摘要
目的:观察中药及针灸辨证施治联合手术治疗胸腰椎骨折伴脊髓损伤的临床疗效。方法:选择2014年7月至2016年12月收治的胸腰椎骨折合并脊髓损伤的患者88例,其中对照组43例行椎管减压融合内固定术联合高压氧治疗,观察组45例在对照组基础上分期辨证口服中药联合针灸治疗。分别于术前、术后3个月及6个月,从改良Barthel指数(MBI)、美国脊髓损伤协会(ASIA)分级及并发症发生率对疗效进行评价。结果:两组术后3个月及6个月的MBI评分均高于术前(P<0.05,P<0.01),表明两组治疗方案均可提高患者日常生活能力;但术后观察组MBI评分高于同期对照组(P<0.01),表明观察组患者日常生活能力更好。术后6个月时观察组ASIA分级改善率高于对照组(P<0.05),且腹胀、便秘等并发症的发生率低于对照组(P<0.01)。结论:手术联合高压氧可有效治疗胸腰椎骨折伴脊髓损伤,配合中药及针灸分期辨证施治可提高临床疗效。
Objective: To observe the efficacy of acupuncture combined with Chinese materia medica and surgery on treatment of thoracolumbar fracture with spinal cord injury. Methods: Eighty-eight thoracolumbar fracture patients with spinal cord injury were selected from July 2014 to December 2016. In the control group, 43 patients received the treatment of decompression and internal fixation combined with hyperbaric oxygen therapy, and 45 patients in the observation group were treated with combination therapy of Chinese materia medica and acupuncture based on syndrome differentiation on the basis of the control treatment. The efficacy at preoperative, postoperative 3 months and 6 months were evaluated by improved Barthel index(MBI),the American spinal injury association(ASIA) grade and incidence of complications respectively. Results: MBI scores were higher in both groups at postoperative 3 months and 6 months than preoperative(P<0.05, P<0.01), it showed that treatments in both groups were able to improve daily life ability of patients. However, MBI scores in the observation group were higher than those in the control group(P<0.01), it showed that patients in the observation group had better daily life ability. The improvement rate of ASIA grade in the observation group was higher than that in the control group(P<0.05), and the incidence of complications, such as bloating and constipation, was lower than that in the control group(P<0.01). Conclusion: Surgery combined with hyperbaric oxygen is an effective therapy for thoracolumbar fracture with spinal cord injury, and it can improve the clinical efficacy when combined with acupuncture and Chinese materia medica based on syndrome differentiation.
作者
程建
刘明明
郭杨
王磊
马勇
黄桂成
牛瑞敏
蔡建平
CHENG Jian;LIU Ming-ming;GUO Yang;WANG Lei;MA Yong;HUANG Gui-cheng;NIU Rui-min;CAI Jian-ping(Department of Orthopedics,The Affiliated Xuzhou Central Hospital of Nanjing University of Chinese Medicine,Xuzhou 221000,China;Graduate School of Nanjing University of Chinese Medicine,Nanjing 210029,China;Department of Orthopedics,Xuzhou City Hospital of TCM,Xuzhou 221000,China)
出处
《中华中医药杂志》
CAS
CSCD
北大核心
2019年第3期1274-1277,共4页
China Journal of Traditional Chinese Medicine and Pharmacy
基金
江苏省中西医结合老年病防治重点实验室开放课题(No.2015LNB007)
徐州市科技局应用基础研究计划(No.KC17107)~~
关键词
脊柱骨折
脊髓损伤
手术治疗
中药
针灸
辨证施治
Spinal fracture
Spinal cord injury
Surgical treatment
Chinese materia medica
Acupuncture
Treatment based on syndrome differentiation
