A Follow-up Study On The Therapeutic Effect Of Yiqi Huoxue Decoction On The Ruptured Lumbar Disc Herniation For More Than 5 Years

Objects:Through the clinical retrospective follow-up study for more than 5 years,To compare and analyze the changes in imaging and clinical efficacy of the patients with ruptured lumbar disc herniation treated by two methods:conservative treatment with Yiqi Huoxue Decoction and surgical treatment with Percutaneous Transforaminal Endoscopic Discectomy(PTED),in order to study the long-term effect and curative effect of Yiqi Huoxue Decoction,and to explore the clinical feasibility of Yiqi Huoxue Decoction in the treatment of ruptured lumbar disc herniation.Methods:From May 2010 to March 2015,30 patients with lumbar disc herniation who were treated with Yiqi Huoxue Decoction in Suzhou Hospital of Traditional Chinese Medicine were randomly selected as the therapy group,and 30 patients with lumbar disc herniation who were treated with PTED as the control group.All patients were diagnosed as ruptured lumbar disc herniation by MRI.After more than 5 years of follow-up,the improvement of clinical symptoms of the disease was compared by analyzing and evaluating the Oswestry Disability Index(ODI),JOA score,Excellent and Good rate,recovery working time and other functional indexes;by comparing the imaging data of protrusion rate,absorption rate,volume change rate and the ratio of maximum area to spinal canal area during the last follow-up and before treatment,we calculated and analyzed the improvement of imaging of the disease by the two treatment methodsResults:(1)In this study,a total of 60 cases were analyzed retrospectively.Among the 30 cases of ruptured LDH treated with Yiqi Huoxue Decoction,one patient suffered from cauda equina syndrome,and the other one was operated because he could not bear the pain.In the control group,2 of the 30 patients in the PTED group worked abroad on business,which was inconvenient for follow-up.Finally,56 patients completed the follow-up(2)Compared with the two groups,More than 5 years of follow-up showed that there was no statistically difference between JOA score,JOA score improvement rate,Excellent and Good rate,ODI Index,ODI index improvement rate and other clinical indicators(P>0.05).The imaging indexes such as the absorption rate of protrusion,the improvement rate of the ratio of the maximum area of protrusion to the area of spinal canal and the improvement rate of protrusion volume were statistically significant(P<0.05).The improvement rate of imaging in the PTED group was better than that the therapy group.There was statistically difference in the time to resume work(P<0.05),the PTED group was obviously shorter than the therapy group about the time to resume work.(3)In the therapy group,protrusions disappeared during the last follow-up in 2 cases(absorption rate of protrusion>80%),13 cases had obvious resorption(80%>absorption rate of protrusion)50%),1 cases had partial resorption(50%>absorption rate of protrusion≥30%),12 cases had no resorption(30%>absorption rate of protrusion)and the disc herniation volume of 2 cases were increased.Except for one patient with perineum numbness and sexual dysfunction,all the other 28 patients had no progressive neurological damage and cauda equina syndrome.Conclusion:(1)Yiqi Huoxue Decoction has a good clinical effect in the treatment of ruptured lumbar disc herniation.(2)Yiqi Huoxue Decoction can narrow the volume of herniated lumbar disc in different degrees,and the probability of resorpton is higher,but the overall imaging improvement rate is lower than that of the PTED group.(3)Yiqi Huoxue Decoction has a low recurrence rate and stable long-term effect in the treatment of ruptured lumbar disc herniation for more than 5 years.