Lee Jinho, Kim Joowon, Shin Joon-Shik, Lee Yoon Jae, Kim Me-Riong, Jeong Seon-Yeong, Choi Young-Jun, Yoon Tae Kyung, Moon Byung-Heon, Yoo Su-Bin, Hong Jungsoo, Ha In-Hyuk
Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea.
Evid Based Complement Alternat Med. 2017;2017:2147408. doi: 10.1155/2017/2147408. Epub 2017 Jul 9.
The long-term course to lumbar intervertebral disc herniation (LDH) patients receiving integrative Korean medicine treatment and predictive factors associated with disc resorption were investigated. LDH patients who received integrative Korean medicine treatment from February 2012 to December 2015 and were registered in the "longitudinal project for LDH on MRI" were included. Disc resorption amount was measured 3-dimensionally with disc degeneration and modic change levels on baseline and follow-up MRIs. Patient characteristics, Korean medicine use, pain, symptom recurrence, and satisfaction were assessed through medical records and phone surveys. Of 505 participants, 19 did not show disc resorption, while 486 did. A total of 220 displayed resorption rates of ≥50%. LDH volume at baseline was 1399.82 ± 594.96 mm, and that on follow-up MRI was 734.37 ± 303.33 mm, indicating a 47.5% decrease ( < 0.0001). Predictive factors for disc resorption were disc extrusion, Komori migration classification, and LDH amount. Approximately 68.4% did not experience symptom recurrence over the 51.86 ± 19.07-month follow-up, and 90.3% were satisfied with Korean medicine treatment. The majority of LDH patients who improved after integrative Korean medicine treatment showed disc resorption within 1 year with favorable long-term outcomes. Predictive factors for disc resorption should be duly considered for informed decision-making. This trial is registered with ClinicalTrials.gov NCT02841163.
对接受韩医综合治疗的腰椎间盘突出症（LDH）患者的长期病程及与椎间盘吸收相关的预测因素进行了研究。纳入了2012年2月至2015年12月接受韩医综合治疗并登记在“LDH的MRI纵向项目”中的LDH患者。通过基线和随访MRI上的椎间盘退变和Modic改变水平三维测量椎间盘吸收量。通过病历和电话调查评估患者特征、韩医使用情况、疼痛、症状复发和满意度。505名参与者中，19人未显示椎间盘吸收，486人显示有吸收。共有220人显示吸收率≥50%。基线时LDH体积为1399.82±594.96mm，随访MRI时为734.37±303.33mm，下降了47.5%（<0.0001）。椎间盘吸收的预测因素为椎间盘突出、小森移位分类和LDH量。在51.86±19.07个月的随访中，约68.4%的患者未出现症状复发，90.3%的患者对韩医治疗满意。大多数接受韩医综合治疗后病情改善的LDH患者在1年内出现椎间盘吸收，长期预后良好。在做出明智决策时应适当考虑椎间盘吸收的预测因素。本试验已在ClinicalTrials.gov注册，注册号为NCT02841163。
