westry doi: /wst R681.5 A Lumber intervertebral Disc Herniation LDH [1]

Transcription

1 绎 VAS JOA Os 原 westry 淤 于 4 2 VAS ODI JOA P<0.052 ODI JOA VAS P<0.05 盂 12 2 VAS ODI JOA 2 2 榆 doi: /wst R681.5 A Lumber intervertebral Disc Herniation LDH [1] % 耀 30% 45 耀 65 [2] 元 2011ZX JDZX DZ PWZL 元元 1074

2 2013 绎 Vol.15 No % 耀 13.6% 10% 耀 15% [3] ~ [4] 1.2 淤 16~65 于 约芋 ~ ~122 [5] ~61 62~ ml J mg 1 2 ( H 滋 g 淤 12 VAS Japanese Orthopaedic Association JOA Oswestry Oswestry Dis 原 ability Index ODI 于 [4]

3 绎 1.6 SPSS 16.0 x 依 s t t 字 2 Ridit P< VAS JOA ODI VAS 4 VAS 12 2 VAS JOA JOA ODI ODI Full Analysis Set FAS 72.1% 70.5% % 36.1% Proba 原 bility Proportionate to Size Sampling PPS

4 2013 绎 Vol.15 No.5 1 n=61 n=61 P / 31/30 35/ 依 依 / cm 依 依 / kg 依 依 / 依 依 VAS 6.59 依 依 JOA 依 依 ODI 依 依 依 2 2 VAS 4 12 d d 6.59 依 依 依 依 依 依 依 0.97 姻 1.87 依 依 依 0.82 姻 P< JOA 4 12 d d 依 依 依 依 依 依 依 依 依 依 ODI 4 12 d d 依 依 依 依 依 依 依 依 依 依

5 绎 5 n P FAS 61 6(9.8) 20(32.8) 18(29.5) 17(27.9) 61 5(8.2) 17(27.9) 21(34.4) 18(29.5) PPS 53 6(11.3) 20(37.7) 18(34.0) 9(17.0) 52 5(9.6) 17(32.7) 21(40.4) 9(17.3) % % 2 49 % % VAS JOA ODI [6] [7~10] [11, 12] 1,,,..:, 2004 颐 1507~ Deyo R A, Mirza S K, Martin B I. Back pain prevalence and visitrates : estimates from US national surveys. Spine, 2006, 31 ( 23 ) 颐 2724~

6 2013 绎 Vol.15 No.5 3,..,2002,6(14) 颐 2034~ :,1994 颐 :.2002 颐 832~833 援 6 Chou R, Qaseem A, Snow V, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med, 2007, 147(7) 颐 478~91 7 Bronfort G, Maiers M J, Evans R L, et al. Supervised exercise, spinal manip ulation, and home exercise for chronic low back pain: a randomized clinical trial. Spine J, 2011, 11(7) 颐 585~ Bishop F L, Zaman S, Lewith G T. Acupuncture for low back pain: A survey of clinical practice in the UK. Complement Ther Med, 2011, 19(3) 颐 144~ Hall A M, Maher C G, Lam P, et al. Tai Chi Exercise for Treatment of Pain and Disability in People With Persistent Low Back Pain: A Randomized Controlled Trial. Arthritis Care Res, 2011, 63(11) 颐 1576~ van Tulder M W, Furlan A D, Gagnier J J. Complementary and alternative therapies for low back pain. Best Pract Res Clin Rheumatol, 2005, 19(4) 颐 639~ Peul W C, Brand R, Thomeer R T, et al. Influence of gender and other prognostic factors on outcome of sciatica. Pain, 2008, 138(1) 颐 180~ Jensen O K, Nielsen C V, Stengaard -Pedersen K. One -year prognosis in sick -listed low back pain patients with and without radiculopathy. Prognostic factors influencing pain and disability. Spine J, 2010, 10(8) 颐 659~675. A Randomized Controlled Trial on Qi-tonifying, Stasis-resolving and Kidney-tonifying Treatment of Lumbar Disc Herniation Xu Jinhai 1,WangJing 2,YeJie 1, 3, Ma Junming 1,WuXuequn 1,MoWen 1, 3, 4 1, 3, 4, Shi Qi (1. Department of Orthopedics and Traumatology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai , China; 2. Clinical Evaluation Center, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai , China; 3. Famous TCM Doctor's Studio of Shi Qi, Shanghai University of Traditional Chinese Medicine, Shanghai , China; 4. Institute of Spine Disease, Shanghai University of Traditional Chinese Medicine, Shanghai , China) Abstract: This study was aimed to evaluate the clinical effect and safety of Chinese medicine treatment of lumbar disc herniation with qi -tonifying, stasis -resolving and kidney -tonifying method. The randomized con 鄄 trolled trial ( RCT) was applied in the study to evaluate the clinical effect of qi- tonifying, stasis- resolving and kidney-tonifying method in the treatment of lumbar disc herniation. A total of 122 lumbar disc herniation pa 鄄 tients were randomly divided into the treatment group (n = 61) and the control group (n = 61). Chinese medicine treatment with the qi -tonifying, stasis -resolving and kidney -tonifying method was applied in the treatment group. And Celecoxib and Methycobal were orally administered in the control group. Then, the VAS scores, JOA scores, Oswestry disability index (ODI) were recorded and analyzed pre-treatment, four weeks af 鄄 ter treatment and the twelfth week of follow- up in order to evaluate the clinical effect. Adverse reactions were also observed and recorded at the same time to give a comprehensive evaluation on its safety. The results showed that there were no significant differences between the treatment group and control group in the baseline data before treatment. Hence, data from two groups were comparable. Compared with pre -treatment, the VAS scores and ODI scores were obviously reduced in both groups after four-week treatment. The JOA scores were increased obviously ( P < 0. 05). There were no statistical differences on ODI scores and JOA scores between two groups. The VAS scores of the treatment group were obviously higher than the control group ( P < 0.05). In the twelfth week of follow -up, the VAS scores, ODI scores and JOA scores had increasing tendency in 1079

7 绎 both groups. There were no statistical differences between two groups. There were no statistical differences on the total effective rate between two groups. In the treatment group, four patients received surgery, four cases lost to follow - up, and four cases with mild adverse event. In the control group, six patients received surgery, three cases lost to follow-up, and two cases with mild adverse event. It was concluded that the RCT of Chi 鄄 nese medicine treatment of lumbar disc herniation with qi - tonifying, stasis - resolving and kidney - tonifying method received same clinical effect as the combination of Celecoxib and Methycobal. The Chinese medicine treatment can effectively relieve pain degree of lumbar disc herniation, improve function of the lumbar vertebrae and improve the daily life and social activity ability of patients. The short -term follow -up effects were con 鄄 firmed. However, the long- term efficacy still requires further study. Keywords: Lumbar disc herniation, stasis -resolving and kidney -tonifying method, randomized controlled trial, clinical effect 1080