Clinical Evaluation Of Xiaosui-Huahe Tang In The Treatment Of Lumbar Disc Herniation With Modic Change

Objects:(1)Inductively analyze the distribution characteristics of the three types of Modic changes in patients with low back pain,and analyze the general factors affecting the occurrence of Modic Ⅱ changes.(2)Comparative observation of the imaging findings and clinical symptoms of patients with lumbar disc herniation in the Modic change group and the non-Modic change group after conservative treatment with Xiaosui-Huahe Tang.The imaging improvement and clinical symptom improvement of the two groups of patients were studied.,Summarize the correlation between its imaging findings and clinical symptoms,and explore whether Modic change is an unfavorable factor for the conservative treatment of lumbar disc herniation by Xiaosui-Huahe Tang.Methods(1)A total of 324 patients with MRI images taken at Suzhou Traditional Chinese Medicine Hospital from March 1,2020 to February 19,2021 and showing lumbar Modic changes were selected,and the patients’ gender,age,and Modic change segments were recorded separately,Whether the diseased segment is accompanied by prominence,Inductively analyze the distribution characteristics of the three types of Modic changes in patients with low back pain;use SPSS 21.0 statistical software for data analysis,use binary variable Logistic regression analysis to analyze age,gender,and Modic change segments,Whether the diseased segment is accompanied by protrusion is related to the occurrence of Modic Ⅱ.(2)From January 2019 to December 2019,60 cases of patients with huge lumbar disc herniation in the outpatient MRI of the Department of Orthopedics and Traumatology of Suzhou Hospital of Traditional Chinese Medicine were taken as the research objects.For Modic changes group and non-Modic changes group,Modic changes group is classified into Modic Igroup and Modic Ⅱ group at the second level.All patients were treated conservatively with oral Xiaosui-Huahe Tang.The improvement of the clinical symptoms and imaging performance of the two groups of patients withXiaosui-Huahe Tang was compared through follow-up.The evaluation indicators were JOA score,ODI score,and MRI sagittal protrusion volume.Results:(1)Modic Ⅱ has the highest incidence rate among all types of Modic,which occurs in L4/L5 and L5/S1 segments.(2)Logistic regression analysis showed that age(X1)and whether it was accompanied by prominence(X2)had a significant relationship with the occurrence of Modic Ⅱ change(P<0.05);gender and segment had no significant relationship with Modic Ⅱ change(P>0.05).The regression equation is:Y=-0.487-0.027X1=0.963X4(Y means Modic Ⅱ type change occurs).The statistical results show that among the patients with Modic changes,the correlation between lumbar disc herniation and the occurrence of Modic II is the strongest.(3)The improvement rate of JOA score and the improvement rate of ODI score of the two groups of patients in the Modic change group and the non-Modic change group were analyzed by independent sample t test,P>0.05,the difference w as not statistically significant.It shows that after oral administration of Xiaosui-Huahe Tang,the symptoms of the 6 two groups were improved.(4)Modic changed the JOA score of the group one month after treatment.ODI score was higher than that of the group without Modic change,P<0.05,the difference was statistically significant;the JOA score of the group without Modic change was higher than that of the Modic change group at 3 months after treatment.P<0.05.the difference was statistically significant.The overall difference in JOA score and ODl score at different time observation points between the two groups of patients was statistically significant,but the difference in JOA score and ODI score at different time observation points between the two groups of patients was not statistically significant.This shows that the clinical symptoms of low back pain in both groups of patients under conservative treatment of ral Xiaosui-Huahe Tang for 6 months have been significantly improved.Modic change group has the most significant improvement within one month of treatment and is better than the no Modic change group,and the treatment of the no Modic change group 3 The symptom improvement was the most obvious within months and was better than Modic change group.The improvement rate of protrusion volume in the two groups of patients 6 months after treatment was tested by independent sample t test,P<0.05,the difference was statistically significant.This shows that the improvement rate of protrusion volume in the 6-month oral Xiaosui-Huahe Tang in the non-Modic change group is better than that in the Modic-modified group.The number of people reabsorbed in the non-Modic change group was more than that in the Modic change group.The chi-square test P<0.05,the difference was statistically significant;indicating that the efiective absorption rate of the non-Modic change group after the intervention of Xiaosui-Huahe Tang was significantly higher than that of the Modic group.(5)Pearson correlation analysis was performed on the improvement rate of protrusion volume,JOA score improvement rate and ODI score improvement rate of the two groups of patients.Between the improvement rate of ODI score and the improvement rate of protrusion volume in Modic change group,|r|=0.488,P<0.05,there is a positive medium correlation;between the improvement rate of JOA score and the improvement rate of protrusion volume|r|=0.306,P>0.05,there is no obvious correlation.The improvement rate of ODI score,the improvement rate of JOA score and the improvement rate of protrusion volume in the group without Modic change,|r|=0.639/0.660.P<0.05,the improvement rate of protrusion volume and the improvement rate of JOA score in the group without Modic change,There is a strong positive correlation between the ODI score improvement rate.(6)Modic type Ⅰ and Modic type Ⅱ patients were tested by Mann-Whitney test,P>0.05,and the improvement rate of protrusion volume before treatment was not statistically significant.The reabsorption rate of lumbar intervertebral disc herniation in Modic type Ⅱpatients is equivalent,and the different types of Modic have no effect on the reabsorption of lumbar intervertebral disc herniation.Conclusion:(1)The incidence of Modic Ⅱ is the highest among all Modic types.It is prone to occur in the L4/L5 and L5/S1 segments.The correlation between lumbar disc herniation and Modic Ⅱ changes is the strongest.(2)Xiaosui-Huahe Tang is effective in the treatment of patients with lumbar disc herniation accompanied by Modic changes.(3)Modic change is an unfavorable factor in promoting resorption of Xiaosui-Huahe Tang.(4)Modic type Ⅰ changes and Modic type Ⅱ changes have no difference in the impact on resorption.