摘要
目的观察独活寄生汤加减联合椎间孔镜下髓核摘除及射频消融纤维环成形术治疗椎间盘源性腰痛的临床疗效。方法 2015年6月2016年5月共收治经椎间盘造影和MRI检查证实的椎间盘源性腰痛患者33例,其中伴有左下肢疼痛麻木3例和右下肢疼痛麻木4例,术前腰痛VAS评分为6.15±0.96分,均采用独活寄生汤加减联合椎间孔镜下髓核摘除及射频消融纤维环成形术治疗,术后1周、4周、3个月和6个月时进行腰痛VAS评分,术后6个月时进行Mac Nab评分。结果本组所有患者均无神经损伤、椎间隙感染等手术并发症发生。术前伴有左下肢疼痛麻木的3例患者和右下肢疼痛麻木的4例患者术后下肢症状均缓解。随访6个月,术后1周腰痛VAS评分为0.78±0.68分,术后4周VAS评分为0.54±0.63分,术后3个月VAS评分为0.46±0.66分,术后6个月VAS评分为0.53±0.67分,术后各时间点评分较术前均有明显降低(P<0.05),术后3个月和6个月评分较术后1周均无明显反弹(P>0.05)。按照Mac Nab评分标准,6个月随访时优15例,良15例,可3例,总有效率100%,优良率90.91%。结论独活寄生汤加减联合椎间孔镜下髓核摘除及射频消融纤维环成形术是治疗椎间盘源性腰痛的微创有效方法。
Objective To observe the clinical effect of Duhuo Jisheng decoction combined with endoscopic foraminotomy nucleus pul- posus removal and RF ablation annuloplasty surgery in the treatment of discogenic low back pain. Methods From June 2015 to May 2016, 33 cases were treated by discography and MRI confirmed lumbar discogenic low back pain patients, including 3 cases accom- panied with left lower limb pain or numbness and 4 cases with right lower extremity pain numb, preoperative pain VAS was 6.15 ± 0.96 points. They were treated with modified Duhuo Jisheng decoction combined with endoscopic foraminotomy nucleus pulposus re- moval and RF ablation fiber ring plasty. The low back pain VAS score after 1 week, 4weeks, 3 months and 6 months, 6 months after the operation of MacNab score was carried out. Results All patients in this group had no complications such as nerve injury and in- fection of intervertebral space. Patients with left lower extremity pain and numbness in 3 patients and right lower limb pain numbness of the lower limb symptoms were relieved in 4 patients. Following-up for 6 months, 1 week after operation, the VAS score of the low back pain was 0.78 ± 0.68.4 weeks after the operation, the VAS score was 0.54 ±0.63; 3 months after the operation, the VAS score was 0.46 ± 0.66. 6 months after the operation, the VAS score was 0.53 ±0.67. All the time after operation, the VAS score was signif- icantly lower （P〈0.05） . 3months after operation and 6 months after operation, there was no obvious rebound （P〉0.05） when com- paring with 1 week after operation. According to MacNab score standard, 6 cases were excellent, 15 cases were excellent, 15 cases were good, 3 cases were normal, the the total effective rate was 100%, and the excellent rate was 90.91%. Conclusion Duhuo Jisheng decoction combined with foraminal mirror nucleus pulposus extirpation and RF ablation fiber ring plasty in the treatment of intervertebral disc source lumbago is minimally invasive, and has effective method.
出处
《中国中医药现代远程教育》
2017年第5期100-101,共2页
Chinese Medicine Modern Distance Education of China
关键词
独活寄生汤
椎间孔镜
椎间盘源性腰痛
痹证
Duhuo Jisheng decoction
endoscopic foraminotomy
discogen in back pain
bi syndrome
