加味益气丸联合针刺夹脊穴对脊髓型颈椎病术后残留症状的影响
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摘要
目的观察河南省洛阳正骨医院内部制剂加味益气丸联合针刺夹脊穴治疗对脊髓型颈椎病颈前路减压椎间植骨融合术后残留症状的影响。方法将77例脊髓型颈椎病患者根据治疗方法分为治疗组(常规手术+口服加味益气丸、针刺夹脊穴)和对照组(常规手术+甲钴胺分散片),14 d为1个疗程,共计治疗2个疗程。经过4~6个月的随访,对所有患者术前、术后1d、1个月、3个月进行颈椎JOA评分并比较分析。结果术后1个月,两组比较无明显差异(P>0.05);术后3个月,治疗组患者JOA评分优于对照组,差异有统计学意义(P<0.05);术后3个月,治疗组有效率95.56%,对照组有效率81.25%(P<0.05)。结论加味益气丸联合针刺夹脊穴可能通过改善局部血液循环、抑制神经元脱髓鞘改变等途径来改善脊髓型颈椎病术后残留症状。
Objective To observe the effects of Luoyang Orthopedic Hospital internal preparation Jiawei Yiqi Wan combined with acupuncture Jiaji points for the treatment of symptoms of residual bone graft fusion for cervical spondylotic myelopathy after anterior cervical discectomy. Methods According to treatment methods, 77 cases of patients with cervical spondylotic myelopathy were divided into treatment group(routine surgery + oral Jiawei Yiqi Wan, acupuncture Jiaji point) and control group(routine operation + Methylcobalamin Dispersible Tablets), 14 days is 1 course of treatment, a total of 2 courses of treatment. After 4~6 months of follow-up, to compare and analyse the JOA scores of all the patients preoperative and 1 d, 1 month and 3 months 14 days after operation. Results 1 month after surgery, two groups had no significant difference(P > 0.05); 3 months after surgery, the patients in the treatment group JOA score is higher than the control group, the difference was statistically significant(P < 0.05); The effective rate of treatment group is 95.56%, the effective rate of the control group is 81.25%, the difference was statistically significant(P < 0.05). Conclusion Jiawei Yiqi Wan combined with acupuncture Jiaji points can improve the residual symptoms in cervical spondylotic myelopathy postoperative by improving the local blood circulation, residual inhibition of neuronal demyelination and other ways.
Objective To observe the effects of Luoyang Orthopedic Hospital internal preparation Jiawei Yiqi Wan combined with acupuncture Jiaji points for the treatment of symptoms of residual bone graft fusion for cervical spondylotic myelopathy after anterior cervical discectomy. Methods According to treatment methods, 77 cases of patients with cervical spondylotic myelopathy were divided into treatment group(routine surgery + oral Jiawei Yiqi Wan, acupuncture Jiaji point) and control group(routine operation + Methylcobalamin Dispersible Tablets), 14 days is 1 course of treatment, a total of 2 courses of treatment. After 4~6 months of follow-up, to compare and analyse the JOA scores of all the patients preoperative and 1 d, 1 month and 3 months 14 days after operation. Results 1 month after surgery, two groups had no significant difference(P > 0.05); 3 months after surgery, the patients in the treatment group JOA score is higher than the control group, the difference was statistically significant(P < 0.05); The effective rate of treatment group is 95.56%, the effective rate of the control group is 81.25%, the difference was statistically significant(P < 0.05). Conclusion Jiawei Yiqi Wan combined with acupuncture Jiaji points can improve the residual symptoms in cervical spondylotic myelopathy postoperative by improving the local blood circulation, residual inhibition of neuronal demyelination and other ways.
引文
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[7]李金洪,孙红振,胡波,等.脊髓型颈椎病术后功能恢复的评估预测分析[J].医学综述,2015,21(2):367-369.
[8]Chang V,Holly L T.Controversies in the management of cervical spondylotic myelopathy[J].Journal of Neurosurgical Sciences,2013,57(3):241-252.
[9]陈科,陈仲,靳安民,等.比较4种方案治疗脊髓型颈椎病效果的系统性评价[J].中国组织工程研究与临床康复,2011,15(48):9059-9063.
[10]高军伟,周临东.中医药治疗脊髓型颈椎病临床研究[J].吉林中医药,2013,33(3):239-240.
