Application In The Treatment Of TCM Through Measurement The Area Of Disc Herniation In The Spina

Background:Lumbar Disc Herniation is one of common orthopaedic disorders, serious impacting on the quality of life and the ability of work to the patients.There are many ways of treatment to LDH, however, surgical and non-surgical therapy are major sorts. Generally, because of its high cost and difficulty, surgical treatment is not the preferred treatment. Using conservative treatments such as massage, drugs, traction, physical therapy and other therapies, most patients can receive varying degrees of recovery.Along with the application and popularization of CT, We find that CT scans can not only show the existence of protrusions, but also have good clinical significance in determining the shape, size, type, the compression of the extent of spinal and involving the nerve root. In clinical CT diagnosis, Orthopedic doctors often evaluate patient's condition and prognosis only by subjective judge, Lack of objective methods. In the clinical.We observe that it is tend to different when applied the same conservative treatment in patients of different size of prominence. Therefore, we want to combine the clinical computer software technology and clinical, working out an software.Because of the different gray between disc herniation and spinal and nerve roots. Measuring the area of the disc herniation in the spinal, find out the relation between the size of disc herniation and clinical efficacy. Observe the symptoms in different prominent position in the case of the same area. Provid clinical reference of treating LDH with conservative treatment.Object:Design software which can measure the area of the disc herniation in the spinal, find out the relation between the size of disc herniation and clinical efficacy.Methods:Observe 60 cases of patients suffered LDH with CT in department of spine division one of Wang jing hospital between december,2009-october,2010. Compartmentalize once, second and third degree according to their different area. Statistical analysis the different area ratio in the spinal canal, the improvement of patients VAS, JO A, SLR, LMA,in order to evaluate the therapeutic effect.Treatment:three groups of sufferer with the same conservative treatment of TCM and Western medicine. Massage:Relexing back parenchyma, pulling-shaking waist & "obliquely-pulling" or "spinal totation manual repositing". The young adults are mainly used "spinal totationg manual reposition" therapy, while the frail elderly are used "obliquely-pulling" therapy. Three times a week.Iontophoresis with traditional Chinese herbal medicine:Spraying Guyouling over the affected part, then adhibitting therapeutic instrument. Three times a week, half an hour every time.Traditional Chinese medicine:Wind-cold-damp retention type and deficiency of liver and kidney type in TCM syndrome differentiation. Wind-cold-damp retention type:dispelling Wind, expelling cold-evil and disinhibiting dampness, use Duhuojisheng decoction. Deficiency of liver and kidney type:Yang deficiency: Warming kidney and enhancing yang, using Jinkuishenqi bolus; Yin deficiency: Reinforcing kidney to replenish yin, use Liuweidihuang bolus.Control group uses traction treatment, physiotherapy, pain medicine and electromagnetic therapy.Hauling weight is from 26 to 30 kg according to the patient's avoirdupois, once a day,20 minutes at a time. Electromagnetic therapy:Use electromagnetic treatmenr and infrared rag shine treatment, once a day each,20 minutes at a time.Treatment cycle:Each period of treatment is 3 weeks, then analyse the data, assess curative effect.Statistical software:SPSS17.0Directly to the patient for the data collection.Measurement data expressed by (±SD), using T test for statistical analysis. Before and after treatment the observation measures of VAS, LVM, SLR, M-JOA differences using single factor analysis of variance (F test). Efficacy is assessed by hierarchical rank and testing.P<0.05 as a statistically significant difference. P> 0.05 for the difference was not statistically significant.Results:At the beginning,sex,age,segment of age are not statistically significant(P> 0.05)in the three group.So the baseline is consistent. After three weeks of treatment, At the degree one, The more deviation from the spinal projections, the more severe of symptoms and signs; At the degree two, the improvement of symptoms and signs are rather between central and unilateral clinical; At the degree three, the closer to the dural projections,the more severe of symptoms and signs.The improvement of VAS after treatment indicators, the three groups after treatment than before treatment were significantly improved (P<0.05) and the smaller of the area the more obvious improvement of VAS; The improvement of JOA, the degree of once,second have significantly improved (P<0.05) than fortreatment,the degree of third have not obvious improvement (P>0.05). The improvement of degree once was better than the second, third degree (P<0.05). The degree of second and third have not statistically significant (P> 0.05). The improvement of SLR, The degree of onec and second have significantly improved than fortreatment (P<0.05), The degree of third have not improvment compared with fortreatment (P> 0.05) and the smaller of the area the more obvious improvement of SLR (P<0.05). The improvement of LMA, the three groups after treatment than before treatment have significantly improved (P<0.05) and the smaller of the area the more obvious improvement of LMA. After three weeks,on the efficacy of degree once is78%.the second is 40%,the third is 8%.After the rank test, Z=-2.756, P=0.006. P<0.01.The difference has statistically significant. The smaller of the area, the more obvious of efficacy.Conclusion:1. Designed a software to measure the area of the disc herniation in spinal, providing a reference for clinical treatment.2. At the degree one, The more deviation from the spinal projections, the more severe of symptoms and signs; At the degree two, the improvement of symptoms and signs are rather between central and unilateral clinical; At the degree three, the closer to the dural projections,the more severe of symptoms and signs.3. The improvement of VAS after treatment indicators, the three groups after treatment than before treatment were significantly improved and the smaller of the area the more obvious improvement of VAS; The improvement of JOA, the degree of once,second have significantly improved than fortreatment,the degree of third have not obvious improvement. The improvement of degree once was better than the second, third degree. The degree of second and third have not statistically significant. The improvement of SLR, The degree of onec and second have significantly improved than fortreatment, The degree of third have not improvment compared with fortreatment and the smaller of the area the more obvious improvement of SLR. The improvement of LMA, the three groups after treatment than before treatment have significantly improved and the smaller of the area the more obvious improvement of LMA.4. Conservative treatment is effective to LDH, and the smaller of the area, the better of the effect.