| Background:Lumbar disc herniation(LDH)is a syndrome caused by deg eneration of the lumbar spine,such as partial or complete rupture of the annul us fibrosus,resulting in protrusion or prolapse of the nucleus pulposus,which i n turn compresses or stimulates the adjacent nerve roots and cauda equina,pro ducing lumbar pain and numbness and pain in the lower extremities as the ma in clinical symptoms.It has become a common and frequently encountered dis ease in orthopedics.The disease often occurs in young adults,withmore male p atients than female patients,and the age distribution is between 18and 60 year s old.Studies show that about 80%of people have sufferedfrom low back pai n,and the disease presents a high incidence rate and low age trend.In the acut e stage of lumbar disc herniation,the clinical symptoms aremore serious.Patie nts often suffer from unbearable pain and can’t sleep.Forcedposture forces pati ents to be unable to live and work normally.The pathological manifestation of the disease in the acute stage is that the intervertebral disc tissue is prominent,the dura mater and nerve root are comp ressed,resulting in congestion and edema.The imaging manifestation is severe nerve root edema.Therefore,reducing or eliminating nerve root edema and rap id relief of low back and leg pain are the main treatment goals in the acute st age.At present,the treatment for the acute phase includes bed rest,traction,a cupuncture and massage,oral and external application of traditional Chinese me dicine,non steroidal anti-inflammatory drugs,epidural blocking treatment with anti-inflammatory and dehydrating agents(mannitol and dexamethasone)and sur gery,but there are no specific drugs and methods for this phase.Jijiaolihuang Decoction comes from the classic prescription synopsis of the golden chamber.The original text puts forward that "there is water and Qi bet ween the intestines",that is,"water goes between the intestines and there is so und when dripping",which is the expression of phlegm stopping in the intestin es.The original prescription is often used to treat "full abdomen,dry tongue an d watery sound in the intestine".We expanded "water vapor in the intestine" to nerve root edema in clinic,and achieved satisfactory results in the treatmentof clinical symptoms of patients with acute lumbar disc herniation.However,the cl inical efficacy and safety of this prescription in the treatment of acute stage of the disease have not been evaluated based on evidence.Therefore,this study us ed its own pre and post control test to observe the clinical efficacy and safety of jijiaolihuang Decoction in the treatment of low back and leg pain in theacut e stage of lumbar disc herniation.Objective:To observe the clinical efficacy and safety of jijiaolihuang Dec oction in the treatment of low back and leg pain in the acute stage of lumbar disc herniation.Research methods:This study is a self-control trial before and after.All pat ients came from the outpatient department of spine Ⅱ,Wangjing hospital,Chin ese Academy of traditional Chinese medicine from September 2020 to March 2022.40 patients who met the criteria of this study were taken as the research object.The patients who met the criteria of natriuretic peptide were treatedwith modified jijiaolihuang Decoction on the basis of health education.①Health edu cation:patients need to stay in bed absolutely during the acute onset period to reduce the weight on the waist,which can relieve pain to a certain extent;Th e patient was also instructed to maintain regular daily activities withinthetoleran ce range.②The prescription composition of this study:Fangji 10g,Sichuan pep per 10g,Tinglizi 10g,wine rhubarb 10g,jixueteng 15g,Sumu 6g,Sichuan Ach yranthes bidentata 6g.Usage:take it with boiled water,1 bag/2 times/day,all after meals;The course of treatment was 2 weeks.Observations were made ats everal time points:1 week prior to treatment,week 1 post treatment,week 2 post treatment,and a follow-up period within 1 month of the therapy.Visualan alogue scales(VAS)and Japanese Orthopaedic Association scores(JOA)was sel ected as the criterion for the assessment of efficacy.Research results:VAS score intra group comparison:1.The differences were statistically significant compared to pre-therapy at th e three time points of post-treatment week 1,post-treatment week 2,and Follo w-up at the end of the course of therapy,respectively(P<0.05).2.The difference between the follow-up period and 2 weeks post-treatment was statistically significant(P<0.05).Intra group comparison of JOA scores:1.The differences were statistically significant compared to pre-therapy at the three time points of post-treatment week 1,post-treatment week 2,and Foll ow-up at the end of the course of therapy,respectively(P<0.05).2.The difference between the follow-up period and 2 weeks post-treatment was statistically significant(P<0.05).Research conclusion:(1)The modified jijiaolihuang decoction can effectively treat acute phase o f lumbar disc herniation.It can quickly reduce low back and leg pain and imp rove lumbar function in the early stage of the disease,and greatly improve the quality of life of patients.The curative effect in the treatment process is safe and worthy of promotion in clinical practice.(2)This study emphasizes the treatment by syndrome differentiation and st ages,which further shows the causes of pain caused by dampness and heat evi l Qi in the acute stage of the disease.The method of "clearing heat and prom oting dampness and tonifying liver and kidney" enriches the new idea of syndr ome differentiation and treatment in the early stage of the disease. |
