复元活血汤对气滞血瘀型腰椎管狭窄患者术后腰椎功能、椎体结构的影响  

Effect of Fuyuan Huoxue Decoction on Postoperative Lumbar Function and Vertebral Structure of Patients with Lumbar Spinal Stenosis of Qi Stagnation and Blood Stasis Type

作　　者：王元龙[1] 宋寒冰[2] 张伟 吕金柱[1] 朱求亮[1] 娄云龙[1] 章学超 章重阳 WANG Yuanlong;SONG Hanbing;ZHANG Wei;LYU Jinzhu;ZHU Qiuliang;LOU Yunlong;ZHANG Xuechao;ZHANG Chongyang(People's Hospital of Anji,Anji Zhejiang 313300,China;First Affiliated Hospital,Heilongjiang University of Chinese Medicine,Harbin Heilongjiang 150040,China;Hangzhou Hospital of Traditional Chinese Medicine,Hangzhou Zhejiang 310007,China)

机构地区：[1]安吉县人民医院,浙江安吉313300 [2]黑龙江中医药大学附属第一医院,黑龙江哈尔滨150040 [3]杭州市中医院,浙江杭州310007

出　　处：《新中医》2024年第10期40-46,共7页New Chinese Medicine

基　　金：湖州市科学技术局项目(2021GY98)。

摘　　要：目的:观察复元活血汤对气滞血瘀型腰椎管狭窄患者术后腰椎功能、椎体结构的影响。方法:选取70例行单侧双通道内镜技术治疗的气滞血瘀型腰椎管狭窄患者,采用随机数字表法分为对照组和观察组各35例。对照组术后给予常规西药治疗,观察组在对照组基础上给予复元活血汤治疗。比较2组住院时间、临床疗效、炎症指标[肿瘤坏死因子-α(TNF-α)、单核细胞趋化蛋白-1(MCP-1)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)水平]、凝血功能指标[纤维蛋白原(FIB)水平、凝血酶原时间(PT)、部分凝血活酶时间(APTT)、凝血酶时间(TT)]、椎体结构指标(伤椎前缘、中间、后缘高度)、腰椎功能相关评分[视觉模拟评分法(VAS)、Oswestry功能障碍指数(ODI)、间歇性跛行评分]及并发症发生率。结果:观察组住院时间短于对照组(P<0.05)。术后第14天,观察组临床疗效优良率91.43%,高于对照组68.57%(P<0.05)。术后第14天,2组血清TNF-α、MCP-1、IL-1β、IL-6水平均较治疗前降低(P<0.05),观察组血清TNF-α、MCP-1、IL-1β、IL-6水平均低于对照组(P<0.05)。术后第14天,2组血清FIB水平均较治疗前降低(P<0.05),观察组血清FIB水平低于对照组(P<0.05);2组PT、APTT、TT均较治疗前延长(P<0.05),观察组PT、APTT、TT均长于对照组(P<0.05)。术后第14天,2组伤椎前缘、中间、后缘高度与治疗前比较,以及组间比较,差异均无统计学意义(P>0.05)。术后第14天,2组VAS、ODI、间歇性跛行评分均较治疗前降低(P<0.05),观察组VAS、ODI、间歇性跛行评分均低于对照组(P<0.05)。治疗期间,观察组并发症发生率2.86%,与对照组8.57%比较,差异无统计学意义(P>0.05)。结论:复元活血汤可有效缓解气滞血瘀型腰椎管狭窄术后患者机体的炎症反应及凝血功能,改善腰椎功能,缩短住院时间。Objective:To observe the effect of Fuyuan Huoxue Decoction on postoperative lumbar function and vertebral structure of patients with lumbar spinal stenosis of qi stagnation and blood stasis type.Methods:A total of 70 cases of patients with lumbar spinal stenosis of qi stagnation and blood stasis type,who were treated with unilateral biportal endoscopic discectomy(UBE),were selected and divided into the control group and the observation group according to the random number table method,with 35 cases in each group.The control group was treated with routine western medicine,and the observation group was additionally treated with Fuyuan Huoxue Decoction based on the treatment of the control group.The length of hospital stay,clinical effects,inflammatory indexes[levels of tumor necrosis factor-α(TNF-α),monocyte chemoattractant protein-1(MCP-1),interleukin-1β(IL-1β),interleukin-6(IL-6)],coagulation function indexes[fibrinogen(FIB)level,prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT)],vertebral structure indexes[the height of anterior,middle and posterior edges of injured vertebrae],vertebral function-related scores[Visual Analogue Scale(VAS),Oswestry Disability Index(ODI),intermittent claudication scores]and complication rates were compared between the two groups.Results:The length of hospital stay in the observation group was shorter than that in the control group(P<0.05).After 14 days of surgery,the clinical effect of fine rate was 91.43%in the observation group,higher than that of 68.57%in the control group(P<0.05).After 14 days of surgery,the levels of TNF-α,MCP-1,IL-1βand IL-6 in serum in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of TNF-α,MCP-1,IL-1βand IL-6 in serum in the observation group were lower than those in the control group(P<0.05).After 14 days of surgery,the levels of serum FIB in the two groups were decreased when compared with those before treatment,and the level of serum FIB in the observation group was l

关 键 词：腰椎管狭窄 单侧双通道内镜技术 气滞血瘀型 复元活血汤 腰椎功能 椎体结构 

分 类 号：R681.5[医药卫生—骨科学]