Clinical Comparative Trial To Epidural Injection Mailuoning Composite Liquid And Hormonal To Treatment Of Lumbar Disc Herniation

Objective: To observe the epidural injection Mailuoning composite liquid and hormonaltreatment of lumbar disc herniation clinical efficacy comparisonMethods: select 160 lumbar disc herniation (LDH) patients diagnostic criteria, were randomlydivided into two groups, respectively, to give epidural Mailuoning composite liquid andDiprospan, administered once every seven days, the general treatment of 3 times, to observebefore and after treatment changes in the overall efficacy used JOA score method.Results: X testing, Chinese medicine group and the hormone group both had significantlyefficiency and the total effective rate was no significant difference (P> 0.05)Conclusions: The epidural injection Mailuoning LDH composite liquid treatment is a safe andeffective treatment methods, the effect has no difference with the hormone but can avoid theside effects of the hormone, less painful in patients and easy to operate features, worthy ofclinical use.Lumbar disc herniation is a common cause of back and leg pain, seriously affecting the health status of patients and quality of life. A growing number of clinical and basic research data show that prominent disc tissue due to inflammatory changes in nerve root pain is the basis of LDH. The treatment of lumbar disc herniation generally divided into surgical treatment and non-surgical treatment. LDH surgery was able to lead to large multi-risk ,trauma. relapse after treatment and exist unfavorable factors, is gradually being replaced by non-surgical treatment. Epidural nerve block as a non-surgical treatment is important method of LDH. Because of its high efficiency, rapid and direct access to lesions, non-surgical treatment widely used by many doctors.Most epidural nerve block drugs is glucocorticoid. Although epidural injection of corticosteroid treatment of LDH achieved good clinically efficacy, but the widespread use of hormones has also brought a lot of side effects. Chinese medicine is important means as non-surgical treatment of lumbar disc herniation . we had already completed animal comparative Trial about Chinese medicine and hormone to treatment of spinal disease .To further explore the efficacy, we conducted clinical trials, lumbar disease patients were randomly divided into control group (hormone) and the Chinese Medicines group(Mailuoning composite liquid) to observe the efficacy of epidural injection.Clinical data1 Case SourceChoose inclusion study criteria 160 cases of LDH patients, all of them were from Wangjing Hospital of China Academy of Traditional Chinese Medicine clinics (cases) and hospitalization (cases) patients in September 2006 - December 2008.2 General InformationChoose the inclusion criteria of this study patients with lumbar disc herniation 160 cases. One male and six cases, four cases of women; the oldest 81 years old and the youngest 20 years old, the average age (52.43±14.41) years old. History of 6 months -10 years, the average (5.6±2.1) years, highlighted segments: LI-2 to highlight seven cases, L3-4 highlighting 27 cases, L4-5 highlight the 48 cases, L5-S1 outstanding 29 cases, L3 - 4, L4-5 highlight the 20 cases, L4-5, L5-S1 highlighting 27 cases, L3-4, L5-S1 highlighted five cases. 15 cases of patients with hypertension, four cases of diabetic patients. 36 cases of pain in his left leg, right leg pain in 31 cases, 55 cases of lower extremity pain, low back pain not only of the 38 cases of lower limb pain. 18 cases of patients with lumbar spine.3 cases of choice3.1 diagnostic criteria (according to editor-in-chief Hu Yougu "lumbar disc herniation (thirdedition)")Into the standard 3.2 cases①meet the diagnostic criteria for LDH;②appeared back pain, sciatica, lower extremity numbness, cold symptoms;③straight leg raising test or to strengthen the positive result④clinical symptoms and signs must be consistent with the results of imaging examinationprominent positions;⑤confirmed the prominence of local less than 1 / 2 spinal canal diameter by CT or MRI;⑥signed informed consent form, will accept the test method of this study was treated asvoluntary subjects①-⑥all of the above are "yes" were only selected for this clinical trial of qualified volunteers.3.3 cases of exclusion criteria①simple spinal stenosis;②simple spondylolisthesis;③lumbar tumor;④lumbar tuberculosis;⑤patients with huge lumbar herniation disc and emerging of cauda equina syndrome;⑥other reasons caused by spinal stenosis①-⑥above are "no" were only selected for this clinical trial of qualified volunteers.3.3 cases