| Purpose:This research is to observe the efficacy of XiaosuiHuaHe Decoction for the patients by observing the patients with ruptured type lumbar intervertebral disc herniation showing ring-enhancement under enhanced MRI during a follow-up visit and to analyze the significance and prognosis of the patients with ruptured type lumbar intervertebral disc herniation showing ring-enhancement under enhanced MRI by comparing with the treatment group of the patients not showing ring-enhancement under enhanced MRI for the purpose of better guiding the clinical work.Methods:In this research,we selected 61 cases of the patients with ruptured type lumbar intervertebral disc herniation showing ring-enhancement who received enhanced MRI in Suzhou TCM Hospital's outpatient or hospitalization from June 2015 to June 2017.According to the imaging diagnosis,they can be divided into the group without ring-enhancement composed of 33 cases(22 male patients and 11 female patients)and the group with ring-enhancement composed of 28 patients(20 male patients and 8 female patients).All patients were treated with non-surgical treatment of XiaoSuiHuaHe Decoction.If the patients who failed to get better with 3 to 6 months of non-surgical treatment(JOA score<16,or the improvement rate was less than 25%),or the symptoms were progressively worsened or accompanied by lesion of cauda equina nerve symptoms during the treatment period.Under the circumstance that the patients are informed,it is suggested that the patients shall accept the surgical treatment According to the surgical rate of the patients,all non-surgical treatment shall be analyzed and assessed for the patients' prognosis in accordance with the lumbar JOA score improvement rate and the prognosis of MRI absorption rate.Results:? There are 61 cases of patients included into the research,in which 9 patients accepted the surgical treatment instead with the surgical rate of 14.75%.There are 52 cases of patients completed the non-surgical treatment.For the group without ring-enhancement and the group with ring-enhancement,non-surgical treatment can greatly improve their JOA score of the patients(P<0.05),after the group with ring-enhancement accepted the systematic treatment for 3 months,6 months,9 months,12 months,JOA score improvement rate was 62.54±22.23%,76.09±22.29%,77.25±1 9.82%,78.24± 18.17%,respectively,higher than 41.84±24.54%,59.60±24.34%,58.77±24.13%,65.14±24.73%of the group without ring-enhancement.? The protrusions were reduced in the group without ring-enhancement and in the group with ring-enhancement treated with XiaosuiHuaHe Decoction(P<0.05),according to the degree of absorption,the absorption rate 64.71 ±20.85%of the protrusions in the group with ring-enhancement was higher than that of 43.48±29.51%in the group without ring-enhancement.(P<0.05),according to the absorption rate,there were 5 cases for complete absorption,5 cases for significant absorption,11 cases for partial absorption in the group without ring-enhancement,and the total reabsorption rate was 77.78%;there were 9 cases for complete absorption,10 cases for significant absorption,4 cases for partial absorption in the group with ring-enhancement,and the total reabsorption rate was 92.00%.According to the research of disease duration and absorption rate,the probability of reabsorption occurring in patients with initial onset was higher than that in patients with onset of more than 6 months.Conclusions:? The research showed that Xiaosui and HuaHe Decoction had exact therapeutic effect on ruptured type lumbar intervertebral disc herniation,and had the promotion effect of reabsorption of lumbar intervertebral disc herniation.?The shorter the course of disease in patients with ruptured type lumbar intervertebral disc herniation,the higher the probability of reabsorption will be.? Patients who have ring-enhancement after MRI enhancement have a more significant effect than those without ring-enhancement.It is suggested that in patients with ruptured type lumbar intervertebral disc herniation,ring-enhancement is performed under enhanced MRI,and the protuberances are likely to be nucleus pulposus tissue.The non-surgical treatment has a good effect,and these patients can accept non-surgical TCM treatment. |
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