| Objective:1.Analyze the curative effect and curative effect comparison of different TCM treatment combinations in conventional western medicine combined with 2,3 and 4 TCM treatment methods,and screen out the better treatment combination.2.Analyze the overall curative effect,curative effect comparison,recurrence and safety analysis of conventional western medicine combined with 2,3 and 4 traditional Chinese medicine treatments,and screen out the better treatment types.Method:1.Data collection: By searching the electronic medical record system of spine surgery in Ruikang Hospital affiliated to guangxi university of chinese medicine,the hospitalized patients with lumbar disc herniation who meet the standard of nano-drainage were screened out,their case data were sorted out,the relevant medical records were recorded,and the Chinese medicine treatment methods used were numbered with capital English letters:Chinese medicine for oral administration is numbered "A",Chinese medicine for hot treatment is numbered "B",mud moxibustion is numbered "C",acupoint application is numbered "D",moxibustion is numbered "E",manual therapy is numbered "F",acupuncture therapy is numbered "G",traction therapy is numbered "H" and intermediate frequency electric stimulation therapy is numbered "I".2.Record the indicators: VAS score,JOA score,effectiveness after treatment,adverse reactions and recurrence after 6 months before and after treatment.3.Grouping methods:(1)First,according to the number of TCM treatments used in conventional western medicine combined with TCM,they are divided into conventional western medicine +2 TCM treatments(2 groups for short),conventional western medicine +3 TCM treatments(3 groups for short)and conventional western medicine +4 TCM treatments(4 groups for short);(2)Screening out the treatment combination with treatment frequency≥10 in each group.4.Statistical analysis:(1)First,compare the VAS score and JOA score of the treatment combinations with treatment frequency ≥10 in two groups,three groups and four groups before and after the treatment,and analyze the curative effect and the duration of the curative effect.Secondly,compare the scores of each time period between groups,analyze the improvement degree of pain symptoms and dysfunction,and select the better treatment combination.(2)Analyze the curative effect,the duration of curative effect and the improvement degree of symptoms and signs of two groups,three groups and four groups with the same method,and select the better treatment type.The total effective rate,recurrence rate and adverse reaction rate of each group were analyzed to judge its efficacy,stability and safety.result:1.Statistical results of cases(1)A total of 506 valid cases were included in this study,including 159 cases in 2 groups,178 cases in 3 groups and 169 cases in 4 groups.(2)Among the 2 groups,there are seven combinations with treatment frequency ≥10,with a total of 134 cases,namely BD group,BI group,BF group,BE group,BG group,AB group and BC group.Among the 3 groups,there are eight combinations with treatment frequency ≥10,with a total of 152 cases,namely ABC group,ABF group,BCF group,BCE group,BCG group,BEF group,BFI group and BFG group.Among the 4 groups,there are seven combinations with treatment frequency ≥10,with a total of 130 cases,namely ABCE group,ABCF group,ABCI group,ABEF group,ABFG group,BCFG group and BCEF group.2.Research results of different treatment combinations in 2 groups.(1)Before and after treatment,the VAS scores of the seven groups were significantly decreased and the JOA scores were significantly increased;However,VAS scores of BF group and BG group continued to decrease significantly and JOA scores continued to increase significantly at 3 months after treatment,and there was no obvious change at 6 months after treatment,but both scores were better than those after treatment,and the differences were statistically significant(P<0.05).The curative effect of group BF and BG was better than that of the other five groups.(2)Before and after treatment,the VAS score of BF group decreased and the JOA score increased significantly compared with BD group and BI group(P < 0.05);From the end of treatment to 6 months after treatment,the VAS scores of BC and BG groups were significantly lower than those of BE groups,and the JOA scores of BF and BG groups were significantly higher than those of BD,BE and BC groups(P<0.05).The improvement degree of pain and dysfunction in other groups was similar(P>0.05).3.Research results of different treatment combinations in 3 groups.