通督活血汤治疗腰椎手术失败综合征临床研究  

Clinical Studies of Tongdu Huoxue Decoction Treating Failed Back Surgery Syndrome

作　　者：蒋顺琬 陈大宇 麦庆春 JIANG Shuwan;CHEN Dayu;MAI Qingchun(The Fourth Medical College of Guangzhou University of Chinese Medicine Shenzhen Hospital of TCM, Shenzhen 518030, Guangdong, China)

机构地区：[1]广州中医药大学第四临床医学院(深圳市中医院)骨二科

出　　处：《中华中医药学刊》2018年第7期1640-1642,共3页Chinese Archives of Traditional Chinese Medicine

基　　金：广东省科技厅项目(2014A020221021)

摘　　要：目的：观察通督活血汤治疗腰椎手术失败综合征（FBSS）的临床疗效。方法：纳入77例FBSS患者,按照随机数字表法分为对照组35例和观察组32例。对照组给予依托考昔片和甲钴胺注射液治疗,观察组在对照组用药基础上加服通督活血汤。观察两组治疗前后视觉模拟评分法（VAS）及日本骨科协会（JOA）下腰痛评分的变化,比较两组改良Macnab疗效。结果：治疗后,两组患者的VAS评分均较治疗前降低,差异均有统计学意义（P〈0.05）;观察组的VAS评分比对照组下降更显著,差异有统计学意义（P〈0.05）。治疗后,两组患者的JOA下腰痛评分均较治疗前降低,差异均有统计学意义（P〈0.05）;观察组的JOA下腰痛评分比对照组下降更显著,差异有统计学意义（P〈0.05）。对照组总有效率97.14,观察组总有效率81.25,两组总有效率比较,差异有统计学意义（χ2=4.513,P=0.034）。结论：在依托考西片和甲钴胺注射液治FBSS基础上加用通督活血汤,可更有效地改善疼痛症状,提高治疗效果。Objective： To observe the clinical curative effect of Tongdu Huoxue Decoction on treating failed back surgery syndrome（ FBSS）. Methods： Seventy-seven cases of FBSS patients as the research objects,according to random number table method,were divided into control group（ 35 cases） and observation group（ 32 cases）. Control group was given Etoricoxib Tablets and Mecobalamin Injection. The observation group based on the control drug added Tongdu Huoxue Decoction. We observed two groups＇ visual analogue scale（ VAS）,Japanese orthopaedic association（ JOA）,changes of low back and pain score before and after treatment and compared two groups＇ modified Macnab curative effect.Results： VAS scores after treatment of two groups were reduced and the differences were statistically significant（ P 〈0. 05）. The observation group＇s VAS score was more significant than the control group＇s and the difference was statistically significant（ P 〈0. 05）. After treatment,two groups＇ JOA low back pain score was reduced and the differences were statistically significant（ P 〈0. 05）. The observation group＇s JOA low back pain score was more significantly lower than that of the control group and the difference was statistically significant（ P 〈0. 05）. Two groups＇ modified Macnab curative effect difference was statistically significant（ P 〈0. 05）. Conclusions： On the basic treatment of Etoricoxib Tablets and Mecobalamin Injection,adding ongdu Huoxue Decoction when treating FBSS can more effectively improve the pain symptoms and the effect.

关 键 词：腰椎手术失败综合征(FBSS) 肝肾亏虚证 通督活血汤 依托考昔片 甲钴胺注射液 视觉模拟评分法(VAS) 日本骨科协会(JOA)下腰痛评分 

分 类 号：R687.3[医药卫生—骨科学]