| ObjectiveThe main purpose of this study is to study the clinical efficacy and safety of modified Longqi Qiangji Yin in the improvement of postoperative residual nerve symptoms in patients with cervical Spondylotic myelopathy.Through comparison,on the basis of routine functional rehabilitation training,the therapeutic effects of Jiawei Longqi Qiangji Yin and western medicine mecobalamin tablets on the improvement of postoperative residual nerve symptoms of cervical Spondylotic myelopathy were compared.to make clear the basis of syndrome differentiation and treatment for the improvement of postoperative residual nerve symptoms of cervical Spondylotic myelopathy.MethodsThe main purpose of this study is to study the clinical efficacy and safety of modified Longqi Qiangji Yin in the improvement of postoperative residual nerve symptoms in patients with cervical Spondylotic myelopathy.On the basis of routine functional rehabilitation training,the therapeutic effects of modified Longqi Qiangji Yin and western medicine mecobalamin tablets on the improvement of neurological symptoms caused by residual spinal cord nerve dysfunction after operation of cervical Spondylotic myelopathy were compared.to explore the rationality of modified Longqi Qiangji Yin in the improvement of residual nerve symptoms after operation of cervical Spondylotic myelopathy,to provide a basis for its clinical application,and to broaden the dialectical perspective for the study of the treatment of cervical Spondylotic myelopathy.Results1.The baseline data of the three groups,such as sex,age,course of disease,education and other aspects,there was no significant difference(P<0.05),which was comparable.2.Cervical JOA score(17):there was no significant difference in JOA score among the three groups before operation(The comparison between the traditional Chinese medicine group and the western medicine group,P=0.187>0.05;the traditional Chinese medicinegroup and the rehabilitation group,P=0.53 0>0.05;The comparison between the western medicine group and the rehabilitation group,P=0.485>0.05),was comparable.Comparison between groups:compared with pre-operation,there was no significant difference among the three groups on the first day after operation(between traditional Chinese medicine group and western medicine group,P=0.449>0.05;between traditional Chinese medicine group and rehabilitationgroup,P=0.115>0.05,between western medicine group and rehabilitation group,P=0.5 00>0.05).Compared with the first day after operation,there was significant difference in cervical JOA score among the three groups after 2 weeks of treatment(between traditional Chinese medicine group and western medicine group,P=0.449>0.05;between traditional Chinese medicine group and rehabilitation group,P=0.000<0.05;between western medicine group and rehabilitation group,P=0.044<0.05).Compared with 2 weeks after operation,after 2 months of treatment,there was significant difference in cervical JOA score among the three groups(between traditional Chinese medicine group and western medicine group,P=0.001<0.05;between traditional Chinese medicine group and rehabilitation group,P=0.000<0.05,and between western medicine group and rehabilitation group,P=0.032<0.05).Intra-group comparison:the JOA score of the traditional Chinese medicine group,the western medicine group and the rehabilitation group increased continuously on the first day,two weeks and two months after operation,respectively,compared with those before operation,and there were significant statistical differences(P=0.000<0.01,P=0.000<0.01,P=0.000<0.01;P=0.000<0.01,P=0.000<0.01,P=0.000<0.01;P=0.000<0.01,P=0.000<0.01,P=0.000<0.01).The JOA scores of traditional Chinese medicine group,western medicine Ⅱ group and rehabilitation group after 2 weeks treatment were significantly higher than those on the first day after operation(P=0.000<0.01,P=0.000<0.01,P=0.000<0.01).There were significant differences in JOA scores between 2 months after treatment and 2 weeks after operation in the three groups(P=0.000<0.01,P=0.000<0.0,P=0.000<0.01).After 2 months of treatment,the average improvement rates of traditional Chinese medicine group,western medicine group and rehabilitation group were 62%,52%and 43%,respectively.According to the score of JOA scale before treatment in the three groups,the distribution statistics of improvement rate were carried out.Using kruskal-wallis test x2=12.781,P=0.002<0.05,it was concluded that there was no significant difference among the three groups.On the whole,it can be seen that the average improvement rate of JOA in the traditional Chinese medicine group