Lumbar Disc Herniation Conservative Treatment And Assessment

objective:Approach therapeutic efficacy on lubar intervertebral disc protrusion LIDF of acute and paracmastic stage by expectant treatment, analyze and compare the different effects by all kinds of different method combination.Method:select 217 LIDP patients of expanding and outstanding pattern.67 patients who are on acute stage are divided into 4 groups:group A:there are 15 patients who are treated with traction and chirismus massage;group B:14 patients who are treated with traction,dehydration therapy and acupuncture point or pain spot block necessarily;group C: 18 patients who are treated by the traction,chirismus massage,microwave on high frequency and thermo-electromag netism;group D:20 patients who are treated by the traction,chirismus massage,microwave on high frequency,thermo-electromagnetism and dehy dration therapy.To give a mark on visual simulation,take the days of getting 50%easement of pain as evaluation criterion.150 patients who are on paracmasis stage are divided into 5 groups:groupⅠ:there are 17 patients who are treated with traction and chirismus massage;groupⅡ:41 patients who are treated by the traction,microwave on low frequency and thermo- electro magnetism; groupⅢ:30 patients who are treated by the traction,chirismus massage, microwave on low frequency and thermo- electromagne tism;groupⅣ:27 patients who are treated by the traction,microwave on low frequency, thermo-electromagnetism and fumigate by the traditional Chinese medicine; groupⅤ:35 patients who are treated by the traction,chirismus massage, microwave on low frequency,thermo-electromagnetism and fumigate by the traditional Chinese medicine.Therapeatic efficacy are distinguished by excellent,good,acceptable and bad in accordance with 70°;③Acceptable:the pain of the waist and leg disappears partly,there is no tendemess beside the vertebra,and radiating pain is relieved,th function of the waist activity is improved,straight-leg raising test is 30°-60°;④Bad: the symptom are not relieved and the straight-leg raising test have no obviously improve.Result:The general mean days of 50%easement of pain are 5.22 days during acute stage.The average days of group A of 50%easement of pain are 8.0666 days,which in group B are 4.1428,in group C are 5.8333,in group D are 3.3.Comparing the therapeutic efficacy,group B,C,D is better than group A significantly,group D is better than group C signigicantly. In the paracmasis stage:the general excellent and good rate is 88%by expectant treatment,the rate have significant deviation between group Iand groupⅢ,groupⅥand groupⅤ.There is bad therapeutic effect in 5 patients,who are all treated by the operation later.During the operation,we see there are 3 patients whose disc are ruptured,and nerve roots are seriously compressed in the other 2 patients,among which there is one recurred patient who had operation before.Conclusion:in acute stage,the therapeutic effect by expectant treatment is reliability in the LIDP patients of expanding and outstanding pattern.In the experiment,group B,group C,group D are better than group A significantly,which demonstrates that the effect by the treatment of simple traction and chirismus massage is not as good as the other group of combined therapy,and is not good as the therapeutic perscription of traction and dehy dration therapy.Group D is better than group C significantly,which certificates that in the combined therapy, dehydration therapy and regional block can relieve pain effectively. Although there is no obvious difference among the other combinations,the best effect can got by take all the methods simultaneously,because it takes the lest days to get 50%easement of pain.In the experiment,the general excellent and good rate is 88%in the paracmasis stage,which proves that expectant treatment is a safe,effective and receptive method, and it is generally adopted in the clinic now as well.The effect in the groupⅤis obviously better than in groupⅣ,which shows that chirismus massage has favourable effect on relieve the symptom of LIDP.The excellent and good rate in the groupⅢis better than groupⅠsignifi-cantly,which demonstrates that micro wave and electromagnetism have satisfactory effect in the paracmasis stage.In the group that various kinds of methods are used to treat the disease simultameous,the excellent and good rate can reach 94.29%,which proves that the above-mentioned treatment can promote each other and evaluate the curative effect each other.Combined therapy can resolve the mechanical,chemical and autoimmunitical inflammation of the part of inter vertebral disk hemia rapidly,it can relieve the pain of the patients and shorten the course of treatment as well.For those who have no effect by the expectant treatment,having the operation earlier is the better choose.