Clinical Efficacy Of Percutaneous Transforaminal Endoscopy Discectomy Combined With Modified Bushen Huoxue Decoction In The Treatment Of Degenerative Lumber Spinal Stenosis

Objective:To investigate the clinical efficacy,in the treatment of Degenerative Lumbar Spinal Stenosis(DLSS)by percutaneous transforaminal endoscopic discectomy(PTED)combined with modified Bushen Huoxue decoction.Reference values are also provided for the clinical physicians,who aim to treat the DLSS.Methods:90 patients were selected,who met inclusion criteria andsuffered from the DLSS.According to the random number table method,the patients were divided into 3 groups,30 cases in each group.Group A was treated with percutaneous transforaminal endoscopic discectomy combined with modified Bushen Huoxue decoction,group B was treated with percutaneous transforaminal endoscopic discectomy alone;group C was treated with modified Bushen Huoxue decoction alone.Collecting and comparing Visual Analogue Scale(VAS)?Quebec Back Pain Disability Scale(QBPDS)?Japaneses Orthopaedic Association Low Back Pain Score(JOA)and serun TNF-? and IL-6 change in content between three groups,which were obtained respectively before the treatment and 1,3 and 6 months after the treatment.Results :(1)The gender,age,duration of disease,pre-treatment VAS score?QBPDS score and JOA low back pain score and serun TNF-? and IL-6 content of the three groups of patients were statistically analyzed.The differences were not statistically significant and were comparable;(2)The comparison between the three groups,VAS score?QBPDS score and JOA low back pain score and the serum TNF-? and IL-6 were significantly different after 1,3 and 6 months of treatment compared with those before treatment(P <0.05),indicating that the three treatment methods can reduce serum TNF-? and IL-6 content,relieve patients' lower back pain and improve lumbar function;(3)Compare with group B and group C,VAS score,QBPDS score,serum TNF-? and IL-6content were all decreased and JOA back pain score was increased at 1,3 and 6 months after treatment in group A(P<0.05).It shows that PTED surgery combined with Bushen Huoxue Decoction is better than PTED surgery alone and Chinese medicine treatment alone;(4)Compare with group C,there was no significant difference in QBPDS score,JOA low back pain score and serum TNF-?content at 1 month after treatment in group B(P>0.05);VAS score?QBPDS score,serum TNF-? and IL-6 content were all decreased and JOA low back pain score was increased at 3 and 6 months after treatment(P<0.05),indicates that the short-term efficacy of PTED surgery is not statistically significant compared with that of traditional Chinese medicine alone,but the long-term efficacy is still better than that of traditional Chinese medicine alone.Conclusion :The symptoms of the three groups were improved in different degrees after treatment;among them,PTED combined with modified Bushen Huoxue Decoction for the treatment of DLSS is better than surgery alone and traditional Chinese dedicine alone,and the treatment method is safe and effective,and is worthy of clinical study and application.