补中益气汤治疗气虚血瘀型老年腰椎融合术后残留症状的疗效观察  

Observation on the Curative Efficacy of Buzhong Yiqi Decoction on Residual Symptoms of Aged Lumbar Fusion with Qi Deficiency and Blood Stasis

作　　者：朱佳福[1] 宋红浦[1] 徐卫星[1] 刘宏[1] ZHU Jiafu;SONG Hongpu;XU Weixing;LIU Hong(Zhejiang Tongde Hospital,Hangzhou 310012,China)

机构地区：[1]浙江省立同德医院,杭州310012

出　　处：《中国中医骨伤科杂志》2024年第3期51-54,共4页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：浙江省中医药科技计划青年人才基金项目(2021ZQ019)。

摘　　要：目的:观察补中益气汤治疗气虚血瘀型老年经椎间孔腰椎椎间融合术(TLIF)后残留症状的临床疗效。方法:将因腰椎融合术后出现残留症状且经中医辨证属于气虚血瘀型的60例患者,按照随机数字表法分为对照组(30例)和观察组(30例);对照组术后采用基础治疗,观察组术后采用基础治疗+补中益气汤口服;收集术前、术后第2天、术后第16天3个观察节点的视觉模拟量表(VAS)评分评估疼痛程度以及腰椎日本骨科协会(JOA)量表评分评估患者症状缓解和功能改善等情况,并比较两组患者术后肌注止痛药总量、口服止痛药总量、术后距末次肌注止痛药的时间、术后距末次口服止痛药的时间等数据;所得数据采用SPSS22.0进行统计分析,评价补中益气汤治疗老年气虚血瘀型腰椎融合术后残留症状的临床疗效。结果:60例患者均获得随访,随访时间为2~4个月。两组患者的年龄、性别、术前VAS及JOA评分、手术节段、手术时长、出血量等一般资料比较,差异均无统计学意义(P>0.05),具有可比性。术后残留症状改善方面:两组患者术后第2天及术后第16天的VAS评分差异无统计学意义(P>0.05),两组患者的疼痛控制效果相当;两组患者术后第2天JOA评分差异无统计学意义(P>0.05),术后第16天JOA评分差异有统计学意义(P<0.05),观察组高于对照组,观察组在症状缓解和功能改善方面优于对照组。镇痛药物使用方面:两组患者肌注止痛药总量、口服止痛药总量、术后距末次肌注止痛药的时间、术后距末次口服止痛药的时间等方面差异有统计学意义(P<0.05),观察组止痛药物使用量及使用时间均少于对照组。结论:补中益气汤可以缓解老年腰椎融合术后残留症状,值得临床推广应用。Objective:To observe the clinical efficacy of Buzhong Yiqi decoction in treating residual symptoms of the aged lumbar fusion with Qi deficiency and blood stasis.Methods:60 patients who had residual symptoms after transforaminal lumbar interbody fusion(TLIF) and belonged to Qi deficiency and blood stasis type according to traditional Chinese medicine(TCM) syndrome differentiation were divided into control group(30 cases) and observation group(30 cases) according to random number table method.The control group received basic treatment after surgery,and the observation group received basic treatment + Buzhong Yiqi decoction orally after surgery.Visual analogue scale(VAS) scores at the three observation points were collected before surgery,on the day 2 and day 16 after surgery to assess pain degree and lumbar Japanese orthopaedic association(JOA) scale to assess symptom relief and functional improvement of patients.The total amount of postoperative intramuscular painkiller,total amount of oral painkiller,postoperative time from the last intramuscular painkiller injection,postoperative time from the last oral painkiller injection and other data were compared between the two groups.The obtained data were statistically analyzed using SPSS 22.0,using P<0.05 was statistically significant to evaluate the clinical efficacy of Buzhong Yiqi decoction in treating residual symptoms after lumbar fusion of Qi deficiency and blood stasis in the elderly patients.Results:All 60 patients were followed up for 2-4 months.There were no significant differences in age,gender,preoperative VAS and JOA scores,surgical stage,surgical duration,and blood loss between the two groups(P>0.05),the two groups were comparable.In terms of improvement of postoperative residual symptoms,there was no significant difference in VAS scores on day 2 and day 16 after surgery between the two groups(P>0.05),the pain control effect of the two groups was similar.There was no statistical difference in JOA scores between the two groups on the day 2 after surgery,an

关 键 词：补中益气汤 老年患者 开放 腰椎融合 术后残留症状 

分 类 号：R681.5[医药卫生—骨科学]