| Degenerative lumbar scoliosis (degenerative lumbar, scoliosis, DLS) is a common disease in clinical department of orthopedics, DLS is mainly due to the degeneration of lumbar vertebral degeneration, bending collapse accompanied by vertebral facet joint bone metabolic disease caused by lumbar spine. Refers to the lateral bending adults emerging, but the original lateral bending is not neglected in lateral bending, excluding secondary to spinal diseases such as tumor, trauma and fracture, tuberculosis and other causes. The typical symptoms of waist and back pain, progressive nerve root distribution area of pain, lumbar scoliosis, serious may be associated with spinal stenosis, intermittent claudication occurred. Traditional Chinese medicine believes that this disease belongs to "back pain", "Bi syndrome" and other areas, the disease is associated with exogenous cold, wet evil and other external factors, and liver and kidney deficiency, phlegm dampness obstruction of internal cross hybrid.Two Department of Wangjing Hospital spinal treatment of this disease, the main use of prescription of traditional Chinese medicine "Sansheng Decoction" plus minus and comprehensive therapy (including internal medicine, a little massage therapy to cure the disease, etc.) were obtained satisfactory curative effect.Clinical research:Objective:(1) To observe the improvement situation of degenerative lumbar scoliosis Oswestry Disability Index of the application of "Sansheng Decoction" with manipulation therapy in the treatment of degenerative scoliosis.(2) To observe the improvement situation of degenerative lumbar scoliosis Oswestry Disability Index of the application of "Sansheng Decoction" in the treatment of degenerative scoliosis.(3) Compared the improvement situation of degenerative lumbar scoliosis Oswestry Disability Index of the above two methods of diagnosis and treatment, and to explore the related factors affecting the efficacy.Method:The subjects of clinical observation were Chinese Academy of traditional Chinese medicine of Wangjing Hospital for treatment of outpatients and inpatients. According to the inclusion and exclusion criteria selected cases of 60 cases, using random method,30 cases in test group,30 cases in the control group. Randomly selected in this test method is a random note.The experimental group was treated with oral Chinese medicine "Sansheng Decoction" combined with manipulation therapy, the hospital preparation of granules, a day sooner or later each agent. Pain point massage therapy, patients feel the most obvious response is measured by the instrument tenderness, take each point massage for 5 minutes. In this way 1 times a week, for 3 weeks as 1 course of treatment. The control group was given oral medicine "Sansheng Decoction" in the treatment of the hospital preparation, granules, a day sooner or later each agent.Cases were selected into the group, the test group and the control group respectively for 3 weeks, in the course of treatment if symptoms disappeared or requirements of patients, can stop the treatment,1 months after treatment follow-up once.Statistical software:SPSS 19.0The measurement indexes by the standard deviation, the measurement data using t test and single factor analysis of variance (if not accord with normal distribution, using the rank sum test). Count index described by number and percentage, count data using chi square test.Results:In the patients of the treatment group and the control group in gender, age, course of disease in scoliosis, vertebral rotation angle, the degree of scoliosis, vertebral, into the top score by t test, there was no statistically significant difference (P> 0.05). Before treatment, the treatment group and the control group at baseline is consistent, comparable and reliability.Through the independent sample t test, the treatment group and the control group after treatment ODI score, the treatment group and the control group the ODI score had significant difference.The treatment group average ODI scores at each time point, followed by the group of 15.73 to 13.57,9.30,5.07,5.20 to follow-up, showed a decreasing trend, and the single factor test, the statistical significance in all statistical time (P< 0.05). By SNK test, the visible into the group of fraction> the first week after treatment score> second weeks after treatment score> third weeks after treatment score= follow-up score. Thus, after three weeks of treatment, the first week, second week and third weeks after treatment effect significantly, relative to the third week follow-up period curative effect had no obvious change, showing its stable after treatment efficacy.The average score of group ODI at each time point, followed by the group of 14.37 to 12.90,10.70,8.93 control,8.87 to follow-up, showed a decreasing trend, and the single factor test, the statistical significance in all statistical time (P< 0.05). By SNK test, the visible into the group of fraction> the first week after treatment score> second weeks after treatment score> third weeks after treatment score= follow-up score. Thus, after three weeks of treatment, the first week, second week and third weeks after treatment effect significantly, relative to the third week follow-up period curative effect had no obvious change, showing its stable after treatment efficacy.Two groups of visits between point and baseline ODI score difference comparison showed:after 1 weeks of treatment compared with baseline ODI score difference was not statistically significant (P>0.05); after second weeks of treatment, the difference between each time point and baseline comparison had statistical significance (P<0.05), said that from the second week treatment group the ODI index is better than the control group.Markedly effective rate of the treatment group and the effective rate were 53.3% and 96.7%, the control group markedly effective rate and effective rate were 0 and 96.7%, by x2 test, there was significant difference between two groups (P<0.01). Evaluation of curative effect of improvement in the ODI index shows that the treatment group was better than control group.Conclusion:Through the above analysis we can see:(1) The "Sansheng Decoction" combined with manipulation therapy degenerative lumbar scoliosis, three weeks after treatment effect in the ODI index improved significantly, compared with the third week follow-up curative effect had no obvious change, showing its effect in the ODI index improved stability.(2) Using a separate oral "Sansheng Decoction" in the treatment of degenerative lumbar scoliosis, three weeks after treatment effect in the ODI index improved significantly, compared with the third week follow-up curative effect had no obvious change, showing its effect in the ODI index improved stability.(3) In the overall effect, markedly effective rate of the treatment group and the effective rate were 53.3% and 96.7%, the control group markedly effective rate and effective rate were 0 and 96.7%. The Sansheng decoction combined with manipulation therapy is better than single Chinese herbs, and the improvement of ODI difference began to emerge in second weeks.In summary, this research through clinical Oswestry Disability Index control, the SAM soup and comprehensive therapy in the treatment of degenerative lumbar scoliosis to improve the situation, to achieve the clinical observation to the application, provide basis for the clinical application of traditional Chinese medicine of the treatment of degenerative lumbar scoliosis, and further study on comprehensive conservative treatment of degenerative lumbar scoliosis in foundation. |
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