is higher than that in the western medicine group and the rehabilitation group.3.MBI score:there was no significant difference in MBI score among the three groups before operation(compared with the western medicine group,the traditional Chinese medicine group was P=0.615>0.05;the traditional Chinese medicine group was P=0.880>0.05,and the western medicine group was P=0.513>0.05,compared with the rehabilitation group),which was comparable.Comparison between groups:on the first day after operation,there was no significant difference between traditional Chinese medicine group and western medicine group(P=0.585>0.05),there was no significant difference between traditional Chinese medicine group and rehabilitation group(P=0.360>0.05),and there was no significant difference between western medicine group and rehabilitation group(P=0.460>0.05).Compared with the first day after operation,after 2 weeks of treatment,there was significant difference between the traditional Chinese medicine group and the western medicine group(P=0.980<0.05),between the traditional Chinese medicine group and the rehabilitation group(P=0.046<0.05),and between the western medicine group and the rehabilitation group(P=0.048<0.05).Compared with 2 weeks of treatment,there were significant differences in MBI scores among the three groups after 2 months of treatment(P=0.001<0.05)between the traditional Chinese medicine group and the western medicine group,and between the traditional Chinese medicine group and the rehabilitation group(P=0.000<0.05).There was significant difference between the western medicine group and the rehabilitation group(P=0.049<0.05).The MBI scores of the traditional Chinese medicine group,the western medicine group and the rehabilitation group were continuously improved at the first day,two weeks and two months after operation,and the difference was statistically significant(all the follow-up points in the three groups were satisfied:P=0.000<0.01,P=0.000<0.01,P=0.000<0.01).The MBI scores of traditional Chinese medicine group,western medicine group and rehabilitation group after 2 weeks treatment were significantly different from those on the first day after operation(P=0.000<0.01,P=0.000<0.01,P=0.000<0.01),and the MBI scores of traditional Chinese medicine group,western medicine group and rehabilitation group after 2 weeks of treatment were significantly different from those of 2 weeks after operation(P=0.000<0.01,P=0.000<0.01,P=0.000<0.01).5.Volume of major and lesser leg muscles of lower extremities5.1 Comparison of thigh circumference before and after treatmentComparison between groups:there was no significant difference in thigh circumference among the three groups before operation(P=0.712>0.05,P=0.282>0.05,P=0.478>0.05),but on the first day after operation,there was no significant difference in thigh circumference among the three groups(P=0.730>0.05,P=0.27>0.05,P=0.450>0.05).Compared with the first day after operation,there was no significant difference between the traditional Chinese medicine group and the western medicine group after 2 weeks of treatment(P=0.666>0.05),between the traditional Chinese medicine group and the rehabilitation group(P=0.132>0.05),and between the western medicine group and the rehabilitation group(P=0.279>0.05).Compared with 2 weeks after operation,after 2 months of treatment,there was significant difference between traditional Chinese medicine group and western medicine group(P=0.046<0.05),between traditional Chinese medicine group and rehabilitation group(P=0.000<0.05),and between western medicine group and rehabilitation group(P=0.033<0.05).Intra-group comparison:there was no significant difference in the thigh circumference among the three groups on the first day after operation and before operation(P=0.730>0.05,P=0.273>0.05,P=0.450>0.05)but there was no significant difference in the thigh circumference in the traditional Chinese medicine group after 2 weeks of treatment(P=0.162>0.05),but in the western medicine group there was significant difference in the thigh circumference between the western medicine group and the western medicine group(P=0.003<0.05),but there was no significant difference in the thigh circumference between the western medicine group and the western medicine group(P=0.003<0.05).There was a significant difference in the III of the thigh circumference of the traditional Chinese medicine group(P=0.000<0.01).Compared with 2 weeks after operation,there was no significant difference in thigh circumference in traditional Chinese medicine group after 2 months treatment(P=0.645>0.05),but there was significant difference