| Objective:To observe the clinical efficacy and safety of Jiawei Subdiaphragmatic Zhuyu Decoction in the treatment of postoperative residual symptoms of degenerative single level lumbar spondylolisthesis,to provide objective reference for postoperative rehabilitation of patients with constipation and residual pain,and to improve patients’ postoperative quality of life.Methods:In this study,patients with low back pain,abdominal distension and abdominal pain who underwent posterior lumbar spine fusion due to degenerative single level lumbar spondylolisthesis in the Spine and Bone Department of Gansu Provincial Hospital of Traditional Chinese Medicine from November 2020 to December 2022 were selected.64 cases were selected according to the inclusion and exclusion criteria,and randomly divided into the control group and the treatment group with 32 cases in each group.Routine treatment was performed in both groups.On the basis of the control group,the treatment group began to take orally supplemented subdiaphragmic Zhuyu Decoction 400 ml on the first day after surgery,once a day,twice a day,each time 200 ml,for 2 weeks.The JOA score,ODI score and VAS score of the two groups were recorded before surgery,the first week,the second week day and the first month after surgery.The changes of the first defecation time and D-dimer,fibrinogen and other indexes of the two groups were recorded.SPSS27.0was used for statistical analysis of the data obtained,so as to evaluate the efficacy and safety of Jiawei Hypogei Zhuyu Decoction.Results:1 There were 60 patients in the two groups.There was no statistical difference in gender,age,slippage segment and degree of slippage(P>0.05),indicating comparability.2 There were no significant differences in D-dimer,fibrinogen,VAS score,JOA score and ODI score before surgery(P>0.05),and the baseline was consistent.3 VAS score,JOA score and ODI score at the first week after surgery,the second week after surgery and the first month after surgery were statistically significant compared with those before treatment(P<0.05).Single factor repeated measure analysis of variance was used in the group,and the comparison before surgery,the first week after surgery,the second week after surgery and the first month after surgery showed a statistically significant difference(P<0.05).4 Independent t test was used between the groups,and compared with the control group,VAS score,JOA score and ODI score were also significantly different at each time point after surgery(P<0.05).5 The first defecation time of test group was earlier than that of control group(P<0.05).6 There were no significant differences in D-dimer and fibrinogen on day 1 after surgery(P>0.05).There were significant differences in D-dimer and fibrinogen on the 7th day after surgery(P<0.05).The changes of D-dimer and fibrinogen on day 1and day 7 after surgery were statistically different in the two groups(P<0.05).The changes of D-dimer and fibrinogen in the two groups on day 1 after surgery were higher than those before surgery,and those on day 7 after surgery were lower than those on day 1 after surgery,but the decreases were more obvious in the experimental group.Conclusion:Modified subphrenic Zhuyu Decoction can improve blood hypercoagulability in patients with degenerative single level lumbar spondylolisthesis after lumbar posterior fusion,promote postoperative neurological recovery,improve postoperative gastrointestinal symptoms and promote defecation,and is worthy of clinical promotion. |
