| Objective : The purpose of this study was to observe and systematically evaluate the clinical efficacy of Jinggushangfang in the treatment of postoperative residual symptoms of PELD,to explore its clinical application value in the treatment of postoperative residual symptoms,and to provide a treatment means for rapid recovery of patients after PELD.Methods:A total of 60 patients who were hospitalized in the Department of Spine Surgery,Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine from January 2022 to December 2022 and voluntarily underwent PELD during hospitalization were selected in this study.A total of 60 patients were assigned a number of 1-60 according to the time of admission,and two groups of random numbers were obtained by SPSS20.0statistical software,and they were named as the observation group and the control group,with 30 cases in each group.The patients in the control group only received conventional treatment after surgery,while the patients in the observation group were treated with Jinju Shang Decoction from the first day after surgery for 4 weeks on the basis of conventional treatment.The patients in the two groups received the postoperative functional exercise program of the same doctor.The VAS score,JOA score and ODI score were collected before operation,1 day,1 week,2 weeks and 4 weeks after operation,and the CRP and ESR data were collected at the same time points.The modified Macnab criteria were used to evaluate the efficacy at 4 weeks after operation.The data of the above groups were processed by SPSS20.0 statistical software,and the efficacy was compared by comparing the differences of various indicators between the two groups.Results : 1.A total of 60 patients were included in this study,and the follow-up time was 4 weeks.During the study period,1 case dropped out in the observation group and the control group,and 58 cases were finally effective.There were 29 cases in the interim observation group,with an average age of(47.69±12.29)years and an average course of(20.86±4.91)months.16 cases were L5/S1;There were 29 cases in the control group,with an average age of(48.72±10.23)years and an average disease duration of(19.48±5.41)months,including 3 cases of L3/4,15 cases of L4/5 and 11 cases of L5/S1.There was no significant difference in baseline data such as gender composition,age distribution,duration of disease and herniated segment between the two groups.There was no significant difference in preoperative VAS score,JOA score,ODI score,CRP and ESR between the two groups(P > 0.05).2.Comparison of VAS scores:Intra-group comparison: the VAS scores of patients in the observation group were compared within the group,P values were less than 0.05,the difference was statistically significant.The VAS scores of patients in the control group were compared within the group,P values were greater than 0.05,the difference was not statistically significant,and the remaining pairwise comparison,P values were less than 0.05,the difference was statistically significant.Comparison between the two groups:the VAS scores of the two groups on the first day after operation,P=0.221 >0.05,there was no statistically significant difference between the two groups.The VAS scores of the two groups decreased after the treatment,and the decrease in the observation group was more significant than that in the control group.3.Comparison of JOA scores: intra-group comparison: pairwise comparison of JOA scores between the two groups,P values were less than 0.05,the difference was statistically significant;Comparison between the two groups:the JOA scores of the two groups on the first day after surgery,1 week after surgery,P > 0.05,the difference was not statistically significant,2 weeks after surgery,4 weeks after surgery,P values were less than 0.05,the difference was statistically significant,compared with the JOA scores before treatment,the JOA scores of the two groups increased after treatment,the observation group increased more significantly than the control group.4.Comparison of ODI scores: intra-group comparison: Pairwise comparison of ODI scores in the two groups,P values were less than 0.05,and the difference was statistically significant.Comparison between the two groups:the ODI scores of the two groups on the first day after operation,1 week after operation,P values were greater than 0.05,the difference was not statistically significant.The ODI scores of the two groups were decreased after treatment,but the observation group was significantly lower than that of the control group.5.Comparison of CRP and ESR: intra-group comparison: The CRP and ESR of the two groups were compared within the same group,with P values less than 0.05,and the difference was statistically significant.Comparison between groups: There was no significant difference between the two groups at 1 day and 4 weeks after operation,P values were greater than 0.05,and there was no significant difference between the two groups at 1 week and 2weeks after operation,P values were less than 0.05,and the difference was statistically significant.The CRP and ESR of the two groups increased briefly after operation,and then returned to normal levels,and the observation group was significantly lower than the control group.6.Comparison of the curative effect of Mac Nab: The excellent and good rate was 93.10% in the observation group and 82.76% in the control group,P=0.157,the difference was not statistically significant,but the excellent and good rate of the observation group was higher than that of the control group.Conclusion:1.PELD can effectively relieve the symptoms of low back pain,low back pain,and radiation numbness and pain in lower limbs of LDH patients.2.After PELD,the combined use of Jinju decoction can more effectively relieve the residual low back pain after PELD than the simple use of conventional dehydration,anti-inflammation and pain relief,etc.3.After PELD,the combined use of Jinju decoction can more effectively restore the nerve function of patients and promote the recovery of lumbar function of patients.(4)After PELD,the combined use of Jinju Shang decoction can more effectively reduce the level of inflammatory factors and promote the repair of body tissues than the simple use of conventional treatment such as dehydration,anti-inflammation and pain relief. |
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