摘要
目的探讨自锁式颈前路减压融合术(Anterior cervical decompression and fusion,ACDF)结合中药治疗脊髓型颈椎病(Cervical spondylotic myelopathy,CSM)对颈椎生理功能恢复的影响。方法选取2018年1月—2020年1月期间惠州市中医医院收治的96例CSM患者为研究对象,按随机数字表法分为对照组和治疗组,每组各48例。对照组单纯自锁式颈前路减压融合术治疗,治疗组自锁式颈前路减压融合术联合补阳还五汤治疗。观察比较两组患者术前及术后3 d、3个月、6个月神经功能恢复情况[视觉模拟疼痛量表(Visual analogue scale,VAS)评分、日本骨科学会颈髓功能(Japanese orthopedics aassociation scores,JOA)评分]、生理功能恢复情况(融合节段Cobb角、椎间隙高度、颈椎整体曲度)、综合疗效(Odom评级法)、术前及术后6个月的生活质量评分(SF-36健康调查量表评分)。结果两组患者术后3个月VAS评分较术后3 d减少,JOA评分较术后3 d增加,差异有统计学意义(P<0.05);且治疗组VAS评分较对照组减少,JOA评分较对照组增加,差异有统计学意义(P<0.05)。两组患者术后6个月VAS评分较术后3个月减少,JOA评分较术后3个月增加,差异有统计学意义(P<0.05);且治疗组VAS评分较对照组减少,JOA评分较对照组增加,差异有统计学意义(P<0.05)。两组患者术后3 d、术后3个月、术后6个月融合节段Cobb角、椎间隙高度、颈椎整体曲度均高于术前,差异有统计学意义(P<0.05);治疗组术后3 d、术后3个月、术后6个月融合节段Cobb角、椎间隙高度、颈椎整体曲度与对照组比较,差异均无统计学意义(P>0.05)。术后治疗组总优良率95.83(46/48)高于对照组81.25(39/48),差异有统计学意义(P<0.05)。术后6个月两组患者SF-36量表生理、心理评分均高于术前,差异有统计学意义(P<0.05);且治疗组上述评分均高于对照组,差异有统计学意义(P<0.05)。结论自锁式ACDF结合中药治疗CSM效果良好,能有�
Objective To investigate the effect of self-locking anterior cervical decompression and fusion(ACDF)combined with Chinese medicine on cervical physiological function in the treatment of cervical spondylotic myelopathy(CSM).Methods A total of 96 patients with CSM who were admitted to Huizhou Hospital of Traditional Chinese Medicine from January 2018 to January 2020 were selected.With the random number table method,they were randomized into the control group(48 cases,self-locking ACDF)and the treatment group(48 cases,self-locking ACDF+Buyang Huanwu Decoction).The neurological function[Visual Analogue Scale(VAS)score,Japanese Orthopedic Association(JOA)Scale score],physiological function(Cobb angle of fusion segment,intervertebral space height,overall cervicalcurvature),before operation and 3 days,3 months,and 6 months after operation,comprehensive curative effect(Odom criteria),and quality of life before operation and 6 months after operation[Short Form 36(SF-36)survey score)]were compared between the two groups.Results Three months after operation,the VAS score was lower and JOA Scale score was higher than those 3 days after operation for both groups(P<0.05)and in the treatment than in the control group(P<0.05).Six months after the operation,theVAS score was lower and JOA Scale score was higher than those 3 months after operation for both groups(P<0.05),and in the treatment group than in the control group(P<0.05).The Cobb angle,intervertebral space height,and overall cervical curvature 3 days,3 months,and 6 months after operation were higher than those before operation in both groups(P<0.05),and the difference between the two groups in the above indexes was insignificant between the two groups 3 days,3 months,and 6 months after operation(P>0.05).The total excellentratewas 95.83%(46/48)in the treatment group after operation,as compared with the 81.25%(39/48)in the control group(P<0.05).Six months after the operation,the physical component score and mental component score inSF-36 were higher than those before treatm
作者
谭志宏
董杰
董达胜
杨济源
TAN Zhi-hong;DONG Jie;DONG Da-sheng;YANG Ji-yuan(Department of Orthopedics,Huizhou Hospital of Traditional Chinese Medicine,Guangdong Province,Huizhou Guangdong 516002)
出处
《世界中西医结合杂志》
2022年第7期1436-1440,共5页
World Journal of Integrated Traditional and Western Medicine
基金
广东省中医药强省科研课题(20151115)。
关键词
脊髓型颈椎病
颈前路减压融合术
补阳还五汤
视觉模拟疼痛量表
日本骨科学会颈髓功能评分量表
Cervical Spondylotic Myelopathy
Anterior Cervical Decompression and Fusion
Buyang Huanwu Decoction
Visual Analogue Scale
Japanese Orthopedics Association Scale for Cervical Myelopathy Evaluation
