Clinical Observation Of Xiefu Tongjing Decoction In Treating Local Edema After Unilateral Biportal Endscope/Biportal Endoscopic Spine Surgery Treatment Of Lumbar Disc Herniation

Objective: To Clinical observation of Xiefu Tongjing decoction in treating local edema after Unilateral Biportal Endscope /Biportal endoscopic spine surgery treatment of Lumbar disc herniationMethod: Seventy-two cases diagnosed as "lumbar disc herniation"(meeting the diagnostic criteria)were selected and semi-randomly divided into the treatment group(Xiefu Tongjing Decoction treatment)and the control group(no Chinese medicine treatment)36 cases each.During the study,6 cases were shed respectively,and 30 cases were effective in both groups.Observation and evaluation time of the two groups were set as,1 day,1 week and 1 month after surgery.Visual analog scale(VAS)score and Functional Impairment Index(Oswestry)score were performed at 1 day,1 week,and 1month after surgery to evaluate the efficacy of Xiefu Tongjing Decoction in improving the local edema pain and function after UBE/BESS treatment of LDH.Blood levels of5-hydroxytryptamine(5-HT)and prostaglandin 2(PGE2)were observed to assess local inflammation.At the same time,spinal magnetic resonance imaging(T1WI,T2 WI and T2-TSE-Dixon)was observed 1 day,1 week and 1 month after surgery,and the improvement rate of LDH injured vertebrae(periarticular effusion,paravertebral myoedema,superficial fascia edema and interspinous ligament edema at the same level were compared and observed.Spinal magnetic resonance imaging(T1WI,T2 WI and T2-TSE-Dixon)before surgery,1 day after surgery,1 week after surgery,and 1 month after surgery were observed,and the soft tissue thickness at the same level of the LDH injured vertebra was compared.To evaluate the effect of Xiefu Tongjing Decoction on local soft tissue edema after UBE/BESS treatment of LDH.In addition,local edema factors were restricted to surgical injury-related factors by observing creatine phosphokinase content in view of other potential related indicators.C-reactive protein,blood albumin content,blood type B natriuretic peptide and other indicators were observed to exclude local infection,malnutrition,cardiac insufficiency,liver failure and other potential edema factors unrelated to this study.Results: 1.Clinical efficacy: At the end of the total course of treatment,the total effective rate of the treatment group was 90.00%,the total effective rate of the control group was 57.60%,the difference between the two groups(X2=4.132,P<0.001),with statistical significance,the total effective rate of the treatment group was significantly higher than that of the control group.2.VAS score,Dysfunction index score(Oswestry score),blood 5-hydroxytryptamine(5-HT),prostaglandin 2(PGE2)and creatine phosphokinase levels in the treatment group and the control group were significantly decreased 1 week and 1 month after surgery,with statistical significance(P<0.001);In addition,VAS score,dysfunction index score(Oswestry score),blood 5-hydroxytryptamine(5-HT),prostaglandin 2(PGE2)and creatine phosphokinase in the treatment group were significantly lower than those in the control group.3.The improvement rates of LDH injured vertebrae(periarticular effusion,paraspinal myoedema,superficial fascia edema,interspinous ligament edema at the same level at 1week and 1 month after surgery)in the treatment group and the control group were compared,and the difference was statistically significant(P<0.001).4.The comparison of tissue MRI thickness of the soft group at the same MRI level between the treatment group and the control group showed that,from different time points,the improvement of soft tissue thickness at the 1 day after surgery was statistically significant compared with the preoperative MRI at the same MRI level(F value =2.827;P<0.05),it can be seen that after UBE/BESS surgery,there is indeed significant postoperative local soft tissue edema in the soft tissue around the injured vertebra in LDH patients.The thickness of soft tissue at the same level of MRI in both groups decreased at 1week and 1 month after surgery(P<0.05),and the difference was statistically significant.The thickness of soft tissue at the same level of MRI in the treatment group was better than that in the control group.5.Serum albumin and B type natriuretic peptide were in the normal range 1 day,1week and 1 month after surgery between the treatment group and the control group,with no statistical significance(P>0.05).6.There was no significant difference in C-reactive protein level between the two groups 1 day after surgery(P>0.05),and there were significant differences in C-reactive protein level between the two groups at different times 1 week after surgery and 1 month after surgery(P<0.05).There was no significant difference in C-reactive protein between the two groups at 1 week and 1 month after surgery(P>0.05).Conclusions: Xiefu Tongjing Decoction can significantly improve the local soft tissue edema after LDH through UBE/BESS,thus achieving the effect of reducing pain and improving function.