| BackgroundAll spinal canal diseases,ranks the first in the incidence of lumbar disc prolapse.Belong to the common disease,frequently-occurring disease is lumbar intervertebral disc protrusion.With the theory of traditional Chinese medicine in the treatment of lumbar intervertebral disc protrusion and the progress in treatment,it is necessary for the diagnosis of lumbar disc prolapse,etiology and pathogenesis of traditional Chinese medicine analysis and treatment of traditional Chinese medicine to make review finishing.In many literatures,through summarizing the law of drug in traditional Chinese medicine treatment methods,inductive lumbar disc disease pathogenesis is "Du Yang Kidney empty overseers hysteresis"."analysis of "wen yang du meridian method" and its important characteristics "jian bu qiang du fang" theory innovation and compatibility.Further observe the clinical effects of the treatment.Clinical application system has the function of education method,rehabilitation training to study the effect of the recurrence of lumbar intervertebral disc protrusion.In particular,in the process of traditional Chinese medicine in the treatment of lumbar intervertebral disc protrusion,there are many reports of clinical research literature,this study firstly summarized literature in nearly three years,find an oral Chinese medicine in the treatment of lumbar intervertebral disc protrusion medication regularly,on the back after many medicine dialectical law that "wen yang du meridian method" and "from du meridian differentiation spinal degenerative disease","Du Yang Kidney empty overseers hysteresis" etc.Series of theory on the basis of scientific and clinical application of rationality.Using this theory to guide the cubic "jian bu qiang du fang",the treatment of lumbar intervertebral disc protrusion and from clinical practice observation curative effect index and serological inflammatory index.Set up in under the guidance of this theory to analysis,it is concluded that the innovative treatment.In the process of Chinese medicine treatment of lumbar disc prolapse syndrome differentiation,prescription drug use is an important part of,but in fact,our clinical education,rehabilitation,functional exercise is an important factor of affect the prognosis of disease and recurrence,we easily neglected problems in clinical.So in the treatment of lumbar intervertebral disc protrusion were studied at the same time,should also attach importance to education and rehabilitation exercise both continuation of rehabilitation treatment,because these two kinds of methods are an important part of disease recurrence.Research purposesObjective1.Through collected nearly three years,published literature of the Chinese oral medicine in the treatment of lumbar intervertebral disc protrusion commonly used drugs are classified and summarized,to find out the regularity and features for use.2.Randomized controlled design through clinical research,observation"WenYang du meridian method" in the treatment of lumbar intervertebral disc protrusion clinical curative effect and serological indexes:painful material and inflammatory indicators.Based on the analysis "Wen yang du meridian method" on the etiology and pathogenesis theory of rationality and the use of "jian bu qiang du fang" in the effectiveness of the treatment.3.By observing the patients included in the standard lumbar intervertebral disc protrusion,to observe the system mission method is used to cooperate with rehabilitation exercise,relative to the use of traditional education methods are mission,guiding patients after discharge effects on disease recurrence.Methods1.By choosing literature into standard between January 2014 and December 2014 published related literature of traditional Chinese medicine in the treatment of lumbar intervertebral disc protrusion,to "and" lumbar intervertebral disc protrusion(traditional Chinese medicine or Chinese medicine or Chinese herbal medicine)"as the retrieval type,included in the standard treatment with oral Chinese medicine reported literature,and literature in the use of traditional Chinese medicine extract,drugs shall becarried out in accordance with the"traditional Chinese pharmacology"unified medicines,determine the drug class.Will conform to the standard of literature records analysis,statistics a various drug uses frequency.Record in the top 25 Chinese medicine;to analyze its characteristics.2.Selection into the standard during March 2014 to January 2014,in orthopedics hospital affiliated to guangzhou university of Chinese medicine clinics for lumbar intervertebral disc protrusion of outpatient and hospitalized cases,patients will be included in the standard as the research object,the sample size for a total of 90 cases.Were randomly divided into a treatment group and observation group.Both groups with foundation treatment the hypothesis hard bed,Chinese medicine hot I package and orientation through drug treatment in TCM.Control by celecoxib plus oral mecobalamin Tablets treatment;the treatment group used treadmills is strong overseers and subtract treatment.12 days to 1 course of treatment.After treatment to observe the curative effect evaluation standard,VAS score and the pain of substance P(SP),neuropeptide Y(NPY),inflammatory stress indicators:interleukin 1 beta(IL-1?),tumor necrosis factor alpha(TNF-?)change.3.Select patients into standard in June 2014 to December 2015 in fractures hospital affiliated to guangzhou university of Chinese medicine hospital treatment of 80 cases of patients with lumbar disc prolapse,using the random number table method were randomly divided into observation group and control group,two groups of 40 cases in each.Two groups during the stay in hospital to observe group and control group in the foundation treatment:the waist hot I package of traditional Chinese medicine,Chinese medicine through drug treatment with nerve nutrition:a mecobalamin injection of 0.5 mg,once-daily intravenous drip;Severe cases with static point mannitol treatment,12 days for a course of treatment.Observation group using the method of the system mission and rehabilitation exercise,.Group adopts the traditional education model.Hospital evaluation of clinical curative effect and VAS score,will relapse patients into standard 16 weeks of follow-up in 78 patients,analysis using the method of systematic education and rehabilitation exercise on patients with recurrence.Results1.Oral medication regularity of traditional Chinese medicine researchAnalysis summary into standard,until January 2014,77 papers published in the December 2016 valid documents,the number of each sample concentration between 40-300,sample age between 35-70 years.Elected to the literature by traditional Chinese medicine(TCM),including 132 of classification can be divided into 9 classes according to their function,total drug use frequency of 1163 times,basically by promoting blood circulation to remove blood stasis drugs,tonic medicine,(drugs,nourish the medicine mainly.The function of TCM in 132 according to