Optimization Of Clinical Pathway Of Lumbar Disc Herniation And Using The ODI,VAS Scores To Observe Clinical Effect

ObjectiveThrough optimization of clinical pathway of Lumbar Disc Herniation,and using the ODI,VAS scores for clinical observation,to evaluate the clinical pathway in the clinical efficacy of 6 months after discharge,in order to further improve the clinical pathway chart and improve clinical curative effect evaluation of accurate rationality.Methods1.Selecting the inpatients who conform to the clinical pathway of Lumbar Disc Herniation treatment in the Orthopedic Four Department of Traditional Chinese Medical Hospital of Guangdong Province Zhuhai,90 patients.The pat-ients were randomly divided into experimental group(sign:Optimized Clinical Pathway group)and control group(sign:Traditional Clinical Pathway group),45 cases each.2.The optimal clinical path group was mainly focused on optimizing the differentiation of syndromes.By studying the early induction,hospitalized cases through the literature review,statistics show that the main lumbar disc prolapse syndrome in liver and kidney deficiency syndrome,cold dampness bizu,qi and blood stasis syndrome,damp and hot bizu four type is common,and found in the traditional pure combined with clinical work of clinical pathway in rheumatism bizu,kidney Yang deficiency syndrome,liver and kidney Yin deficiency syndrome in clinical does not see more,while rheumatism bizu and cold evil,kidney Yang deficiency failure and kidney Yin deficiency,more show such as liver and kidney Yin deficiency can be supplemented with kidney Yang deficiency,lead to clinical syndrome differentiation induction is difficult,so the traditional clinical pathway of rheumatism bizu syndrome,cold dampness bizu,hot and humid bizu certificate,qi and blood stasis syndrome,kidney Yang deficiency failure,liver and kidney Yin deficiency syndrome of six kinds of classification optimization for liver and kidney deficiency syndrome,cold dampness bizu,qi and blood stasis syndrome,damp and hot bizu type and so on four points.2.The ODI and VAS evaluation scales were added to the original efficacy assessment system.In the clinical curative effect evaluation of many separate always lumbar intervertebral disc protrusion by JOA low back pain assessment evaluation,clinical found:1.The curative effect evaluation of the single,can not fully reflect the effect of authenticity;2.It lacks a quantitative pain assessment system;3.The straight leg-raising test questionnaire,muscle strength,need professional assessment project such as bladder function,if in an indirect way to evaluate after discharge,not sure the accuracy of assessment of efficacy.So,in the increase in curative effect evaluation system of the VAS pain score quantitative assessment and ODI questionnaire.3.The experimental group was treated by the optimized clinical pathway process,and the control group was treated according to the traditional clinical pathway process.Then,we observe the changes of the two groups of before clinical treatment,two period of treatment,and 1,3,6 months after discharge scores of ODI and VAS,through comparing between groups or in the each group.Results1.The distribution was no statistically significant difference(P>0.05)between experimental group and control group about gender and age,comparable.2.The two groups scores of ODI and VAS were improved obviously after the treatment in two period of treatment and 1,3,6 months after discharge;but,the ODI and VAS scores of experimental group in two period of treatment and 1,3,6 months after discharge were better than that of control group,the differences were statistically significant(P<0.025).3.Experimental group ODI scores from the start of treatment to 6 months after discharge continued to decline,and the differences were statistically significant(P<0.05);Control group ODI scores from the start of treatment to two period of treatment significantly decreased,but after two period of treatment to 6 months after discharge ODI scores overall trend was increased,and the differences were statistically significant(P<0.05).4.Experimental group VAS scores from the start of treatment to the first month after discharge continued to significantly lower,and the differences were statistically significant(P<0.05),the first month after discharge to 6 months after discharge,though VAS scores still had sustained a slight decline,but there were no statistically significant difference(P>0.05);Control VAS scores from the start of treatment to two period of treatment significantly decreased,but after two period of treatment to 6 months after discharge VAS scores overall trend was increased,and the differences were statistically significant(P<0.05).5.During the period of observation,no obvious adverse reaction occurred in both groups.ConclusionBy implementing the optimized clinical pathway of Lumbar Disc Herniation treatment can effectively improve the clinical curative effect and improve patient quality of life,and the curative effect is maintained within six months after discharge,as well as using the ODI,VAS scale assessment can more accurately reflect the treatment effect,is worth popularizing in clinic gradually.