The MRI Observation And Clinical Related Research Of "Yiqi Zhuyu And Lishui Decoction" On The Resorption Of Lumbar Disc Herniation

Objective:To observe the therapeutic effect by YiqiZhuyu and Lishui Decoction in the treatment of lumbar disc herniation (LDH) by a clinical randomized controlled trial. The MRI was used to observe the resorption of herniated nucleus pulposus (HNP), explore the clinical and imaging evidence As well as to find the key factor of promoting the HNP resorption after LDH.Methods:Among outpatients and inpatients of Suzhou Hospital of Chinese Traditional Medicine, 95 cases were enrolled to the research. After treating by YiqiZhuyu and Lishui Decoction, the efficacy was evaluated by JOA score, Oswestry Disability Index (ODI) and Visual Analogue Scales(VAS). By the MRI observation, the relationship between HNP resorption and the clinical symptom should be analyzed. The course of disease, the type of herniation, the age of patient, the Modic Change(MC) and degeneration of discs were analyzed to explorer the correlation with resorption of HNP.Results:(1) In most of the patients, JOA scores were improved, the ODIs and VASs were reduced after the treatment by YiqiZhuyu and Lishui Decoction combined with western medicine. The rate of goodness is 97.9%, there was statistically significant difference with the control group(P=0.000). (2) The resorption rate between the two groups had statistically significant difference via rank test(P=0.000). All cases with resorption rate above 50%were taken YiqiZhuyu and Lishui Decoction. (3) The improvement of JOA/ODI/VAS and the resorption rate had midrange/midrange/weak positive correlation by the Spearman rank correlation test of all 95 samples(rO.01=0.526/0.485/0.349). Some cases which were not found obviously resorption also might have good therapeutic effects.(4) In different courses, different style, different shape of spinal canal, had MC or not, the resorption rate had statistically significant difference analyzed by rank test separately(P<0.05).10 cases discovered of obviously resorption (more than 50%) were all in less than one year course(8 cases for the first time), the type of the posterior longitudinal ligament(PLL) ruptured(8 cases of episomal), type of ellipse or triangle spinal canal(7 cases of ellipse), and with no MC. The resorption rate had no differences among different ages, and between disc degeneration and undegeneration(P>0.05).Conclusions:(1) The YiqiZhuyu and Lishui Decoction can both play a good therapeutic effect and promote the resorption of HNP for the patients of LDH. (2) The shorter course lasts, the farther the HNP frees, the more similar with ellipse-type spinal canal, the stronger ability of the resorption. Conversely, cases with long-course, un-rupture of PLL, the three-leave-type spinal canal, and with Modic changes had weaker ability of HNP resorption. (4)The factor of age and disc degeneration had no interaction with HNP resorption.