Efficacy Of Lumbarintervertebral Disc Herniationtreatment By Using Melilotus Extract

There are two parts in the article:review literature and clinical study.In the first part of the article, the pathogeny and predisposing factors of lumbar intervertebral disc herniation (LDH), the type of LDH, pain mechanisms and its research progress were firstly reviewed. Secondly, the progress of the non-surgical treatment of LDH was reviewed. Thirdly, the research of chemical composition in Melilotus Extract Tablets and clinical application of Melilotus Extract Tablets were reviewed. Because of its advantage, Melilotus Extract tablets in the treatment of LDH are easily accepted by the majority of patients, which show its good prospects for development.The second part is clinical study:Objective:In a long time, melilotus extract has been used as a folk medicine in inflammation-related or edema therapy. The aim of this investigation was to determine the potential benefits of this herbal extract, comparing with a placebo, in treating lumbar intervertebral disc herniation. The effect of two groups (the melilotus extract group and the placebo group) was assessed, while lifequality and pain of the patients who suffering lumbar intervertebral disc herniation were evaluated. Discuss the mechanism of this herbal extract and provide the evidence for popularization of melilotus extract on treating lumbar intervertebral disc herniation.Methods:From October 2014 to December 2015, patients suffering lumbar intervertebral disc herniation in Orthopedic Department of Guangzhou Panyu Central Hospital were randomized into melilotus extractand control groups. Patients undertook a two-week bed restand waist and back muscle exercise for basic therapy in both groups. Then the treatment group was treated by Melilotus Extract Tablets, and the control group take vitamin C as a placebo. Ourmeasurement tool were:the MOS item short from health survey (SF-36), Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS).By comparing the data before with after treatment, the outcome indicators of general health, functional and pain are observed, and the effect before and after treatment by using melilotus extract is evaluated.Results:In the research, there was no adverse reaction in all patients during the medication, such as lower extremity venous thrombosis and other complications. And there are 91 in 118 patients were followed up, which divided into the control and the treatment groups. And all of the patients were followed 12 weeks after treatment.1. A statistically significant difference was not observed between the two groups, in terms of distribution of sex and age (p>0.05).2. Before treatment, thecontrolgroupwas compared the treatment group, and there was no statistically difference.3. When the groups were compared at the time of pre-treatment,2 weeks, 4weeks and 12 weeks after treatment, a statistically significant difference was found in the VAS (p<0.05), Oswestry Low Back Pain Disability Questionnaire (p<0.05). And in physical functioning of the SF-36, thecomparison of score in PF, BP, GH, SF between the two groups in different time point, the difference was statistically significant (P<0.05); and the RP, when the two groups compare in pre-treatment and 12 weeks after treatment, the difference was not statistically significant (P> 0.05), the opposite after 2 weeks and 4 weeks after treatment(P<0.01); while scoring comparison of two groups in VT, RE and MH were no difference significant (P> 0.05).4. In ODI and VAS, the scores between the two groups in pre-treatment, 2 weeks,4 weeks and 12 weeks after treatment, the difference was statistically significant (P<0.008). While in 36-SF, pairwise comparison of the treatment group in pre-treatment and 2 weeks,4 weeks and 12 weeks after treatment, the difference was statistically significant (P<0.008). And in the control group: the PF dimension, except for the comparison of the score between pre-treatment and 2 weeks after treatment,2 weeks and 4 weeks after treatment, there was no statistically significant difference (P> 0.008), but other time points scoring pairwise comparisons were statistically significant (P<0.008); the RP dimension, except for the difference was not statistically significant in the comparison of the score in pre-treatment and 2 weeks after treatment(P> 0.008), other various time points pairwise comparisons were statistically significant (P<0.008); and the BP dimension, except for scoring pairwise comparisons in 2 weeks and 4 weeks after treatment,4 weeks and 12 weeks after treatment, the difference was not significant (P>0.05), and the remaining time score pairwise comparisons were statistically significant (P<0.008);In GH dimension, in addition to the comparison of the score in 2 weeks and 4 weeks after treatment were not statistically significant (P> 0.008), other time point remaining pairwise comparisons were statistically significant (P<0.008); SF dimensions, scoring pairwise comparisons in 12 weeks after treatment with pre-treatment,2 weeks and 4 weeks after treatment, the difference was statistically significance(P<0.008).Conclusion:The two groups both showed improvement in pain, disability, general health status, social function and behavioral status, but the treatment group showed further improvements in these measures after using melilotus extract at least 2 weeks. Melilotus extract can improve pain, disability, and spinal function in patients who suffering lumbar intervertebral disc herniation and reduce the short-term surgical rate, the hospital costs of patients, which can be easily accepted because of avoiding of surgery.