[11]吴杨鹏,范筱,张俐.张俐教授运用活血通督汤治疗脊髓型颈椎病的经验介绍[J].中国中医骨伤科杂志,2016,24(8):68-70.
[12]安光辉,赵毅,孙鹏.夹脊穴治疗颈椎病的理论与应用[J].中国临床康复,2006,10(31):129-131.
[13]杜天信,王秀真,杜志谦,等.加味益气丸定性鉴别与含量测定[J].中国实验方剂学杂志,2013,19(5):129-131.
[14]常世卿,王苏静,郭维淮.加味益气丸对小鼠免疫功能的影响[J].中医正骨,2002,14(9):16-16.
[15]贾英杰.论重剂黄芪在恶性肿瘤治疗中的运用[J].中国中医基础医学杂志,2016,23(2):70-72.
[16]赵树军,范里,王博学,等.壮骨益髓颗粒治疗脊髓型颈椎病[J].长春中医药大学学报,2015,31(1):143-145.
[17]张竞亮,夏建龙.益气活血方对脊髓型颈椎病患者术后脊髓功能的影响[J].安徽中医药大学学报,2014,33(3):56-58.
[18]陈凯,张俐.丹参及其制剂对脊髓损伤的保护作用及机制研究概况[J].中华中医药杂志,2012,27(11):2887-2890.
[19]史良铭.电针夹脊穴结合康复治疗治疗腰椎间盘突出症的临床研究[D].广州:广州中医药大学,2013.
[2]杨龙,姚敏,孙悦礼,等.脊髓型颈椎病的循证治疗研究现状[J].世界中医药,2015,10(11):1796-1801.
[3]孙宇,陈琪福.第二届颈推病专题座谈会纪要[J].中华外科杂志,1993,31(8):472.
[4]周非非,孙宇,党耕町.颈椎病外科治疗效果评价方法的进展[J].中国脊柱脊髓杂志,2008,18(1):70-73.
[5]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:349.
[6]李俊杰,梁舒涵,彭奇,等.补阳还五汤治疗脊髓型颈椎病颈前路减压椎间植骨融合内固定术后残留症状的疗效观察[J].中医药导报,2015,21(20):60-62.
[7]李金洪,孙红振,胡波,等.脊髓型颈椎病术后功能恢复的评估预测分析[J].医学综述,2015,21(2):367-369.
[8]Chang V,Holly L T.Controversies in the management of cervical spondylotic myelopathy[J].Journal of Neurosurgical Sciences,2013,57(3):241-252.
[9]陈科,陈仲,靳安民,等.比较4种方案治疗脊髓型颈椎病效果的系统性评价[J].中国组织工程研究与临床康复,2011,15(48):9059-9063.
[10]高军伟,周临东.中医药治疗脊髓型颈椎病临床研究[J].吉林中医药,2013,33(3):239-240.
[11]吴杨鹏,范筱,张俐.张俐教授运用活血通督汤治疗脊髓型颈椎病的经验介绍[J].中国中医骨伤科杂志,2016,24(8):68-70.
[12]安光辉,赵毅,孙鹏.夹脊穴治疗颈椎病的理论与应用[J].中国临床康复,2006,10(31):129-131.
[13]杜天信,王秀真,杜志谦,等.加味益气丸定性鉴别与含量测定[J].中国实验方剂学杂志,2013,19(5):129-131.
[14]常世卿,王苏静,郭维淮.加味益气丸对小鼠免疫功能的影响[J].中医正骨,2002,14(9):16-16.
[15]贾英杰.论重剂黄芪在恶性肿瘤治疗中的运用[J].中国中医基础医学杂志,2016,23(2):70-72.
[16]赵树军,范里,王博学,等.壮骨益髓颗粒治疗脊髓型颈椎病[J].长春中医药大学学报,2015,31(1):143-145.
[17]张竞亮,夏建龙.益气活血方对脊髓型颈椎病患者术后脊髓功能的影响[J].安徽中医药大学学报,2014,33(3):56-58.
[18]陈凯,张俐.丹参及其制剂对脊髓损伤的保护作用及机制研究概况[J].中华中医药杂志,2012,27(11):2887-2890.
[19]史良铭.电针夹脊穴结合康复治疗治疗腰椎间盘突出症的临床研究[D].广州:广州中医药大学,2013.