药杂志》2017年第11期1265-1266,共2页Journal of Practical Traditional Chinese Medicine

基　　金：河南省中医药科学研究专项课题(课题编号:2014ZY02104)

摘　　要：目的:观察硬膜外封闭疗法联合身痛逐瘀汤治疗腰椎间盘突出伴继发性椎管狭窄症的临床疗效。方法:100例按随机数字表法分为观察组和对照组各50例。两组均用硬膜外封闭疗法,观察组联合身痛逐瘀汤治疗,观察治疗前后两组Oswestry功能障碍指数(ODI)、视觉模拟量表(VAS)评分,血清基质金属蛋白酶3(MMP-3)、白细胞介素1β(IL-1β)、肿瘤坏死因子-α(TNF-α)指标。治疗14天后比较两组临床疗效。结果:治疗后两组腰椎ODI和VAS评分均较治疗前明显改善,且观察组改善程度大于对照组(P<0.05)。两组血清MMP-3、TNF-α、IL-1β水平均明显下降(均P<0.05),且观察组下降幅度大于对照组(P<0.05)。总有效率观察组高于对照组(P<0.05)。结论:硬膜外封闭疗法联合身痛逐瘀汤治疗腰椎间盘突出伴继发性椎管狭窄症具有较好的临床疗效,优于单用硬膜外封闭疗法治疗。Objective：To observe the clinical therapeutic effect of epidural occlusion therapy combined with Shentong Zhuyu Decoction in treatment of lumbar disc herniation with secondary spinal stenosis. Method：100 patients were evenly divided into observation group（50 cases） and control group（50 cases） according to random number table method. Both groups were treated with epidural anesthesia therapy and the observation group were treated with Shentong Zhuyu Decoction in addition. The Ochestry dysfunction index（ODI）,visual analogue scale（VAS） score, serum matrix metal（MMP-3）,interleukin-1β（IL-1β） and tumor necrosis factor-α（TNF-α） of both groups were measured before and after the treatment. The clinical therapeutic effect of the two groups was compared after 14 days of treatment. Result：After the treatment,the ODI and VAS score of lumbar vertebrae was significantly improved compared with that before treatment and the improvement of the observation group was superior to that of the control group（P0.05）.The level of serum MMP-3,TNF-α and IL-1β in the two groups were significantly lower than that in the control group（P0.05）.The clinical therapeutic effect of the observation group was significantly superior to that of the control group（P0.05）.Conclusion：Epidural closure therapy combined with Shentong Zhuyu Decoction has a good clinical effect in the treatment of lumbar disc herniation with secondary spinal stenosis,which is superior to single epidural occlusion therapy.

关 键 词：腰椎间盘突出 椎管狭窄症 硬膜外封闭疗法 身痛逐淤汤 

分 类 号：R681.53[医药卫生—骨科学]