The Clinical Efficacy Observation Of Huoxue Zhitong Decoction On Preventing Of Intervertebral Disk Mediated Postoperative Epidural Fibrosis

Purpose:Peridural fibrosis is one of the more frequent complications of lumbar disc herniation.This is a clinical randomized controlled trials study,through which we observation the clinical efficacy of Huoxue Zhitong Decoction on preventing of intervertebral disk mediated postoperative epidural fibrosis,then evaluate the effectiveness on preventing of intervertebral disk mediated postoperative epidural fibrosis,and to explore the mechanism of this process.Methods:60 patients were divided into experimental group and control group randomly,30 cases in each group,all of those had undergone lumbar disc disease for chronic pain of at least 3 months duration,during which periods symptoms persist after accept non-surgical treatment.Routine drugs were performed in all patients divided into control group undergone posterior decompression and fenestration and pedicle screw fixation;the patients in treatment group took Huoxue Zhitong Decoction for 3 weeks on the basis of the interventional measures in the treatment group.We compared the visual analogue scale(VAS)and Japanese Orthopedic Association score(JOA)and the amelioration of lumbar function before lumbar disc surgery and then 3 day,3 months and 6 months after surgery.We compared the VAS score,JOA score and the amelioration of lumbar function before lumbar disc surgery and then 3 day,3 months and 6 months after surgery.The patients' functional clinical outcome was measured according to the recovery and clinical improvements in straight leg raise(SLR)and the range of motion test,including flexion,extension,and lateral flexion on the day before and the day of 1,3 and 6 months after surgery.We compared the hemorheology on the day before and the day of 1,2 weeks after surgery.All of the patients accept MRI examination at the time of 3 months and 6 months after surgery,then graded the degree of the peridural tissue around the spinal dura mater by MRI.We performed data analysis with the help of SPSS for Windows,version 20.0.Results:A total of 57(95.0%)studies meet the condition of half a year's follow-up from the 60 patients included in the study.The operations were all successfully accomplished,without complication.The basicline characteristics(age,gender,weight,duration,VAS score,JOA score,SLR and the range of motion test)between the two groups is equally comparable(P>0.05).The VAS scores are significantly lower in the treatment group than in the control group according to 7-day,3-month and 6-month post treatment(P<0.05).Two groups of JOA score were compared at the time of 1 week,3 months and 6 months after surgery,the treatment group s score was higher than the control group,the difference was statistically significant(P<0.05);There was no significantly difference in the function of lumbar between the two groups according to 7-day posttreatment(P>0.05),while 3 months and 6 months after surgery,the treatment group is higher than the control group,the difference was statistically significant(P<0.05).There was significantly difference in SLR and the range of motion test between the two groups,the treatment group was significantly better than the control group according to 1,3 and 6 months posttreatment(P<0.05).There's no significant difference in hemorheological index among two groups according to 7-day posttreatment(P>0.05),while the difference was statistically significant 2 weeks after surgery,the index of treatment group was lower than the other one's(P<0.05).There was significantly differences in the degree of the peridural tissue between the two groups(P>0.05),the proportion of low grade degree of the peridural tissue results was significantly higher in the treatment group than in the control group according to 3-month and 6-month posttreatment(P<0.05).Conclusion:Huoxue Zhitong Decoction can obviously lower the score of Visual Analogue Scale;Improve the function of lumbar JOA score,Improve postoperative microcirculation in vivo.Our study showed that Huoxue Zhitong Decoction can effectively decreased the peridural fibrosis formation in human being after laminectomy.