| Objective: 1.Based on data mining,through follow-up,we retrospectively studied the short-term efficacy of external treatment of TCM after Radiofrequency Intervention for blood stasis type lumbar disc herniation(L4/5).2.To evaluate and analyze the therapeutic effect and safety of various combinations of TCM external therapies after Radiofrequency Intervention for blood stasis type lumbar disc herniation(L4/5).Method: 1.Through HIS system and Medical Duyun system,we retrieved the inpatients with blood stasis type lumbar disc herniation(L4/5)who met the criteria of Radiofrequency Intervention in the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine(the date of retrieval was the last 3 years in November 2019,according to the reverse order of time,600 cases were expected to be collected).Data of these patients were collated,medical records were collected,and VAS pain scale scores at admission and immediately after discharge,JOA score of lower back pain of Japanese Orthopaedic Association,Roland-Morris dysfunction questionnaire and TCM syndrome measurement scale of blood stasis type LDH were improved.The patients' low back and leg pain and life success at 3 months and 6 months after discharge were investigated by telephone follow-up.To improve the score of the above scale and establish a database.2.Based on the summary of data and information,the patients were divided into the following eight groups according to different combinations of TCM external therapies after Radiofrequency Intervention: group A(routine postoperative analgesic therapy),group B(routine analgesic treatment + acupuncture therapy),group C(routine analgesic treatment + massage therapy),group D(routine analgesic treatment + TCM physical therapy),group E(routine analgesic treatment + acupuncture treatment + massage therapy),and group F(routine analgesic treatment + massage therapy),group G(conventional analgesic treatment + massage treatment + traditional Chinese medicine physiotherapy),group H(conventional analgesic treatment + acupuncture treatment + massage treatment + traditional Chinese medicine physiotherapy).3.Statistical analysis was conducted on the scale scores at admission,immediately after discharge,3 months after discharge and 6 months after discharge in eight groups and each group to observe the therapeutic effect of external treatment of TCM on blood stasis type lumbar disc herniation(L4/5)after Radiofrequency Intervention,and the mutual factors among different treatment methods in positive results or the related factors of common treatment methods in all positive result groups were discussed and analyzed.Result: 1.General Conditions: 543 effective cases were collected in this study,including 148 in Group A,48 in Group B,7 in Group C,84 in Group D,21 in Group E,92 in Group F,10 in Group G and 133 in Group H.(1)The number and proportion of male and female patients: Among 543 effective patients,209 were male,accounting for 38.49% of the total number,and 334 were female,accounting for 61.51% of the total number.(2)There were 5 adolescent(13-17 years old)patients,accounting for 1% of the total number;164 young(18-45 years old)patients,accounting for 30% of the total number;334 middle-aged(46-69 years old)patients,accounting for 62% of the total number;and 40 elderly(>69 years old)patients,accounting for 7% of the total number.(3)Composition ratio of patients' body mass index(BMI): there are 10 lean patients,accounting for 1.48% of the total number;215 normal BMI patients,accounting for 39.59% of the total number;213 overweight patients,accounting for 39.23% of the total number;105 obese patients,accounting for 19.34% of the total number.2.Research result(1)Comparisons between the immediate discharge and admission scoring scales in each group: The results showed that the scores of VAS,RMDQ and TCM Syndrome Scale at the moment of discharge were significantly lower than those at the time of admission,and the JOA score at the moment of discharge was significantly higher than those at the time of admission,and the differences were statistically significant(P < 0.01).(2)Three months after discharge,each group was compared with the immediate discharge scale score group: The results showed that:(1)the VAS score of group A,B,D,E,F,H was significantly higher than that of group B at 3 months after discharge(P < 0.01),and there was no statistical difference among groups C,G(P > 0.05).(2)The JOA scores in groups A,B,D,E,F and H at 3 months after discharge were significantly lower than those immediately after discharge(P < 0.01),and there was no statistical difference among groups C,G(P > 0.05).(3)The RMDQ scores of group A,B,D,E,F and H at 3 months after discharge were significantly higher than those of immediate discharge(P < 0.01),and there was no statistical difference among groups C,G(P > 0.05).(4)The scores of TCM Syndrome Scale in groups A,B,D,E,F and H at 3 months after discharge were significantly higher than those immediately after discharge(P < 0.01),and there was no statistical difference in other groups(P > 0.05).(3)In each group,the score of the scale was compared between 6 months after discharge and 3 months after discharge.The results showed that:(1)VAS score in group A was significantly higher than that in group 3 months after discharge(P < 0.01);VAS score in group E was significantly lower than that in group 3 months after discharge(P < 0.05),and there was no statistical difference in other groups(P > 0.05).(2)The JOA score of group A at 6 months after discharge was significantly lower than that at 3 months after discharge(P < 0.01);the JOA score of group E and H at 6 months after discharge was significantly higher than that at 3 months after discharge(P < 0.05),and the other groups had no statistical difference(P > 0.05).(3)The RMDQ score at 6 months after discharge in group A was significantly higher than that at 3 months after discharge(P < 0.01);the RMDQ score at 6 months after discharge in group E was significantly lower than that at 3 months after discharge(P < 0.05),and there was no statistical difference among the other groups(P > 0.05).(4)The score of TCM Syndrome Scale in Group A at 6 months after discharge was significantly higher than that at 3 months after discharge(P < 0.01),and there was no statistical difference in other groups(P > 0.05).(4)Comparisons between groups on the score scale immediately after discharge and at admission: The results showed that there were significant differences in JOA,RMDQ and TCM Syndrome Measurement Scale scores between the groups(P < 0.05),and there was no significant difference in VAS scores between the groups(P = 0.231).After pairwise comparison between groups,the difference of JOA score in group H was significantly lower than that in group F(P=0.022);the difference of RMDQ score in group F was significantly lower than that in group A(P=0.000);the difference of TCM syndrome score in groups D,E,F,G,H was significantly higher than that in group A(P<0.05).(5)Comparisons between the three months after discharge and the immediate discharge scale scores in each group: The results showed that there were no significant differences in VAS,JOA,RMDQ and TCM Syndrome Scale scores among the groups(P > 0.05).(6)Comparisons of scale scores between groups 6 months after discharge and 3 months after discharge: The results showed that there were significant differences in VAS,JOA,RMDQ and TCM Syndrome Scale scores among the groups(P<0.01).After pairwise comparison between groups,the VAS score difference of group D,E,F,H was significantly lower than that of group A(P<0.01);the JOA score difference of group D,E,F,H was significantly higher than that of group A(P=0.00);the RMDQ score difference of group B,D,E,F,H was significantly lower than that of group A(P<0.05);the TCM Syndrome Scale score difference of group B,D,E,F,H was significantly lower than that of group A(P<0.05).Conclusion: 1.In this study,the prevalence of female is higher than that of male,and the sex ratio is about 2:3(male: female).2.In this study,the middle-aged population is the main population with LDH,accounting for 62% of the total number of patients.3.High BMI patients accounted for 58.57% of the total number of patients,suggesting a possible correlation between high BMI and the incidence of LDH.4.The short-term curative effect of blood stasis type LDH(L4/5)after Radiofrequency Intervention combined with TCM external therapy is significant stable and safe.5.Massage therapy plays the best role in controlling disease recurrence in comparison of various groups of TCM external therapies after Radiofrequency Intervention of blood stasis type LDH(L4/5),which is worthy of further research and promotion. |
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