| Objective:Observe the clinical efficacy of Danqi Huoxue Capsule combined with posterior single open-door laminoplasty in the treatment of cervical spinal stenosis,in order to provide a better method for the treatment of cervical spinal canal stenosis.Methods:Include 70 patients diagnosed with Qi deficiency and blood stasis type of cervical spinal stenosis(CSS)in the Spine Surgery Department of Shanxi Provincial Hospital of Traditional Chinese Medicine from October 2018 to February 2020.They were randomly divided into treatment group and control group,each group 35 cases.Collect patients’ general information(name,gender,age,duration of symptoms,pathogenic factors,number of diseased segments).After completing the preoperative examinations,all patients underwent cervical posterior single open-door laminoplasty(CPSOLP),and the continuous decompression segment,intraoperative blood loss and operation time were recorded.The control group needed clinical routine treatment according to the condition after the operation;in addition to the routine treatment,the treatment group started to take Danqi Huoxue Capsule on the next day.The two groups of patients were followed up on time,and the hospitalization time,follow-up time and postoperative complications were recorded respectively.Three months after the operation,the cervical spine CT was performed to understand the bony fusion of the hilar axis,and the C5 horizontal spinal canal sagittal diameter and calculate the spinal canal enlargement rate.Use Japanese Orthopaedic Association Score(JOA),Visual Analogue Scale(VAS),Neck Disability Index(NDI),Recovery Rate(RR),The Foot Tapping Test(FTT)was used for clinical evaluation.The scores of the two groups of patients were recorded before surgery,1 week after surgery,3 months after surgery,and at the last follow-up.The scores were compared separately to evaluate the clinical efficacy of Danqi Huoxue Capsule combined with posterior single open-door laminoplasty in the treatment of cervical spinal stenosis.Results:(1)There was no significant difference in gender and age composition between the two groups(P>0.05).The duration of symptoms,pathogenic factors,and number of diseased segments were compared between the two groups,and the difference was not statistically significant(P>0.05).(2)All patients were followed up on time and there were no cases of drop-off.The two groups of patients were compared for continuous decompression segment,intraoperative blood loss,operation time,hospital stay,and follow-up duration.There was no statistically significant difference(P>0.05).(3)Before operation,the sagittal diameter of the C5 horizontal spinal canal in the treatment group was(9.31±0.72)mm,and the control group(9.14±0.88)mm,there was no difference between the two groups(P>0.05).Both groups of patients underwent cervical CT scans 3 months after surgery.The results showed that all patients had fusion of the hilar axis bone graft,and the measured C5 level spinal canal sagittal diameter was significantly enlarged compared with preoperatively.The treatment group(16.17±1.04)mm and the control group(15.80 ± 1.02)mm were significantly different from those before surgery(P<0.05);there was no statistically significant difference in the sagittal diameter of the spinal canal at the C5 level between the two groups at 3 months after surgery(P>0.05).Compared with the spinal canal enlargement rate of the treatment group(74.05±9.92)%and the control group(73.48 ± 8.88)%,the difference was not statistically significant(P>0.05).(4)There were no complications such as internal plant loosening,displacement,breakage,rejection and postoperative infection,re-closing,cerebrospinal fluid leakage,hematoma,cervical kyphosis,etc.in the two groups.The treatment group had 1 patient with incision fat liquefaction.After treatment,the incision healed well.There were 5patients(14.3%)with axial symptoms(AS)in the treatment group and 14 patients(40%)in the control group.There was a significant difference between the two groups(P<0.05);according to the measure of severe axial symptoms Table,treatment group: 2 cases of degree I(40%),2 cases of degree II(40%),1 case of degree III(20%),control group: 4cases of degree I(28.6%),3 cases of degree II(21.4)%),4 cases of degree III(28.6%),3cases of degree IV(21.4%).The incidence of C5 nerve root palsy(NRP)in the control group(8.6%)was slightly higher than that in the treatment group(2.9%)(P>0.05);there were 3 cases in the control group,2 cases of grade I(66.7%)1 case(33.3%),degree III;1case in the treatment group,degree I(100%).(5)The NDI and VAS scores of the two groups at 1 week,3 months,and the last follow-up were compared with those before the operation,and the differences were statistically significant(P<0.05).There was no statistically significant difference in NDI and VAS scores between the two groups before operation(P>0.05).The NDI and VAS scores of the two groups were decreased 1 week after operation compared with those before operation.The decrease in the treatment group was slightly lower than that in the control group.Significant,but the difference was not statistically significant(P>0.05);NDI and VAS scores at 3 months after surgery and at the last follow-up were further decreased compared with 1 week after surgery,and the decrease in the treatment group was more significant.There was a statistical difference between the two groups(P<0.05).(6)The JOA scores of the two groups at 1 week,3 months,and last follow-up were compared with those before the operation,and the difference was statistically significant(P<0.05).The scores of the treatment group before operation(8.74±1.54)were compared with those of the control group(8.51 ± 1.65),and the difference was not statistically significant(P>0.05);the JOA(9.94±1.39)of the treatment group was compared with that of the control group(9.63 ± 1.42)at 1 week after operation,the difference was not statistically significant(P>0.05);the JOA scores of the treatment group and the control group were significantly higher at 3 months after surgery and at the last follow-up than before and 1 week after surgery,and the treatment group rose more obvious,and the difference between the two groups is statistically significant(P<0.05).The JOA improvement rate at the last follow-up in the treatment group was(73.72 ± 12.22)%compared with the control group(63.52 ± 18.18)%,the difference was statistically significant(P<0.01).The evaluation results of the cervical spine function improvement rate(RR)of the two groups: the treatment group was excellent in 20 cases,good in 13 cases,fair in 2 cases,povor in 0 cases,and the excellent and good rate was 94.3%;in the control group,12 cases were excellent,good in 18 cases,fair in 3 cases,and poor In 2 cases,the excellent and good rate was 85.7%;after the rank sum test,the difference was statistically significant(P<0.05).(7)Both groups of patients underwent an FTT tapping test during follow-up.The results showed that the number of tappings of the two groups of patients gradually increased with the extension of the follow-up time.The number of FTTs in the two groups at 1 week,3 months after surgery,and the last time were compared with those before surgery,and the difference was statistically significant(P<0.05).The FTT times of the two groups were compared before and 1 week after the operation,and the difference was not statistically significant(P>0.05),while the number of foot tappings between the two groups was statistically different at 3 months after the operation and the last follow-up(P<0.05).Conclusion:(1)In patients with cervical spinal stenosis,the volume of the spinal canal is significantly enlarged,the compression of the spinal cord and nerves is relieved,and the spinal cord and nerve functions are improved after the cervical posterior single open-door laminoplast and mini-titanium plate support internal fixation.This operation has the advantages of high safety,significant clinical efficacy,high rate of bone fusion on the portal axis,and good stability of the cervical spine.(2)For patients with cervical spinal stenosis of Qi deficiency and blood stasis,taking Danqi Huoxue Capsules early after surgery can further promote the recovery of spinal cord and nerve function,speed up recovery,reduce axial symptoms,and improve cervical spine function compared with surgical treatment. |
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