The MRI And Clinical Follow-up Study On The Treatment Of Ruptured Lumbar Disc Herniation With “Xiaosui And Huahe Decoction” Over 3 Years

Purpose:Lumbar disc herniation(LDH)is a common clinical disease.This study was conducted through a follow-up observation of patients with ruptured lumbar disc herniation for more than 3 years and these patients were treated with Xiaosui and Huahe Decoction clinically.The research was to study the mid-term effect and efficacy of Xiaosui and Huahe Decoction in the treatment of patients with ruptured lumbar disc herniation,to find the imaging basis,theoretical support,and possible influencing factors that promoted the reduction or even complete disappearance of the nucleus pulposus in medical treatment of ruptured LDH.All were designed to better guide and serve the clinic.Methods:From September 2010 to June 2015,78 patients with ruptured lumbar disc herniation who were treated or hospitalized in the outpatient department of Suzhou Hospital of Traditional Chinese Medicine.all patients met the criteria below:MRI examination was diagnosed as ruptured lumbar disc herniation and voluntarily accepted Chinese medicine.Based on comprehensive treatment,the final follow-up registration was completed.The subjects in this group were treated with Xiaosui and Huahe Decoction as the main treatment,using JOA score,ODI,straight leg raising test(SLRE),etc.to evaluate the comprehensive curative effect:by analyzing the imaging results of related MRI,we explored the factors that influenced the remission of patients with Xiaosui and Huahe Decoction.At the same time,the relationship between the patient's disease course,time and other factors and the spontaneous ablation of nucleus pulposus tissue was analyzed.Results:(1)The treatment of ruptured lumbar disc herniation with traditional Chinese medicine as the main treatment method was effective in relieving the clinical symptoms and improving the patients' comprehensive indicators.The indicators contained JOA score.Straight leg raising test(SLRE),etc.The final excellent rate of clinical observation can reach high.(2)The difference in absorption rate between the treatment group and the control group in this study was statistically significant(P<0.05).Among them.40%of the patients insisted on taking the traditional Chinese medicine detoxification nucleus pulposus.and the nucleus pulposus tissue retracted more significantly,namely the disc absorption rate.50%.(3)Analysis of the improvement rate and absorption rate of JOA,ODI and straight leg raising test(SLRE)in 78 patients in this group showed that the positive rate of JOA and SLRE improvement rate was different.In addition,MRI showed that the reduction of nucleus pulposus tissue volume was not completely proportional to the improvement of clinical symptoms of patients.It meant there was a phenomenon that the clinical symptoms were relieved and the volume retraction was not obvious.(4)There were statistically significant differences between the different stages of disease,different spinal canal morphology,existence of bull's eye signs,Modic changes(P<0.05).Among them,there were some cases with obvious re-absorption(absorption rate?50%)in the observation group.Through the correlation analysis,it can be found that their common points are as follow:the majority of patients had low back pain for the first attack,and the course of the disease was relatively short,mostly less than 1 year.MRI cross-section showed a large area of the spinal canal,with ovals and triangles accounting for the majority.Most of the patients in the MRI sagittal position had no Modic changes.The radiographic nucleus pulposus tissue was large and even partially dissociated from the spinal canal.Enhanced MRI showed that the ring around the nucleus pulposus tissue enhancement(water signal),that presented "Bully eye sign" signs.(5)The improvement of SLRE after TCM treatment with Chinese medicine of eliminating myelinated nucleus was significant,indicating that the patient's nerve root pain was relieved to some extent.From the point of view of 1-3 years or more,the difference between the two groups was not significant or even statistically significant(P>0.05).This can also indicate in a certain sense the clinically occurring root pain in patients.Prominent nucleus pulposus tissue around the accumulation of inflammatory mediators,nerve root inflammatory congestion and edema are closely related.(6)By counting the area of nucleus pulposus tissue protrusion and related absorption rate in this group of subjects,there were some cases with absorption rate>75%in the Chinese medicine treatment group,which occupied a certain percentage of the entire treatment group.The author believed that the elimination of marrow nucleus soup could greatly increase the retraction of disc tissue ablation for patients with ruptured lumbar disc herniation.In addition,the study also found that the probability of prominent nucleus pulposus ablation in patients with ruptured LDH was inversely proportional to disease duration.In other words.the shorter the course of the disease was.the more likely it was to reabsorb.Conclusions:(1)The treatment of ruptured LDH with a comprehensive therapy based on traditional Chinese medicine detoxification nucleus pulposus has a good clinical effect,and can promote the emergence of prominent nucleus pulposus to varying degrees.(2)The shorter course of disease in patients with ruptured LDH,the larger the area of the vertebral canal,the sign of"bull's eye syndrome",and the greater the nucleus pulposus tissue protrusion,the more resuscitation of nucleus pulposus is likely in the spinal canal.(3)Long course of disease,Modic changes,and spinal canal area can be improved,but the phenomenon of re-absorption is not likely to occur.