[摘要] 目的 探討“腰痛三號(hào)方”聯(lián)合經(jīng)皮椎間孔鏡（PTED）治療椎間盤源性腰痛的臨床效果。 方法 選擇2013年1月～2016年7月在本院收治的46例椎間盤源性腰痛患者，隨機(jī)分為對(duì)照組和治療組，每組23例；對(duì)照組予以單純PTED手術(shù)治療，術(shù)后常規(guī)對(duì)癥治療；治療組在同期進(jìn)行的PTED治療基礎(chǔ)上，予口服“腰痛三號(hào)方”，每日1 劑，分早晚2 次口服，1周為1個(gè)療程，共4個(gè)療程。于術(shù)前、術(shù)后1、6個(gè)月行疼痛視覺模擬評(píng)分（visual analogue scale， VAS） 和oswestry功能障礙指數(shù) （oswestry disablilty index，ODI）對(duì)比分析兩種方法治療椎間盤源性腰痛的臨床療效以及腰背部功能的改善情況，末次訪時(shí)按改良Macnab 標(biāo)準(zhǔn)評(píng)價(jià)臨床療效。 結(jié)果 治療前兩組患者VAS、ODI 評(píng)分差異無統(tǒng)計(jì)學(xué)意義（P>0.05），術(shù)后1個(gè)月、6個(gè)月隨訪時(shí)“腰痛三號(hào)方”聯(lián)合PTED治療后的VAS、ODI 評(píng)分平均值均明顯低于對(duì)照組，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）；且愈顯率和總有效率分別為73.9% 和 95.6%，均明顯高于對(duì)照組（P<0.05）。全部患者未見不良反應(yīng)。 結(jié)論 應(yīng)用“腰痛三號(hào)方”聯(lián)合PTED治療椎間盤源性腰痛患者，在緩解疼痛及改善生活質(zhì)量等方面療效顯著，有助于提高治療的有效性及安全性，值得在臨床上推廣應(yīng)用。
　　[關(guān)鍵詞] 腰痛三號(hào)方；經(jīng)皮椎間孔鏡；椎間盤源性腰痛
　　[中圖分類號(hào)] R687.3；R2 [文獻(xiàn)標(biāo)識(shí)碼] B [文章編號(hào)] 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.

相關(guān)熱詞搜索：腰痛 椎間盤 臨床 觀察 治療