摘要
目的探讨黄芪桂枝五物汤辅助前路减压椎间植骨融合术(ACDF)治疗神经根型颈椎病(cervical spondvrlotic radiculopathy,CSR)的临床疗效,并分析其对颈椎功能、血液流变学的影响。方法回顾性选取2021年3月至2023年3月于郑州市金水区总医院接受ACDF治疗的CSR患者106例为研究对象,依据治疗方案分为对照组、研究组,每组各53例。对照组术后予以常规西药治疗,研究组术后予以黄芪桂枝五物汤治疗,连续治疗4周。统计对比两组临床疗效及治疗前后中医证候积分、疼痛程度[视觉模拟量表(VAS)]、Northwick Park颈痛量表(NPQ)、颈椎活动度(CROM)、颈椎病临床评价量表(CASCS)、神经根损伤程度、血液流变学、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)]、氧化应激[总抗氧化能力(T-AOC)、丙二醛(MDA)、氧化型谷胱甘肽(GSSG)]各指标水平。比较两组治疗期间不良反应发生率。结果与对照组83.02%比较,研究组总有效率96.23%较高(P<0.05);与对照组比较,研究组治疗后中医证候积分、上肢VAS评分、颈肩VAS评分、NPQ评分降低,CROM、CASCS评分升高(P<0.05),C5、C6、C7、C8神经根损伤评分升高(P<0.05),血浆黏度、全血高切黏度、全血低切黏度降低(P<0.05),血清TNF-α、IL-1β、IL-6水平降低(P<0.05),血清T-AOC水平升高,MDA、GSSG水平降低(P<0.05);两组不良反应比较差异无统计学意义(P>0.05)。结论黄芪桂枝五物汤辅助ACDF治疗CSR的疗效确切,可缓解疼痛,改善颈椎功能,提高生活质量,降低血液黏度,减轻神经根损伤程度,抑制炎症-氧化应激反应,且具有一定安全性。
Objective To investigate the clinical efficacy of Huangqi Guizhi Wuwu Decoction assisted anterior cervical discectomy and fusion(ACDF)in the treatment of cervical spondvrlotic radiculopathy(CSR),and analyze the effects on cervical vertebra function and hemorheology.Methods A total of 106 CSR patients who received ACDF treatment in Jinshui District General Hospital of Zhengzhou City from March 2021 to March 2023 were retrospectively selected as the study objects,and were divided into control group and study group according to the treatment plans,with 53 cases in each group.The control group was treated with conventional western medicine after operation,and the study group was treated with Huangqi Guizhi Wuwu Decoction after operation,for continuous 4 weeks.Clinical efficacy and the index levels of TCM syndrome score,pain degree(visual analogue scale[VAS]),Northwick Park neck pain questionnaire(NPQ),cervical range of motion(CROM),clinical assessment scale for cervical spondylosis(CASCS),degree of nerve root injury,hemorheology,inflammatory factors(tumor necrosis factor-α[TNF-α],interleukin-1β[IL-1β],and interleukin-6[IL-6]),oxidative stress(T-AOC,MDA,and GSSG)before and after treatment were statistically compared between the two groups.The incidence of adverse reactions during treatment was compared between the two groups.Results The total effective rate of the study group was 96.23%higher than that of the control group 83.02%(P<0.05).Compared with the control group,the TCM syndrome score,upper limb VAS score,neck and shoulder VAS score and NPQ score of the study group were decreased after treatment,while the CROM and CASCS scores were increased(P<0.05),and the nerve root injury scores of C5,C6,C7 and C8 were increased(P<0.05).Plasma viscosity,whole blood high shear viscosity and whole blood low shear viscosity were decreased(P<0.05),serum TNF-α,IL-1βand IL-6 levels were decreased(P<0.05),serum T-AOC level was increased,MDA and GSSG levels were decreased(P<0.05).There was no difference of statistical signific
作者
朱茂荣
李瑞国
武西芳
ZHU Mao-rong;LI Rui-guo;WU Xi-fang
出处
《中国疗养医学》
2024年第8期54-59,共6页
Chinese Journal of Convalescent Medicine
关键词
神经根型颈椎病
前路减压椎间植骨融合术
黄芪桂枝五物汤
疗效
颈椎功能
Cervical spondvrlotic radiculopath
Anterior cervical discectomy and fusion
Huangqi Guizhi Wuwu Decoction
Efficacy
Cervical vertebra function
