Safety And Efficacy Of Epidural Steroid Injection Combined With Herbal Fumigation In Management Of Discogenic Low Back Pain: A Retrospective Clinical Study

Objective:With the advances of science and technology, people’s living andworking style has also undergone earth-shaking changes. As a result,apart from the improvement of the quality of life, there are somehealth issues came along, and the focus of this study:discogeniclow back pain, is one of them. The purpose of this study is to explorethe safety and efficacy of the application of epidural steroidinjection combined with herbal fumigation in management ofdiscogenic low back pain, and provide information on the treatmentof this disease.Methods:Dated from May2011to March2013,60in-patients of discogenic lowback pain from the Orthopedics Department of Wuhan Hospital ofChinese Medicine were mainly treated with combined-therapy(Epidural steroid injection combined with Herbal Fumigation) ororal administration of Chinese Medicine. The combined-therapygroup consisted of34cases,18males and16females,with an averageage of(56.5±8.65),and mean course of disease(14.36±8.2)months.The control group(oral administration of Chinese Medicine) consisted of26cases,14males and12females,average age(57.43±7.92) and mean course of disease(13.63±6.87) months. Themethods of intervention for the combined-therapy group wereepidural steroid injection combined with herbal fumigation. Theepidural steroid injection was performed by the anesthetist. Aftera satisfactory puncture, the mixed infusion was injected into theepidural space gentlely.If there were2intervertebral discs wereinvoled,the upper should be opted. The mixed infusion was comprisedof5ml2%Lidocane,5ml normal saline,10mg of Betamethasone,100mgVitamin B1and0.5mg of Vitamin B12. The procedure was performed oncea week, and a single course of treatment consists of2injections.The herbal fumigation was preceded with a specialized fumigationbed, and the formula is for external use, which is customized forOrthopedic. The duration of fumigation was30min each time, oncea day, and a period of treatment was10days. While the interventionof the control group was oral administration of Chinese Medicine.Different formula for different types of syndrome of TCM.Theinterval of administration was twice a day and200ml each time,and10days was a period of treatment. Evaluated each group withVisual Analogue Score(VAS) and JOA Low Back Pain Scoring systemat the end of the treatment. All data were analyzed by the SPSS17.0statistical software.Results:①The VAS of the combined-therapy group post-treatment was（3.4±0.8）, while the VAS of the control group was（4.1±0.6）. TheVAS differences between pre-treatment and post-treatment of eachgroup are statistically significant. In terms of the alleviationof pain and the improvement of JOA score, the combined-therapy group is superior to the control group（P<0.05）.②The effective rateof the combined-therapy group post-treatment was94.1%, while thecontrol group was88.5%.The short-term therapeutic efficacy of thecombined-therapy group is superior to the control group(P<0.05).Conclusion:With rapid onset of effect, the mechanism of epidural steroidinjection is explicit, while the herbal fumigation is convenientand effective. The combination of epidural and herbal fumigationhas complementary advantages, making it possible to improve thesymptoms of DLBP rapidly and efficiently. With high-safety andpracticability, the combination is a proper approach to DLBP,andworth promoting and applying.