[1]万宏波,马海燕,蒋云霞,等.口服益气化瘀汤联合功能锻炼治疗腰椎退行性疾病 术后残留腰腿痛的临床研究[J].中医正骨,2015,27(06):1-5.
　WAN Hongbo,MA Haiyan,JIANG Yunxia,et al.Clinical study on oral application of Yiqi Huayu Tang(益气化瘀汤)combined with functional exercise for the treatment of postoperative residual lumbocrural pain in patients with lumbar degenerative disease[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(06):1-5.
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口服益气化瘀汤联合功能锻炼治疗腰椎退行性疾病 术后残留腰腿痛的临床研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第27卷
期数:
2015年06期
页码:
1-5
栏目:
临床研究
出版日期:
2015-06-30

文章信息/Info

Title:
Clinical study on oral application of Yiqi Huayu Tang(益气化瘀汤)combined with functional exercise for the treatment of postoperative residual lumbocrural pain in patients with lumbar degenerative disease
作者:
万宏波1; 马海燕2; 蒋云霞3; 莫文1; 姚若愚1; 邬学群1
1.上海中医药大学附属龙华医院,上海 200032;
2.上海黄浦区中西医结合医院,上海 200010;
3.上海中医药大学附属龙华医院(分院),上海 200123
Author(s):
WAN Hongbo1; MA Haiyan2; JIANG Yunxia3; MO Wen1; YAO Ruoyu1; WU Xuequn1
1.Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China 2.Huangpu District combinational hospital of traditional Chinese medicine and Western medicine in Shanghai,Shanghai 200010,China 3.Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Pudong branch,Shanghai 200123,China
关键词:
椎管狭窄;  椎间盘移位;  腰椎;  腰腿痛;  益气化瘀汤;  功能锻炼;  治疗; 临床研究性
Keywords:
spinal stenosis;  intervertebral disc displacement;  lumbar vertebrae;  lumbago-leg pain;  Yiqi Huayu Tang;  functional exercise;  therapies; investigational
摘要:
目的:观察口服益气化瘀汤联合功能锻炼治疗腰椎退行性疾病术后残留腰腿痛的临床疗效。方法:将132例因腰椎退行性疾 病接受手术治疗后残留腰腿痛的患者(腰椎间盘突出症85例,腰椎管狭窄症47例)随机分为2组,联合治疗组69例、功能锻炼组63例 。联合治疗组采用口服益气化瘀汤结合五点支撑锻炼治疗,功能锻炼组仅进行五点支撑锻炼。采用疼痛视觉模拟评分(visual analogue score,VAS)、Oswestry功能障碍指数(Oswestry dability index,ODI)问卷表、JOA腰痛疾患疗效评分标准、简明健康 状况调查表(short form 36 health survey questionnaire,SF-36)评定临床疗效。结果:治疗前后不同时间疼痛VAS评分的差异 有统计学意义,即存在时间效应(F=1759.038,P=0.000)。2组疼痛VAS评分比较总体上有统计学意义,即存在分组效应 (F=11.431,P=0.001)。治疗前和治疗14 d后2组评分比较,组间差异均无统计学意义(t=0.590,P=0.557; t=-1.676,P=0.096); 治 疗7 d、21 d后联合治疗组的评分均低于功能锻炼组(t=-3.913,P=0.000; t=-8.822,P=0.000)。时间因素与分组因素存在交互效 应(F=26.623,P=0.000)。治疗前后不同时间ODI评分的差异有统计学意义,即存在时间效应(F=634.277,P=0.000)。2组ODI评分比 较总体上有统计学意义,即存在分组效应(F=4.067,P=0.046); 除治疗前外,治疗7 d、14 d、21 d后联合治疗组的评分均低于功 能锻炼组(t=0.455,P=0.650; t=-2.044,P=0.043; t=-2.224,P=0.028; t=-5.658,P=0.000)。时间因素与分组因素存在交互效应 (F=9.217,P=0.000)。治疗前后不同时间JOA评分的差异有统计学意义,即存在时间效应(F=1054.688,P=0.000)。2组JOA评分比较 总体上有统计学意义,即存在分组效应(F=173.613,P=0.000); 除治疗前外,治疗7 d、14 d、21 d后联合治疗组的评分均高于功 能锻炼组(t=-0.149,P=0.882; t=5.944,P=0.000; t=12.636,P=0.000; t=9.774,P=0.000)。时间因素与分组因素存在交互效应 (F=30.428,P=0.000)。治疗前2组患者的SF-36评分比较,组间差异无统计学意义[(58.277±10.552)分, (58.857±8.640)分,t=-0.344,P=0.732]; 治疗21 d后2组患者的SF-36评分均增加(t=-10.030,P=0.000; t=- 10.492,P=0.000); 治疗21 d后2组患者的SF-36评分比较,差异无统计学意义[(64.582±11.162)分,(62.452±8.935)分 ,t=-1.203,P=0.310]。结论:口服益气化瘀汤联合功能锻炼对于腰椎术后患者神经功能的恢复及疼痛的改善有明显促进作用,对 患者整体健康状况的改善效果明显,可提高患者的生活质量。
Abstract:
Objective:To observe the clinical curative effects of oral application of Yiqi Huayu Tang(益气化瘀汤) combined with functional exercise in the treatment of postoperative residual lumbocrural pain in patients with lumbar degenerative disease.Methods:One hundred and thirty-two patients with residual lumbocrural pain after surgery for lumbar degenerative disease were randomly divided into combination treatment group(69 cases)and functional exercise group(63 cases).A total of 85 patients were diagnosed as lumbar disc herniation and 47 patients were diagnosed as lumbar spinal stenosis.The patients in combination treatment group were treated with oral application of Yiqi Huayu Tang combined with five-point weight-support exercise,while the others in the functional exercise group were merely treated with five-point weight-support exercise.The curative effect were evaluated by using visual analogue score(VAS),Oswestry dability index(ODI)questionnaire,JOA scores for low back pain and short form 36 health survey questionnaire(SF-36).Results:There was statistical difference in VAS scores between different time points,in other words,there was time effect(F=1759.038,P=0.000).In general,there was statistical difference in VAS scores between the 2 groups,in other words,there was grouping effect(F=11.431,P=0.001).There was no statistical difference in VAS scores between the 2 groups before the treatment and at the 14th day after the beginning of the treatment(t=0.590,P=0.557; t=-1.676,P=0.096).The VAS scores were lower in combination treatment group compared to functional exercise group at the 7th and 21th day after the beginning of the treatment(t=-3.913,P=0.000; t=-8.822,P=0.000).There was interaction between time factor and grouping factor (F=26.623,P=0.000).There was statistical difference in ODI scores between different time points,in other words,there was time effect(F=634.277,P=0.000).In general,there was statistical difference in ODI scores between the 2 groups,in other words,there was grouping effect(F=4.067,P=0.046).The ODI scores were lower in combination treatment group compared to functional exercise group at the 7th,14th and 21th day after the beginning of the treatment(t=0.455,P=0.650; t=-2.044,P=0.043; t=-2.224,P=0.028; t=-5.658,P=0.000).There was interaction between time factor and grouping factor(F=9.217,P=0.000).There was statistical difference in JOA scores between different time points,in other words,there was time effect(F=1054.688,P=0.000).In general,there was statistical difference in JOA scores between the 2 groups,in other words,there was grouping effect (F=173.613,P=0.000).The JOA scores were higher in combination treatment group compared to functional exercise group at the 7th,14th and 21th day after the beginning of the treatment(t=-0.149,P=0.882; t=5.944,P=0.000; t=12.636,P=0.000; t=9.774,P=0.000).There was interaction between time factor and grouping factor (F=30.428,P=0.000).There was no statistical difference in SF-36 scores between the 2 groups before the treatment(58.277+/-10.552 vs 58.857+/-8.640 points,t=-0.344,P=0.732).The SF-36 scores increased at 21th day after the beginning of the treatment in both of the groups(t=-10.030,P=0.000; t=-10.492,P=0.000).There was no statistical difference in SF-36 scores between the 2 groups at 21th day after the beginning of the treatment (64.582+/-11.162 vs 62.452+/-8.935 points,t=-1.203,P=0.310).Conclusion:The combination therapy of oral application of Yiqi Huayu Tang and functional exercise can obviously promote the recovery of neural function and relieve postoperative residual lumbocrural pain after lumbar vertebrae surgery,meanwhile,patient's health and quality of life can be greatly improved.

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备注/Memo

备注/Memo:
2014-11-20收稿 2015-01-22修回
基金项目:上海市教委预算内课题项目(736)
通讯作者:莫文 E-mail:mw2218@126.com
更新日期/Last Update: 2015-06-30