of exclusion criteria①simple spinal stenosis;②simple spondylolisthesis;③lumbar tumor;④lumbar tuberculosis;⑤patients with lumbar disc herniation huge emerging prominence of cauda equina syndrome; ⑥other reasons caused by spinal stenosis①-⑥above are "no" were only selected for this clinical trial of qualified volunteers.3.4Excluding cases of the standard 3.4①who treatment less than 3 weeks can 't determine the effectiveness of treatment orinformation incomplete;②allergy or drug allergy in this study;Patients meet any of the above experiment conditions can be removed.Research Methods1.2 Case Selection: choice of LDH in patients with lumbar disc herniation 160 cases, both in September 2006-December 2008 Wangjing Hospital of China Academy of Traditional Chinese Medicine clinic (cases) and hospitalization (cases) patients. Divided into traditional Chinese medicine group and the hormone group, by statistical analysis, the two groups in gender composition, age distribution, highlight segment, the seriousness of the comparable time course (see Table 1).By x~2 test, two groups of gender composition, the seriousness of the segment highlighted the difference was not statistically significant, comparable. By t test, two groups of age distribution, time course of disease was no significant difference in comparison with comparability.Table 1 the two groups in gender composition, age distribution, highlight segment, the seriousness of the time course.2 treatment Treatment group used Mailuoning, 2% lidocaine with 5% sodium bicarbonate injection prepared, shot for as Mailuoning composite liquid. Patients took the middle of epidural puncture posture, puncture point for patients with lesions of the vertebral space. Patients was lying side, conventional disinfection then did local infiltration anesthesia with 1% lidocaine 3ml, epidural puncture with the 16th epidural needle,if puncture successful, no blood, no cerebrospinal fluid (CSF), slowly injection into the Mailuoning 12 - 15ml. lying side after 30min and then shake legs. Once Treatment for one week,last 3 weeks.Control group of drugs is: 2% lidocaine 5ML, 0.9% sodium chloride 9ML Diprospan 1ML. Patients took the middle of epidural puncture posture, puncture point for patients with lesions of the vertebral space. Patients was lying side, conventional disinfection then did local infiltration anesthesia with 1% lidocaine 3ml, epidural puncture with the 16th epidural needle,if puncture successful, no blood, no cerebrospinal fluid (CSF), slowly injection into the Mailuoning 12 -15ml. lying side after 30min and then shake legs. Once Treatment for one week, last 3 weeks.3.Observation dates3.1 points overall symptoms (according to the Japanese Society of Plastic Surgery of low back pain criteria (Japanese Orthopedic Association, JOA))3.2 Determination of clinical pain (using pain visual analogue scale method (Visual analogue scales, VAS) for pain medication before and after observing the extent of records)3.3 recorded adverse reactions in patients ,records cases of adverse reactions during treatment.4 statistical methodsSPSS13.0 statistical data obtained from the application software for processing. X2 test count data applications, the normal distribution of measurement data to mean±standard deviation that the two samples were found a few with matching t test; skew the distribution of measurement data with non-parametric methods of statistical analysis of paired rank and testing.Score Results: The two groups of patients were followed up 16-24 weeks, an average of 20 months, two of the score in Table 3. Note:compared to Chinese me dine group (?)Application of the data processing software SPSS13.0 statistical results showed that traditional Chinese medicine group and the hormone group was no significant difference in the fine Mailuoning group rate of 73.75%, total effective rate of 97.50 %. while the hormone group of excellent and good rate of 68.75%. total effective rate of 96.25%. Hormone therapy group. 7 cases of patients with loss of appetite and weight gain, two cases of obesity appear to mind, and Mailuoning group found no adverse reactions, two cases were no significant difference.ConclusionMailuoning composite fluid and hormone treatment group no significant difference, Mailuoning liquid compound with the advantages of stable long-term efficacy and avoid side effects of the hormone for diabetes and the application of the group of hypertensive patients. Mailuoning composite fluid and the same effect as hormone therapy can relieve the suffering of surgery patients to reduce the cost of treatment. Should be to promote the use of clinically.