| 李长明,邓小梅,楼宇梁,方燕芬,胡丽娟,全仁夫.活血方定向透药联合早期康复训练治疗斜外侧腰椎间融合术术后残留腰腿痛的疗效观察[J].浙江中西医结合杂志,2024,34(7): |
| 活血方定向透药联合早期康复训练治疗斜外侧腰椎间融合术术后残留腰腿痛的疗效观察 |
| Clinical efficacy of directional penetration of traditional Chinese medicine of Huoxue Fang combined with early rehabilitation training on residual low back pain after oblique lateral lumbar interbody fusion surgery |
| 投稿时间：2023-12-05 修订日期：2024-06-06 |
| DOI： |
| 中文关键词: 外治法 中医定向透药 斜外侧腰椎融合术 脊柱术后 残留腰腿痛 |
| 英文关键词:External treatment method directional penetration of traditional Chinese medicine Oblique lateral lumbar fusion surgery After spinal surgery Residual low back and leg pain |
| 基金项目:杭州市卫生科技计划项目(0020191135) |
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| 中文摘要: |
| 目的：探讨OLIF术后残留腰腿痛应用活血方定向透药联合早期康复训练治疗的效果。方法：选取2020年09月-2022年12月我院收治的退行性脊柱疾病行OLIF术后残留腰痛患者62例，并依据治疗方法不同分为2组。对照组采用早期康复训练联合应用塞来昔布胶囊+乙哌立松片治疗，研究组在对照组基础上联合活血方定向透药治疗。比较2组治疗后临床疗效：包括VAS评分、中医证候评分、ODI评分；分析实验室指标：包括CK、IL-1、IL-6值；观察影像学资料：包括左侧腰大肌CSA；并统计总体疗效。结果：治疗后研究组VAS评分、中医证候评分、ODI评分分别为(0.90±0.54)、(7.45±1.96)、(8.16±2.27) 分，均低于对照组(1.35±0.61)、(14.06±1.82) 、(9.97±1.83)分(P均＜ 0.05)。治疗后研究组生活质量（躯体功能、社会功能、角色功能及物质生活状态）评分分别为(72.32±3.34) 、(81.39±4.10) 、(83.97±3.45) 、(83.03±3.33)分，均高于对照组(63.42±3.89) 、(74.13±2.79) 、(73.68±3.44) 、(73.77±3.95)分(P均＜0.05)；治疗后研究组CK、IL-1、IL-6值分别为(186.26±10.26) 、(1.01±0.16) 、(4.83±0.22) ，均低于对照组(204.65±15.25) 、(1.49±0.18) 、(5.98±0.18) (P均＜0.05)；研究组治疗后腰大肌CSA为（784.89±19.02）mm2明显低于对照组（801.38±13.26）mm2(P＜0.05)；研究组治疗有效率96.78% 高于对照组74.19%(?2 = 6.639，P＜0.05)；结论：与对照组比较，应用活血方定向透药联合早期康复训练治疗OLIF术后残留腰腿痛疗效确切，能有效发挥中医定向透药的药物穿透优势，不仅可有效缓解患者疼痛症状，又可改善患者肌肉炎性水肿，提高腰椎功能，改善生活质量，值得临床推广。 |
| 英文摘要: |
| Objective To investigate the effect of directional penetration of traditional Chinese medicine of Huoxue Fang combined with early rehabilitation training on residual low back pain after oblique lateral lumbar interbody fusion surgery. Methods From September 2020 to December 2022, 62 patients with residual low back pain after OLIF surgery for degenerative spinal diseases were selected and divided into two groups according to different treatment methods. The control group received early rehabilitation training combined with Celecoxib Capsules and Eperisone Tablets. and on the basis of the control group, the research group combined with directional penetration of traditional Chinese medicine of Huoxue Fang. Compare the clinical efficacy of two groups after treatment, including VAS , TCM syndrome score, and ODI ; Analysis laboratory indicators: including CK, IL-1, and IL-6 values; And observation of imaging data: including left psoas major muscle CSA; And calculate the overall efficacy.Results The scores of VAS , TCM syndrome score, and ODI in the research group were [(0.90±0.54),(7.45±1.96),(8.16±2.27)]points,respectively,lower than those in the control group [(1.35±0.61),(14.06±1.82) ,(9.97±1.83)]points ( All P ＜ 0.05). The scores of physical function, social work, role function and physical life status in the research group were [(72.32±3.34),(81.39±4.10),(83.97±3.45) ,(83.03±3.33)]points,respectively,higher than those in the control group [(63.42±3.89),(74.13±2.79) ,(73.68±3.44) ,(73.77±3.95)]points ( All P ＜ 0.05).The scores of CK, IL-1, IL-6 in the research group were [(186.26±10.26),(1.01±0.16),(4.83±0.22)]points, respectively,lower than those in the control group [(204.65±15.25),(1.49±0.18),(5.98±0.18)]points ( All P ＜ 0.05). The CSA of the psoas major muscle in the research group (784.89±19.02) mm2, respectively,lower than those in the control group(801.38 ± 13.26) mm2 (P<0.05). |
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