(1)Before and after treatment,the VAS scores of the eight groups were significantly decreased and the JOA scores were significantly increased;However,VAS scores of BCF,BCG and BFG groups continued to decrease and JOA scores continued to increase after 3 months of treatment,and there was no obvious change after 6 months of treatment,but both scores were better than those after treatment,and the differences were statistically significant(P<0.05).The curative effect of BCF group,BCG group and BFG group is better than that of the other five groups.(2)Before and after treatment,the JOA score of BCF group was significantly higher than that of ABC group,BCE group and BEF group(P <0.05);From the end of treatment to 6 months after treatment,the VAS scores of BCF,BCG and BFG groups decreased and the JOA scores increased significantly compared with ABC,BCE and BEF groups(P<0.05).The improvement degree of pain and dysfunction in other groups was similar(P>0.05).4.Research results of different treatment combinations in 4 groups.(1)Before and after treatment,the VAS scores of the seven groups were significantly decreased and the JOA scores were significantly increased;However,the VAS scores of ABFG group and BCFG group continued to decrease significantly after 3 months of treatment,while the JOA scores continued to increase significantly,and there was no obvious change after 6months of treatment,but both scores were better than those after treatment,and the differences were statistically significant(P<0.05).The curative effect of BCF group,BCG group and BFG group is better than that of the other five groups.(2)After treatment to 6 months after treatment,the VAS scores and JOA scores of ABFG and BCFG groups were significantly lower than those of ABCE group(P<0.05),while those of BCFG group were significantly higher than those of ABCI group(P<0.05).The improvement degree of pain and dysfunction in other groups was similar(P>0.05).5.Statistical results of three groups: 2 groups,3 groups and 4 groups.(1)before and after treatment,the VAS scores of the three groups were significantly decreased,and the JOA scores were significantly increased;Among them,VAS scores of three groups and four groups continued to decrease and JOA scores continued to increase after three months of treatment,and there was no significant change in VAS scores and JOA scores after six months of treatment,while VAS scores and JOA scores of two groups increased and decreased significantly after six months of treatment,with statistical significance(P<0.05).The curative effect of three groups and four groups is better than that of two groups.(2)Before and after treatment,the VAS scores of three groups and four groups decreased and the JOA scores increased significantly(P<0.05).The improvement degree of pain and dysfunction in other groups was similar(P>0.05).(3)Total effective rate: after treatment,the total effective rate of the 2groups was 94.34%,that of the 3 groups was 95.51%,and that of the 4 groups was 94.08%.There was no significant difference between the three groups(P > 0.05).After treatment,the cure rate of 2 groups was 49.69%,that of 3groups was 55.06%,and that of 4 groups was 53.85%.The cure rate of 2groups was significantly lower than that of 3 groups and 4 groups,and the difference was statistically significant(P<0.05).(4)Recurrence rate: 6 months after treatment,the recurrence rate of the 2groups was 10.06%;The recurrence rate of 3 groups was 7.87%;The recurrence rate of the 4 groups was 8.88%,and there was no significant difference among the three groups(P>0.05).(5)Adverse reaction rate: The adverse reaction rate of the two groups was 1.89% during the treatment;The adverse reaction rate of the three groups was 2.25%;The adverse reaction rate of four groups was 2.37%.There was no significant difference in adverse reaction rate among the three groups(P>0.05).Conclusion:1.Comprehensive curative effect persistence and improvement degree of symptoms and signs:(1)Conventional western medicine+scalding+manipulation and conventional western medicine+scalding+acupuncture are superior to the other five groups;(2)Conventional western medicine+scalding+manipulation+acupuncture,conventional western medicine+scalding+manipulation+mud moxibustion,conventional western medicine+scalding+acupuncture+mud moxibustion are better than the other five groups;(3)Conventional western medicine+scalding+manipulation+acupuncture+oral administration of traditional Chinese medicine,conventional western medicine+scalding+manipulation+acupuncture+mud moxibustion are superior to the other five groups.2.Comprehensive curative effect persistence and improvement degree of symptoms and signs,conventional western medicine combined with three TCM treatments and conventional western medicine combined with four TCM treatments are superior to conventional western medicine combined with two TCM treatments.3.Non-operative treatment scheme of integrated traditional Chinese and western medicine is effective,stable and safe in treating lumbar disc herniation in the near future. |
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