赵光辉 董唐博 廖承友 陈小龙

*基金項目：国家中医药管理局于其华全国名老中医工作室建设项目（国中医药人教函〔2022〕75号）；安徽中医药大学2022年科研基金重点项目（2021LCTH03）

第一作者简介：赵光辉（1981-），男，副主任医师，研究方向：中医药防治脊柱脊髓疾病。

△通信作者：陈小龙，E-mail：274609399@qq.com

摘要：目的  观察地龙舒腰汤对腰椎间盘突出症经皮椎间孔镜术后残留症状的临床疗效，为临床上优化治疗及缓解患者症状提供参考。方法  将诊断为腰椎间盘突出症并行经皮椎间孔镜术，术后残留腰腿部症状的患者60例，按照随机数字表法分为对照组30例与观察组30例。对照组患者予以常规西药及腰背肌功能锻炼治疗，观察组在对照组的基础上，服用地龙舒腰汤治疗，连续服药14 d。比较2组患者手术前、术后第2周疼痛视觉模拟量表（VAS）、日本骨科学会评估腰椎治疗量表（JOA）及腰椎功能障碍指数量表（ODI）。结果  术后第2周2组患者疼痛程度及腰椎功能障碍指数均低于术前，且观察组均低于对照组，差异均具有统计学意义（P<0.05）；手术后2组患者JOA评分均高于术前，且观察组高于对照组，差异均具有统计学意义（P<0.05）；观察组总有效率为96.70%高于对照组的73.33%，差异具有统计学意义（P<0.05）。结论  地龙舒腰汤改善腰椎间盘突出症经皮椎间孔镜术后残留症状有较好疗效。

关键词：地龙舒腰汤；腰椎间盘突出症；经皮椎间孔镜术；术后残留症状

中图分类号：R681.5    文献标志码：B    文章编号：1007-2349（2024）05-0040-05

Clinical Observation of Dilong Shuyao Decoction in the Treatment of Residual Symptomsof Lumbar Disc Herniation after Foraminoscopy

ZHAO Guang-zhui1， DONG Tang-bo1， 2， LIAO Cheng-you1， 2， CHEN Xiao-long2

（1. Taihe Hospital of Traditional Chinese Medicine Affiliated to Anhui University of Traditional Chinese Medicine， Fuyang 236600， China;2. Anhui University of Traditional Chinese Medicine， Hefei 230038， China）

【Abstract】Objective： To observe the clinical effect of Dilong Shuwei Decoction on residual symptoms of lumbar disc herniation after percutaneous foraminoscopy， and to provide reference for clinical optimization treatment and relief of symptoms in patients. Methods： 60 patients diagnosed as lumbar disc herniation， who underwent percutaneous foraminoscopy with residual lumbar and leg symptoms， were divided into control group （30 cases） and observation group （30 cases） according to random number table method. The control group was treated with conventional western medicine and lumbar and back muscle function exercise and the observation group was treated with Dilong Shuyao Decoction on the basis of the control group for 14 days. The Visual Analogue Scale （VAS）， the Japanese Orthopaedic Society Assessment Lumbar Treatment Scale （JOA） and the Lumbar Dysfunction Index Scale （ODI） were compared between the two groups before and 2 weeks after surgery. Results： The pain degree and lumbar dysfunction index in the two groups were lower than those before surgery， and the observation group was lower than the control group， and the differences were statistically significant （P<0.05）. JOA scores in the two groups after surgery were higher than those before surgery， and the observation group was higher than the control group， and the differences were statistically significant （P<0.05）. The total effective rate of the observation group was 96.70%， higher than that of the control group （73.33%）， and the difference was statistically significant （P<0.05）. Conclusion： Dilong Shuyao Decoction has a better effect on the improvement of the residual symptoms of lumbar disc herniation after percutaneous foraminoscopy.

【Key words】Dilong Shuyao Decoction; Lumbar Disc Herniation; Percutaneous Foraminoscopy; Postoperation Residual Symptom

腰椎间盘突出症（lumbar disc herniation，LDH）是临床上多发的脊柱退行性病变［1］，主要因腰部长期慢性劳损、腰椎间盘退行性病变或外来损伤等因素所致纤维环局部或全部破裂，神经根或马尾神经被部分破裂的纤维环或髓核组织向后刺激所引起的一系列临床综合症［2］。对于保守治疗3个月症状仍无明显缓解或复发患者，常采用手术治疗。……