the classification can be divided into 12 classes,which mainly(medicine(26.83%),promoting blood circulation to remove blood stasis drugs(24.42%),tonify drugs(12.93%),4 kinds of medicine is given priority to nourish the medicine(8.25%).Statistics separately according to the efficacy of four kinds of main Chinese medicine use frequency,frequency,and on behalf of the medicine,the medicine(a total of 31,total drug use frequency of 312 times,on behalf of the living by medicine,parasitic,radix aconiti,tougucao,clematis root,radix gentianae macrophyllae,common clubmoss herb,pittosporum skin,cortex periplocae,papaya.Medicine for activating blood circulation,a total of 27,total drug use frequency of 284 times,on behalf of the red flowers,peach kernel and rhizome champion,radix comatulae,frankincense and myrrh;20 flavour to tonify deficiency of medicine with a total drug use frequency of 151 times,on behalf of angelica,encomia bark,radix dip-stick,male tea scuffle fruit;16 flavour to nourish the medicine with a total drug use frequency of 96 times,on behalf of cassia twig,alarum,wind proof,ephedra;The rest of the five types of traditional Chinese medicine(TCM),a total of 38,total drug use frequency of 320 times.2.WenYang du meridian method was applied in the treatment of lumbar intervertebral disc protrusion clinical studies.(1)This study refers to that stipulated in the "standard of diagnosis of disease and curative effect of traditional Chinese medicine" curative effect evaluation standard,clinical powerfully and effectively,is invalid.Two groups of treatment,according to the results of the treatment group and control group total effective rate was 97.80%,91.10%respectively,the two groups after treatment has achieved satisfactory efficient.Two group total effective rates after statistics treatment(P<0.05),with statistical significance,treatment group total effectiveness is better than the control group.(2)The treatment group compared with control group VAS score before treatment,after statistics processing,no statistical significance(P>0.05),two groups have comparability.VAS score was compared before and after treatment in both groups,after statistics processing,with statistical significance(P<0.05),after treatment than before treatment.VAS score in the treatment group and control group after treatment,after statistics processing(P<0.05),there is statistical significance,the treatment group is better than the control group.(3)The treatment group and control group before and after treatment was detected in SP and NPY,TNF-?,IL-1? concluded:the control group and treatment group before treatment four indicators to compare the statistical calculation(P>0.05),no statistical significance,comparable.Treatment group and control group also had an improved four indexes before and after treatment,after statistics calculation(P<0.05),statistically significant,visible two treatment methods in improving the SP and NPY,TNF-?,IL-1? is effective treatment;In the SP and NPY improve degree,statistics calculation in the two groups are different(P<0.05),there is statistical significance,the treatment group is better than the control group;In the TNF-?,IL-1?improvement extent,after statistics calculation(P>0.05),no statistical significance,visible in the two groups after treatment in the index to improve degree,no obvious difference.3.System mission method combined with rehabilitation exercise on the research of the recurrence in patients with lumbar disc prolapse(1)Discharged two groups of curative effect comparison:after treatment,78 patients more than effective treatment effect of discharge;On the comparison to show the efficiency of two groups of patients,by statistical calculation(P<0.05),so the observation group of patients show efficiency is higher than the control group.Two groups total effective rate comparison results showed(P>0.05),the total effective rate difference between the two groups comparable.(2)Discharge when the observation group and control group,78 cases of patients with VAS score 3 points or less,into the VAS score compared 77 patients relapse research,through statistical calculation(P>0.05),no statistical significance,comparable.(3)Observation group and control group of patients with recurrent analysis:In patients with recurrence of follow-up study general situation is comparable.1)the observation group recurrence number 12 people;control group recurrence number 21 people,comparison of the two groups by statistical calculation(P<0.05),with statistical significance.2)the recurrence time to compare two groups of patients(week),the observation group 8.08 ±1.71;6.63 ± 1.61 in the control group;Two groups through statistical calculation(P<0.05),there is statistical significance,the observation group first recurrence,longer than the control group.3)the recurrence rate in two groups of patients with recurrent follow-up comparison,observation group 2.85±1.14 times;3.79 ±1.14 in the control group;After statistics calculation(P<0.05),there is statistical significance,observation group recurrence rate than the control group.4)the average treatment time to recurrence of two groups of patients number calculation,observation group 7.23±1.42;8.83 ± 2.01 in the control group;after statistics calculation(P<O.05),there is statistical significance;Observation group average number of treatment is better than the control group.Conclusion(1)The present situation of oral Chinese medicine treatment of lumbar disc prolapse,through literature analysis focused on the functions of most drugs dampness,promoting blood circulation to remove blood stasis drugs,tonify deficiency drugs and nourish the medicine.Research summary the rule for use based on further discussion,drug treatment more for the cause of traditional Chinese medicine treatment of the disease rather than on the treatment of disease pathogenesis.(2)Application WenYang du meridian method,the treatment of lumbar intervertebral disc protrusion is used on striding on findings "jian bu qiang du fang" treatment:compared with the western medicine control group can have a better clinical curative effect;VAS scores than the control group can better improve the patients;Can improve the patients' serum IL-1?,TNF-? alpha level;More on the improvement of SP and NPY is better than the control group.And strong inference walked briskly overseers may improve pain in patients with nerve conduction pathway of significance.(3)Using the system mission method combined with rehabilitation training,to improve the patients with recurrent lumbar disc prolapse time,recurrence rate and treatment times,has a positive meaning.So we should not only improve the treatment ways and means,more should cooperate attaches great importance to the system of diversified clinical education,health care,and actively guide the patients'' s rehabilitation exercise,continuation of treatment effect.To optimize patient rehabilitation process,reduce the recurrence rate in patients with lumbar disc prolapse... |
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