甲钴胺联合痹祺胶囊治疗内镜术后腰神经根残留损害的回顾性分析  

Retrospective Study on Mecobalamin Combined with Biqi Capsule for Residual Lumbar Nerve Root Injury after Endoscopic Surgery

作　　者：陈波涛 李黔春 袁刚 李永文[3] 樊效鸿[1] CHEN Bo-tao;LI Qian-chun;YUAN Gang;LI Yong-wen;FAN Xiao-hong(Deparment of Orthopedics,Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610075;Department of Orthopedics,Jiulongpo Hospital of Traditional Chinese Medicine of Chongqing,Chongqing 400080;Department of Orthopedics of Chinese Medicine,Liuzhou People’s Hospital of Guangxi,Guangxi 545000)

机构地区：[1]成都中医药大学附属医院骨科,成都610075 [2]重庆市九龙坡区中医院骨伤科,重庆400080 [3]广西柳州市人民医院中医骨伤科,广西545000

出　　处：《中国中西医结合杂志》2021年第1期50-55,共6页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：四川省科技厅重大科技专项资助项目(No.2018SZDZX0013);重庆市市级中医药重点学科建设项目(No.渝中医〔2019〕11号)。

摘　　要：目的观察中成药痹祺胶囊、西药甲钴胺及联合治疗腰椎内镜术后出院患者中腰神经根残留损害的临床疗效。方法回顾性分析2014年12月1日—2018年11月30日因腰椎间盘突出症行腰椎内镜治疗,术后仍有腰神经根残留损害的患者。从门诊及住院病案系统提取数据。依据术后2周门诊复诊时是否进行药物治疗,分为药物暴露组(77例)和无药物暴露组(16例)。药物暴露组根据用药不同分为联合治疗组(39例)、痹祺胶囊组(21例)、甲钴胺组(17例)。对人口学特征、临床特点和治疗结果进行统计学分析。结果共纳入93例,随访时间为13.5(12.0~15.0)个月。男女比为1.58:1,年龄为45.0(41.0~53.0)岁,病程为18.0(14.0~26.0)周,各组人口学特征比较,差异无统计学意义(P>0.05)。椎间盘突出部位、MRI分级、病变节段等临床特点比较,差异无统计学意义(P>0.05)。与无药物暴露组比较,药物暴露组3个月随访时JOA评分和JOA改善率均提高(U=225.00,P<0.001);12个月随访时JOA改善率升高(U=351.00,P=0.007),JOA评分比较差异无统计学意义(P>0.05)。3个月随访时,甲钴胺组(调整后P=0.039)、无药物暴露组(调整后P=0.010)分别与联合用药组比较,JOA评分差异有统计学意义,痹祺胶囊组差异无统计学意义(调整后P=0.080)。12个月随访时,痹祺胶囊组(调整后P=0.002)、甲钴胺组(调整后P=0.003)、无药物暴露组(调整后P=0.008)分别与联合用药组比较,JOA评分差异有统计学意义。痹祺胶囊药品不良反应的发生率为3.3%(2/60)。结论内镜术后腰神经根残留神经损害,痹褀胶囊联合甲钴胺治疗有助于早期改善临床症状,促进受损神经的修复,优于两种药物单用,且越早使用临床疗效越好。Objective To observe the clinical efficacy of Biqi Capsule,mecobalamin and Biqi Capsule combined with mecobalamin in the treatment of lumbar nerve root residual injury after lumbar endoscopic surgery.Methods Retrospective analysis was made on the data of the patients from Dec.1,2014 to Nov.30,2018 due to lumbar disc herniation underwent lumbar endoscopic treatment,who still had residual lumbar nerve root injury.Data were extracted from outpatient and inpatient medical record systems.The patients were assigned to drugexposure group(77 cases)and non-drug-exposure group(16 cases)according to whether to take medication at 2 weeks after operation.The drug-exposure group was assigned to three groups:combined group(39 cases),Biqi Capsule group(21 cases)and mecobalamin group(17 cases).The demographic characteristics,clinical characteristics and outcomes were analyzed.Results A total of 93 patients were included,with a follow-up time of 13.5(12.0-15.0)months.The male to female ratio was 1.58:1,the age was 45.0(41.0-53.0)years,and the course of disease was 18.0(14.0-26.0)weeks.There was no significant difference in demographic characteristics among groups(P>0.05).There were no significant difference in the clinical features,MRI grades and lesion sites of disc herniation(P>0.05).Compared with the non-drug exposure group,the JOA score and JOA improvement rate in the drug exposure group increased during the 3-month follow-up(U=225.00,P<0.001),while the JOA improvement rate increased in the 12-month follow-up(U=351.00,P=0.007),and there was no significant difference in JOA score(P>0.05).The JOA scores of mecobalamin group(adjusted P=0.039)and non-drug exposure group(adjusted P=0.010)were significantly different from the combined group,but there was no significant difference in the Biqi Capsule group(adjusted P=0.080).The JOA scores of Biqi Capsule group(adjusted P=0.002),mecobalamin group(adjusted P=0.003)and no drug exposure group(adjusted P=0.008)were significantly different from those of the combined group.The incidence of

关 键 词：痹祺胶囊 神经根损害 回顾性分析 

分 类 号：R687.3[医药卫生—骨科学]