补阳还五汤加快椎管内肿瘤术后功能恢复随机对照研究  

Clinical Research of Buyang Huanwu Decoction on Postoperative Functional Recovery of Intraspinal Tumor:A Randomized Controlled Trial

作　　者：秦德芳 李丽[3] 张泽舜 展洪星[2] 霍泳林 赵敏清 马丁 刘军[4] QIN De-fang;LI Li;ZHANG Ze-shun;ZHAN Hong-xing;HUO Yong-lin;ZHAO Min-qing;MA Ding;LIU Jun(Second Clinical Medical College of Guangzhou University of Traditional Chinese Medicine,Guangzhou 510006;Department of Neurosurgery,Zhuhai Branch of Guangdong Traditional Chinese Medicine Hospital,Guangdong 519000;Department of Internal Medicine,Zhuhai Health School,Guangdong 519000;Department of Orthopedics,Guangdong Hospital of Traditional Chinese Medicine,Guangzhou 510006)

机构地区：[1]广州中医药大学第二临床医学院,广州510006 [2]广东省中医院珠海医院神经外科,广东519000 [3]珠海市卫生学校内科教研室,广东519000 [4]广东省中医院骨科,广州510006

出　　处：《中国中西医结合杂志》2021年第9期1073-1079,共7页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：广东省中医药局科研项目(No.20182138)。

摘　　要：目的探讨补阳还五汤对椎管内肿瘤患者术后功能恢复的作用及机制。方法选择2018年1月—2019年12月广东省中医院珠海医院收治的椎管内肿瘤患者60例,随机分为试验组和对照组,每组各30例。两组均采用手术加常规疗法,试验组于术前1日开始口服补阳还五汤,疗程为10日。术前及术后10日进行美国脊髓损伤协会(ASIA)评分、日本骨科协会(JOA)评估疗效,术前及术后第1、3、5、7、10日检测血浆神经元特异性烯醇化酶(NSE)、C-反应蛋白(CRP)水平。记录两组患者住院时间、引流管拔管时间、脑脊液漏例数。结果与本组术前比较,两组术后第1、3、5、7、10日血浆CRP水平升高(P<0.001,P<0.05);试验组术后第3、5、7、10日血浆NSE水平降低(P<0.05),对照组术后第5、7、10日血浆NSE水平降低(P<0.05);两组术后ASIA评分均明显提高(P<0.001)。与对照组比较,试验组住院天数、脑脊液漏数量减少(P<0.05),术后ASIA差值、JOA总有效率升高(P<0.001,P<0.05),术后第1、3、5、7、10日CRP水平降低(P<0.01,P<0.05),术后第3、7、10日NSE水平降低(P<0.01,P<0.05)。结论补阳还五汤在改善椎管内肿瘤术后症状、加快神经康复、减少并发症等方面效果明显。Objective To investigate the effect and mechanism of Buyang Huanwu Decoction(BHD)on the postoperative functional recovery of patients with intraspinal tumors.Methods In total,60 cases with intraspinal tumor admitted to Zhuhai Branch of Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2018 to December 2019 were randomly assigned to the experimental group and the control group,with 30 cases in each group.The patients in both groups received surgery and routine therapy.The experimental group took BHD in addition from the day before operation,and the course of treatment lasted 10 days.Before the operation and on the 10th day of the operation,the American Spinal Injury Association(ASIA)and Japanese Orthopaedic Association(JOA)scores were performed to evaluate the efficacy.The levels of neuron-specific enolase(NSE)and C-reactive protein(CRP)in plasma were detected before operation and on the 1st,3rd,5th,7th,and 10th days after operation.The hospitalization days,the extubation time of the drainage tube,and the cerebrospinal fluid leakage were recorded.Results Compared with the same group before operation,the plasma CRP levels of the two groups increased on the 1st,3rd,5th,7th,and 10th day after operation(P<0.001,P<0.05),the plasma NSE level of the experimental group decreased on the 3rd,5th,7th,and 10th day after operation(P<0.05),and the plasma NSE level of the control group decreased on the 5th,7th,and 10th day after operation(P<0.05);ASIA scores of the two groups after operation were significantly improved(P<0.001).Compared with the control group,the hospitalization days and cerebrospinal fluid leakage in the experimental group were reduced(P<0.05),postoperative ASIA difference and JOA score increased(P<0.001,P<0.05),the CRP level of the experimental group decreased on the 1st,3rd,5th,7th,and 10th day after surgery(P<0.01,P<0.05),the level of NSE decreased on the 3rd,7th and 10th day after surgery(P<0.01,P<0.05).Conclusion BHD can improve the postoperative symptoms of intraspinal tumor,accel

关 键 词：补阳还五汤 椎管内肿瘤 血浆水平 JOA评分 ASIA评分 中西医结合 

分 类 号：R273[医药卫生—中西医结合]