单节段腰椎管狭窄症患者扶阳宣痹汤联合TLIF治疗的效果观察  

Observation on the effect of Fuyang Xuanbi Decoction combined with TLIF on patients with single level lumbar spinal stenosis

作　　者：金柱 李蒙 张印[1] JIN Zhu(Department of Orthopedics,First People’s Hospital of Nanyang City,Nanyang 473000,Henan,China)

机构地区：[1]南阳市第一人民医院骨一科,河南南阳473000

出　　处：《牡丹江医学院学报》2024年第6期74-79,共6页Journal of Mudanjiang Medical University

基　　金：南阳市科技攻关项目(23JCQY2057)。

摘　　要：目的 探讨扶阳宣痹汤联合经椎间孔腰椎体间融合术(Transforaminal lumbar interbody fusion,TLIF)治疗单节段腰椎管狭窄症(Lumbar spinal stenosis,LSS)患者的疗效。方法 采用配对病例对照研究法,回顾性选取2020年10月至2023年10月在我院行TLIF治疗的94例LSS患者纳入研究,按治疗方案不同分为参照组(n=47)、研究组(n=47)。其中单纯采用TLIF治疗者纳入参照组,采用扶阳宣痹汤联合TLIF治疗者纳入研究组。比较2组术后恢复情况(术后下床时间、住院时间),术前、术后2、4周腰疼程度[疼痛视觉模拟量表(VAS)评分]、腰椎功能恢复情况[日本骨科协会评估治疗(JOA)评分、Oswestry功能障碍指数(ODI)评分]、血清炎症因子指标[超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肌酸激酶(CK)]水平及术后并发症发生情况。结果 研究组术后下床时间、住院时间短于参照组(P<0.05);研究组术后2周、4周VAS评分低于参照组(P<0.05);研究组术后2、4周JOA评分高于参照组,ODI评分低于参照组(P<0.05);研究组术后2、4周hs-CRP、IL-6、CK水平低于参照组(P<0.05);研究组术后并发症总发生率为6.38%,与参照组12.77%比较,差异无统计学意义(P>0.05)。结论 扶阳宣痹汤联合TLIF治疗LSS患者可有效缓解术后疼痛,减轻术后炎症反应,改善腰椎功能,加快预后康复进程,且安全性可靠。Objective To investigate the curative effect of Fuyang Xuanbi Decoction combined with Transforaminal lumbar interbody fusion(TLIF) in the treatment of single level Lumbar spinal stenosis(LSS).Methods A paired case-control study was used to retrospectively select 94 patients with LSS who received TLIF treatment in our hospital from October 2020 to October 2023,and all patients were divided into reference group(n=47) and study group(n=47) according to different treatment regimens.Patients treated with TLIF alone were included in the reference group,and those treated with Fuyang Xuanbi Decoction combined with TLIF were included in the study group.The postoperative recovery(time of getting out of bed after surgery,length of stay in hospital) of the two groups were compared.Degree of low back pain [Visual Analogue Scale(VAS) score],lumbar function recovery [Japanese Orthopaedic Association Evaluation and Treatment(JOA) score,Oswestry Disability Index(ODI) score],serum inflammatory factor indexes Hypersensitive C-reactive protein(hs-CRP),interleukin-6(IL-6),Creatine kinase(CK) levels and postoperative complications before surgery and 2 and 4 weeks after surgery of the two groups were compared.Results The time of getting out of bed and staying in hospital in the study group were shorter than those in the control group(P<0.05).The VAS scores of the study group at 2 and 4 weeks after operation were lower than those of the reference group(P<0.05).JOA score of the study group was higher than that of the reference group at 2 and 4 weeks after operation,and ODI score was lower than that of the reference group(P<0.05).The levels of hs-CRP,IL-6,and CK were lower in the study group than in the reference group at 2 and 4 weeks postoperatively(P<0.05).The total incidence of postoperative complications in the study group was 6.38%,compared with 12.77% in the reference group,the difference was not statistically significant(P>0.05).Conclusion Fuyang Xuanbi Decoction combined with TLIF in the treatment of LSS patients can effectively

关 键 词：单节段腰椎管狭窄症 扶阳宣痹汤 经椎间孔腰椎体间融合术 炎症反应 康复进程 腰椎功能 

分 类 号：R687.3[医药卫生—骨科学]