“腰痛三号方”联合经皮椎间孔镜治疗椎间盘源性腰痛23例临床观察

　　[摘要] 目的 探讨“腰痛三号方”联合经皮椎间孔镜（PTED）治疗椎间盘源性腰痛的临床效果。 方法 选择2013年1月～2016年7月在本院收治的46例椎间盘源性腰痛患者，随机分为对照组和治疗组，每组23例；对照组予以单纯PTED手术治疗，术后常规对症治疗；治疗组在同期进行的PTED治疗基础上，予口服“腰痛三号方”，每日1 剂，分早晚2 次口服，1周为1个疗程，共4个疗程。于术前、术后1、6个月行疼痛视觉模拟评分（visual analogue scale， VAS） 和oswestry功能障碍指数 （oswestry disablilty index，ODI）对比分析两种方法治疗椎间盘源性腰痛的临床疗效以及腰背部功能的改善情况，末次访时按改良Macnab 标准评价临床疗效。 结果 治疗前两组患者VAS、ODI 评分差异无统计学意义（P>0.05），术后1个月、6个月随访时“腰痛三号方”联合PTED治疗后的VAS、ODI 评分平均值均明显低于对照组，差异均有统计学意义（P<0.05）；且愈显率和总有效率分别为73.9% 和 95.6%，均明显高于对照组（P<0.05）。全部患者未见不良反应。 结论 应用“腰痛三号方”联合PTED治疗椎间盘源性腰痛患者，在缓解疼痛及改善生活质量等方面疗效显著，有助于提高治疗的有效性及安全性，值得在临床上推广应用。
　　[关键词] 腰痛三号方；经皮椎间孔镜；椎间盘源性腰痛
　　[中圖分类号] R687.3；R2 [文献标识码] B [文章编号] 1673-9701（2018）08-0086-04
　　Clinical observation on "Yaotong No. 3 Formula" combined with percutaneous transforaminal endoscopy in the treatment of 23 cases of discogenic low back pain
　　XIN Long YU Leijun XU Weixing WANG Jian SONG Hongpu LIU Jian ZHONG Fuhua LIU Hong YANG Yang
　　Department of Spine Surgery， Zhejiang Provincial Tongde Hospital， Hangzhou 310012， China
　　[Abstract] Objective To investigate the clinical effect of "Yaotong No. 3 Formula" combined with percutaneous transforaminal endoscopy （PTED） in the treatment of discogenic low back pain. Methods From January 2013 to July 2016， 46 patients with lumbar discogenic low back pain who were admitted to our hospital were randomly divided into control group and treatment group， with 23 cases in each group. The control group was given PTED alone， and was given conventional symptomatic treatment after surgery； the treatment group was orally given "Yaotong No. 3 Formula" decoction on the basis of PTED during the same period， with one decoction per day， orally administered twice in the morning and evening. A course of treatment was one week， with a total of 4 courses. Visual analogue scale（VAS） and Oswestry disablilty index（ODI） were performed before surgery and 1 month and 6 months after surgery. The clinical efficacy of the two methods in the treatment of discogenic low back pain and the improvement of lumbar and back function， and the clinical efficacy was evaluated at the last visit according to the modified Macnab Standard. Results There was no statistically significant difference in VAS and ODI scores between the two groups before treatment（P>0.05）. The mean VAS and ODI scores after "Yaotong No. 3 Formula" combined with PTED at 1 month and 6 months after surgery were significantly lower than those in the control group， and the differences were statistically significant（P<0.05）； the effective rate and total effective rate were 73.9% and 95.6% respectively， which were significantly higher than those in the control group（P<0.05）. There were no adverse reactions in all cases. Conclusion The application of "Yaotong No. 3 Formula" combined with PTED in the treatment of discogenic low back pain has a significant curative effect in relieving pain and improving quality of life， which helps improve the effectiveness and safety of the treatment， and is worthy of clinical application and promotion.

相关热词搜索：腰痛 椎间盘 临床 观察 治疗