世界中医药
文章摘要
引用本文:王胜芳,张小容,张海波.补肾活血汤加减、针刺联合高压氧对脊柱骨折并脊髓损伤术后患者康复效果研究[J].世界中医药,2019,(11):.  
补肾活血汤加减、针刺联合高压氧对脊柱骨折并脊髓损伤术后患者康复效果研究
Effects of Modified Bushen Huoxue Decoction,Acupuncture Combined with Hyperbaric Oxygen on Postoperative Rehabilitation of Patients with Spinal Fracture and Spinal Cord Injury
投稿时间:2018-12-23  
DOI:10.3969/j.issn.1673-7202.2019.11.048
中文关键词:  脊柱骨折  脊髓损伤  补肾活血汤  针刺  高压氧  术后康复  痛感  括约肌功能  感觉  运动功能  神经功能  神经营养因子  炎性反应状态
English Keywords:Broken spine  Spinal cord injury  Bushen Huoxue Decoction  Acupuncture  Hyperbaric oxygen  Postoperative rehabilitation  Pain  Sphincter function  Feeling  Motor function  Neurological function  Neurotrophic factor  Inflammatory state
基金项目:国家科技支撑计划项目(2013BAI13B032);青海省自然科学基金项目(2015-ZJ-913)
作者单位
王胜芳,张小容,张海波 青海红十字医院西宁810000 
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中文摘要:
      目的:观察补肾活血汤加减、针刺联合高压氧对脊柱骨折并脊髓损伤术后患者的康复效果。方法:选取2017年1月至2018年6月青海红十字医院收治的脊柱骨折合并脊髓损伤患者78例作为研究对象,按照随机数字表法分为对照组和观察组,每组39例。2组患者均进行手术减压、骨折复位内固定治疗,术后均采用我院常规处理及护理,对照组在此基础上联合高压氧治疗,观察组在对照组治疗基础上联合补肾活血汤加减、针刺治疗。治疗前、治疗6个月后评价痛感、括约肌功能、感觉、运动功能、神经功能Franke分级情况变化,测定血清脑源性神经营养因子(Brain-derived Neurotrophic Factor,BDNF)、神经生长因子(Nerve Growth Factor,NGF)水平;术前、术后1周监测血清炎性反应指标肿瘤坏死因子-α(Tumor Necrosis Factor-α,TNF-α)、C反应蛋白(C-reactive Protein,CRP)水、血浆降钙素原(procalcitonin,PCT)水平。结果:与治疗前比较,2组患者治疗6个月后疼痛、括约肌功能、感觉功能、运动功能、神经功能Franke分级情况均明显改善,疼痛VAS评分、括约肌功能评分均明显降低,ASIA感觉、运动评分均明显升高,组间比较,以观察组各指标变化更为明显,差异有统计学意义(P<0.05);2组患者治疗6个月后神经营养因子BDNF、NGF水平明显升高(P<0.05),以观察组明显高于对照组,差异有统计学意义(P<0.05);与术前比较,2组患者术后1周的血清中炎性反应因子TNF-α、CRP、PCT水平明显升高(P<0.05);组间比较,以观察组明显低于对照组(P<0.05)。结论:补肾活血汤加减、针刺联合高压氧促进脊柱骨折并脊髓损伤术后患者康复具有良好的效果,利于减轻疼痛,改善患者术后括约肌功能、感觉、运动功能和神经功能,降低术后炎性反应因子水平,有一定的临床推广运用价值。
English Summary:
      To observe the effect of self-designed bushenhuoxue decoction and acupuncture combined with hyperbaric oxygen on postoperative rehabilitation of patients with spinal fracture and spinal cord injury.Methods:A total of 78 cases of spinal fracture combined with spinal cord injury admitted to Qinghai Red Cross Hospital from January 2017 to June 2018 were selected,and they were divided into a control group and an observation group according to the random number table,with 39 cases in each group.The 2 groups of patients were treated with surgical decompression and fracture reduction internal fixation,and the postoperative treatment and nursing were adopted in our hospital.On this basis,the control group was treated with hyperbaric oxygen,and the observation group was treated with modified Bushen Huoxue Decoction and acupuncture.The changes in pain perception,sphincter function,sensory,motor function and nerve function Franke classification were evaluated before and after 6 months of treatment,and the levels of brain-derived neurotrophic factor(BDNF)and nerve growth factor(NGF)in serum were determined.The levels of tumor necrosis factor-α(TNF-α),c-reactive protein(CRP)and procalcitonin(PCT)were monitored before and 1 week after surgery.Results:Compared with before treatment,the pain,muscle function,sensory function,motor function and neural function Franke classification rate of 2 groups after 6 months' treatment were significantly improved.The pain VAS score and sphincter function scores were significantly decreased,while the ASIA,sensory and motor score were significantly elevated.Comparison between groups,the index changes in the observation group was more obvious,and the difference was statistically significant(P<0.05); After 6 months of treatment,the levels of BDNF and NGF in the 2 groups were significantly increased(P<0.05); The observation group was significantly higher than the control group,with statistically significant differences(P<0.05).Compared with the preoperative results,the serum levels of inflammatory cytokines TNF-α,CRP and PCT were significantly increased in the 2 groups 1 week after surgery(P<0.05).Compared between groups,the observation group was significantly lower than the control group(P<0.05).Conclusion:The modified Bushen Huoxue Decoction,acupuncture combined with hyperbaric oxygen is good to promote the rehabilitation of patients with spinal fracture and spinal cord injury,which has a good effect,is conducive to reducing pain,improving the function of sphincter,sensory,motor and neurological functions of patients after surgery,and reducing the levels of postoperative inflammatory factors,has certain clinical application value.
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