The MRI Change And Therapeutic Effect Observation Of Xiaosui Huahe Decoction On The Massive Lumbar Disc Herniation

Objects:To investigate the feasibility of Xiaosui Huahe Decoction in the treatment of massive lumbar disc herniation(LDH).Through the clinical retrospective study,we compare the MRI change and clinical effects of the cases of massive LDH treated with Xiaosui Huahe Decoction and percutaneous transforaminal endoscopic discectomy(PTED).Methods:(1)Among outpatients and inpatients of Suzhou Hospital of Traditional Chinese Medicine between January 2015 and January 2019,56 cases with massive LDH were enrolled to the research.After more than 1 years of follow-up,the clinical effects of two kinds of treatment methods were evaluated by JOA score,Excellent and Good rate,Oswestry Disability Index(ODI),time to resume work.(2)Therapy group with Xiaosui Huahe Decoction were compared with the cases treated with PTED.The improvement of the imaging performance of the two kinds of treatment methods was evaluated by the MRI prominent rate,MRI resorption rate,MRI disc herniation volume improvement rate and the herniated area as percentage of corresponding vertebral canal area improvement rate.(3)The correlation between the size of bull's eye configuration and resorption rate was investigated by observing the MRI images of Resorption cases.Results:(1)Among the 30 cases of massive LDH treated with Xiaosui Huahe Decoction,3 cases were operated because of intolerable pain and 1 case because of cauda equina syndrome.The remaining 26 cases completed the follow-up study.Of the 26 patients,one had residual neurological symptoms and the symptoms of another 25 cases were significantly improved.More than 1 years of follow-up showed that there was no statistically difference between JOA score,Excellent and Good rate,ODI Index,compared with the PTED group(P>0.05).(2)Follow up showed that the time to resume work in the therapy group was obviously longer than that in the PTED group(P<0.05).(3)In the therapy group,protrusions disappeared during the last follow-up in 6 cases,6 cases had obvious resorption,3 cases had partial resorption,8 cases had no resorption and the disc herniation volume of 3 cases were increased.The imaging performance of 12 reabsorbed patients was significantly improved.More than 1 years of follow-up showed that there were statistical differences between MRI prominent rate,MRI resorption rate,MRI disc herniation volume improvement rate and the herniated area as percentage of corresponding vertebral canal area improvement rate,compared with the PTED group(P<0.05).(4)The average width and area of bull's eye configuration and the resorption rat had obvious positive correlation by the Pearson rank correlation analysis of 6 samples(rs=0.824/0.816,P<0.05).Conclusion:(1)Xiaosui Huahe Decoction play a good therapeutic effect on massive LDH.(2)The resorption probability of massive LDH will be promoted treated with Xiaosui Huahe Decoction.The clinical symptoms and MRI imaging performance are improved after resorption.(3)Patients with bull's eye configuration on MRI are more likely to have resorption.