The Study Of Surgery Combined With TCM Treatment In Elderly Lumbar Spinal Stenosis For Functional Recovery In Early Clinical Effects

ObjectiveThe main subject by observing the canal decompression and pedicle screw fixation and fusion with Chinese medicine dialectical treatment of elderly patients with lumbar spinal stenosis, to find the functional recovery of the early clinical effect in phases, compared to the use of simple canal decompression and pedicle screw clinical effect of internal fixation and fusion surgery, to explore the clinical effect of the first treatment in patients with early postoperative pain and functional recovery, and provide an effective, safe Integrative Medicine treatment for the elderly lumbar spinal canal stenosis, improve clinical outcomes in the future to provide some clinical experience.Materials and methods:This article collected from Chinese Medicine Hospital of Hubei Province from October2009October to2011in hospitalized senile lumbar spinal canal stenosis,68patients with clinical data of patients prior to admission after conservative treatment ineffective or the patient consciously satisfaction required inpatient surgical treatment.68patients were randomly divided into two groups, treatment group with34cases and control group with34cases, two groups of patients before the various aspects of gender, age, duration, onset segments, clinical symptoms, type, etc., comparable. The control group canal decompression and pedicle screw fixation and fusion, patients given anti-inflammatory, rehydration, nutrition, nerve, and to improve bone symptomatic treatment, and guidance to patients with lower back functional exercise. Treatment group in addition to the control group treatment, the other with Chinese medicine in the patient lift the fast phased dialectical treatment of oral medicine decoction, one week in the early Bu Yang Huan Wu soup basic addition and subtraction, after Duhuojisheng soup based side discriminating increase or decrease depending on the circumstances. Generally7days for a course, share the six courses. Observe the two groups before treatment and after treatment,1week,2weeks,4weeks,6weeks of symptoms and signs, functions and activities, and the use of visual analogue score (VAS) and the Japanese Orthopaedics Association (JOA) standard score, the two groups before treatment and after treatment,1week,2weeks,4weeks,6weeks, respectively, scored all of the data using statistical analysis software SPSS16.0for relevant statistical analysis, all measurement data using a descriptive study, with mean±2test,χ±S) said that the count data using χ standard deviation (measurement data using t tests, analysis of the application SPSS16.0statistical software (Let P<0.05) for the difference was statistically significant, with a significant difference.According to the postoperative improvement in pain VAS scores observed before;(JOA) score observed in patients in patients with subjective symptoms, clinical signs, activities of daily living by the limits of bladder function in various aspects of change. According to the JOA score was calculated to improve the rate, comprehensive evaluation of patients with clinical symptoms, clinical signs and activities of daily living to improve the situation. Review of liver and kidney function and the biochemical parameters, see the side effects of traditional Chinese medicine on patients, the above evaluation of clinical efficacy.Results:The two groups of68patients were followed up. VAS results of the comparison:the treatment group and control group one week after the VAS score (8.93±0.33), respectively (8.87±0.74) decreased (4.23±0.882),(4.30±0.973), p-values were less than0.05. statistically significant, indicating that1week of treatment compared with treatment before the pain ease significantly. One week between the two groups after treatment, t=0.3108P>0.05, no significant difference; two weeks between the two groups after treatment, t=1.1677P>0.05, no significant difference between the two groups of four weeks; after treatment t=1.9609P>0.05, no significant difference; six weeks between the two groups after treatment, t=3.238P<0.05, statistically significant, treatment compared with treatment before the pain ease significantly。The JOA Comparison of results:the treatment group and control group one week after the JOA score (8.77±1.53), respectively (9.12±1.61) ascended (12.83±2.59),(13.30±2.27), p-values were less than0.05 statistically significant, indicating that1week of treatment compared with treatment before the pain ease significantly.1weeks between the two groups after treatment, the JOA score t=0.7958P>0.05, no significant difference; two weeks between the two groups after treatment, t=0.9023P>0.05, no significant difference;4weeks after treatment between the two groups t=2.1762P<0.05, significant difference; six weeks between the two groups after treatment, t=2.0234P<0.05, statistically significant. Two groups were calculated according to the pre-treatment and6weeks after treatment, the JOA score improvement rate in the treatment group were excellent in14cases, good in19cases, fine in one cases, and poor in0cases, the average improvement rate of88.23%; control group were excellent in12cases, good in20cases, fine in two cases and poor in0cases. The average improvement rate of79.41%; the treatment group improved significantly compared with the control group. Liver and kidney function and biochemical indicators was normal. Two groups of patients with postoperative complications after symptomatic conservative treatment were cured.Conclusion:Lumbar spinal canal stenosis with no apparent remission in elderly patients with symptoms after conservative treatment of the system, canal decompression and pedicle screw fixation and fusion with the TCM treatment staging, patients with early postoperative functional recovery compared with surgery alone had better clinical overall efficacy, showing this treatment is a relatively safe, and early clinical outcome better treatment.