in thigh circumference in western medicine group(P=0.013<0.05),and there was significant difference in thigh circumference in traditional Chinese medicine group(P=0.000<0.01).5.2 Comparison of muscle volume and leg circumference between groups before and after treatmentComparison between groups there was no significant difference in preoperative muscle volume and leg circumference among the three groups(P=0.283>0.05,P=0.223>0.05,P=0.882>0.05),and there was no significant difference in preoperative muscle volume and leg circumference among the three groups(P=0.329>0.05,P=0.259>0.05,P=0.878>0.05).Compared with that before operation,on the first day after operation,there was no significant difference in leg circumference among the three groups.Compared with the first day after operation,after 2 weeks of treatment,there was no significant difference between the traditional Chinese medicine group and the western medicine group(P=0.173>0.05),between the traditional Chinese medicine group and the rehabilitation group(P=0.0.116>0.05),and between the western medicine group and the rehabilitation group(P=0.829>0.01).Compared with 2 weeks after operation,after 2 months of treatment,there was significant difference in leg circumference between traditional Chinese medicine group and western medicine group(P=0.049<0.05),between traditional Chinese medicine group and rehabilitation group(P=0.000<0.05),and between western medicine group and rehabilitation group(P=0.048<0.05).Intra-group comparison:there was no significant difference in leg circumference among the three groups on the first day after operation and before operation(P=0.329>0.05,P=0.259>0.05,P=0.878>0.05);Compared with the first day after operation,after 2 weeks treatment,there was no significant difference in leg circumference in traditional Chinese medicine group(P=0.037>0.05),but there was significant difference in western medicine group(P=0.000<0.05),and there was significant difference in rehabilitation group(P=0.000<0.01).Compared with 2 weeks after operation,after 2 months treatment,there was no significant difference in leg circumference in traditional Chinese medicine group(P=0.057>0.05),but there was significant difference in western medicine group(P=0.000<0.05).There was significant difference in leg circumference in rehabilitation group(P=0.000<0.01).6.After 2 months of treatment,the clinical efficacy of the three groups was evaluated.Among the 66 patients,38 cases were cured,22 cases improved and 6 cases ineffective.The total effective rate of the traditional Chinese medicine group was 95.45%,that of the western medicine group was 90.91%,and that of the rehabilitation group was 86.36%.There was significant difference among the three groups(P=0.001<0.05).Conclusion:1.modified Longqi Qiangji Yin combined with routine functional rehabilitation training has a good curative effect,which can significantly improve the JOA score and MBI score of patients with cervical Spondylotic myelopathy after operation,effectively alleviate the decrease of muscle volume of both lower limbs,prevent muscle atrophy and improve the ability of daily life and quality of patients.2.The short-term effect of modified Longqi Qiangji Yin combined with routine functional rehabilitation training on postoperative residual nerve symptoms of cervical Spondylotic myelopathy is better than that of routine functional rehabilitation training alone,which is similar to that of mecobalamin tablets combined with routine functional rehabilitation training.At the same time,in a short time,modified Longqi Qiangji Yin combined with routine functional rehabilitation training is similar to routine functional rehabilitation training and mecobalamin tablets in preventing lower limb muscle atrophy.The long-term effect of modified Longqi Qiangji Yin combined with routine functional rehabilitation training is significantly better than that of simple routine functional rehabilitation training and mecobalamin tablets combined with conventional functional rehabilitation training,which plays a more prominent role in preventing lower limb muscle Ⅳ atrophy.3.According to the overall clinical efficacy evaluation of the three groups,the total effective rate of modified Longqi Qiangji Yin combined with routine functional rehabilitation training was significantly better than that of the other two groups.4.Oral traditional Chinese medicine decoction modified Longqi Qiangji Yin is safe and reliable,no obvious serious adverse reactions,good patient compliance and high acceptance of long-term treatment. |
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