通督活血汤在退行性腰椎滑脱症患者后路腰椎椎间融合术后康复中的应用效果  

Application Effect of Tongdu Huoxue Decoction in Rehabilitation of Posterior Lumbar Interbody Fusion in Patients with Degenerative Lumbar Spondylolisthesis

作　　者：李旭飞 杨邦文 罗应乾 LI Xufei;YANG Bangwen;LUO Yingqian(Department of No.2 Orthopedics,Renhuai Traditional Chinese Medicine Hospital,Zunyi 563000,China)

机构地区：[1]贵州省仁怀市中医院骨二科,贵州遵义563000

出　　处：《中国伤残医学》2025年第4期85-89,共5页Chinese Journal of Trauma and Disability Medicine

基　　金：遵义市科技计划项目科研立项课题[遵市科合HZ字(2023)394号]。

摘　　要：目的:探讨通督活血汤应用于退行性腰椎滑脱症(DLS)患者后路腰椎椎间融合术(PLIF)后康复中的效果。方法:选取2023年3月-2024年6月仁怀市中医院收治的80例DLS患者为研究对象,随机将其分为对照组及研究组,各40例。PLIF后,对照组采用常规治疗,研究组在对照组基础上采用通督活血汤治疗。对比两组腰痛程度、腰椎功能、炎症指标水平、疼痛物质水平、肌酸激酶水平及安全性。结果:术后1周、1、3个月,研究组的疼痛视觉模拟评分均低于对照组,差异均有统计学意义(P<0.05)。术后1、3个月,研究组的腰椎日本骨科协会评分均高于对照组,Oswestry功能障碍指数评分均低于对照组,差异均有统计学意义(P<0.05)。术后1、3个月,研究组的白细胞介素-1α、肿瘤坏死因子-α及单核细胞趋化蛋白-1水平均低于对照组,差异均有统计学意义(P<0.05)。术后1、3个月,研究组的去甲肾上腺素、多巴胺及5-羟色胺水平均低于对照组,差异均有统计学意义(P<0.05)。术后1个月,研究组的肌酸激酶水平高于对照组,差异有统计学意义(P<0.05);术后3个月,两组的血清肌酸激酶水平比较,差异无统计学意义(P>0.05)。术后治疗期间,两组均未出现药物不良反应。结论:DLS患者PLIF后服用通督活血汤,有助于促进致痛介质的吸收,减轻术后疼痛,并控制炎症因子水平,加速腰椎功能恢复,具有较高的应用价值。Objective:To investigate the effect of Tongdu Huoxue Decoction in rehabilitation of posterior lumbar interbody fusion(PLIF)in patients with degenerative lumbar spondylolisthesis(DLS).Methods:A total of 80 DLS patients admitted to Renhuai Traditional Chinese Medicine Hospital from March 2023 to June 2024 were selected as the study objects,they were randomly divided into a control group and a study group,with 40 cases in each group.After PLIF,the control group received conventional treatment,and the study group received Tongdu Huoxue Decoction on the basis of the control group.The degree of low back pain,lumbar function,inflammatory indexes,pain substance levels,creatine kinase level and safety of the two groups were compared.Results:At 1 week,1 and 3 months after surgery,the Pain Visual Analogue Scale score of the study group was lower than that of the control group,and the differences were statistically significant(P<0.05).At 1 and 3 months after surgery,the lumbar Japanese Orthopaedic Association scores were higher in the study group than in the control group,and the Oswestry Disability Index scores were lower than those in the control group,and the differences were statistically significant(P<0.05).At 1 and 3 months after surgery,the levels of interleukin-1α,tumor necrosis factor-αand monocyte chemotactic protein-1 in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).At 1 and 3 months after surgery,the levels of norepinephrine,dopamine and 5-hydroxytryptamine in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).At 1 month after surgery,the creatine kinase level in the study group was lower than that in the control group,the difference was statistically significant(P<0.05);3 months after surgery,there was no significant difference in the serum creatine kinase level between the two groups(P>0.05).There were no adverse drug reactions in both groups during postoperative treatment

关 键 词：退行性腰椎滑脱症 后路腰椎椎间融合术 通督活血汤 腰椎功能 炎性因子 致痛物质 

分 类 号：R274.9[医药卫生—中西医结合]