Ma Zhi-Jia, Jiang Hong, Yu Peng-Fei, Liu Jin-Tao, Li Xiao-Chun
Suzhou Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Traditional Chinese Medicine, Suzhou 215009, Jiangsu, China.
Suzhou Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Traditional Chinese Medicine, Suzhou 215009, Jiangsu, China;
Zhongguo Gu Shang. 2019 Mar 25;32(3):239-243. doi: 10.3969/j.issn.1003-0034.2019.03.009.
To explore the clinical effect of conservative treatment for giant lumbar intervertebral disc herniation and analyze the factors affecting its resorption.
From January 2013 to December 2016, the clinical data of 130 patients with giant lumbar intervertebral disc herniation were collected. The patients were classified according to the characteristics of Iwabuchi displacement and "bull eye sign", Xiaosui Huahe decoction of traditional Chinese medicine conservative treatment was used in the patients. There were 93 males and 37 females, aged from 15 to 64 years old with an average of(37.11±13.96) years old; with the disease duration ranging from 1 day to 8 years with an average of(11.82±20.45) months. Rate of intervertebral disc herniation was measured by Futian's method, and clinical effect was evaluated by JOA score.
All the patients were followed up from 13 to 48 months with an average of(21.45±11.87) months, and there were no significant differences in follow-up time between different imaging types(>0.05). The absorption rate 95 patients with persistent conservative treatment was(44.08±35.70)%. The absorption rate of Iwabuchi displacement positive group and "bull eye sign" positive group was significantly higher than the average value(<0.05). The rate of excellent and good JOA scores in 95 patients was 78.95%, 81.05% and 78.95% at 3, 6 and 12 months after treatment, respectively(<0.05). Finally 35 patients accepted surgical treatment, the rate of excellent and good JOA scores was 100% at 3, 6, 12 months after treatment(<0.05).
The clinical effect of Xiaosui Huahe decoction conservative treatment is satisfactory for giant lumbar intervertebral disc herniation. Patients with Iwabuchi displacement and "bull's eye sign" had significant herniation resorption.
探讨巨大腰椎间盘突出症保守治疗的临床效果，并分析影响其吸收的因素。
收集2013年1月至2016年12月期间130例巨大腰椎间盘突出症患者的临床资料。根据岩渊移位特征及“靶征”对患者进行分类，采用中药消髓化核汤进行保守治疗。其中男性93例，女性37例，年龄15～64岁，平均（37.11±13.96）岁；病程1天至8年，平均（11.82±20.45）个月。采用福田法测量椎间盘突出率，采用JOA评分评估临床疗效。
所有患者随访13～48个月，平均（21.45±11.87）个月，不同影像学类型之间的随访时间差异无统计学意义（>0.05）。95例持续保守治疗患者的吸收 率为（44.08±35.70）%。岩渊移位阳性组和“靶征”阳性组的吸收率显著高于平均值（<0.05）。95例患者治疗后3、6、12个月的JOA评分优良率分别为78.95%、81.05%、78.95%（<0.05）。最后35例患者接受手术治疗，治疗后3、6、12个月的JOA评分优良率均为100%（<0.05）。
消髓化核汤保守治疗巨大腰椎间盘突出症的临床效果满意。岩渊移位及“靶征”阳性的患者椎间盘突出吸收明显。
