补阳还五汤辅助治疗对腰椎间盘突出症术后患者血液流变学、疼痛介质和生活质量的影响

摘要 目的：探讨补阳还五汤辅助治疗对腰椎间盘突出症（LDH）术后患者血液流变学、疼痛介质和生活质量的影响。方法：回顾性选取中日友好医院2015年1月到2019年12月期间收治的LDH术后患者的临床资料，符合要求的共有180例。入选的患者按手术治疗的先后顺序编号，随机分为对照组和研究组，各为90例。对照组患者术后接受常规治疗，研究组在对照组的基础上结合补阳还五汤治疗，治疗2周。观察两组治疗2周后的临床总有效率，对比两组治疗前、治疗2周后的疼痛视觉模拟（VAS）评分、日本矫形外科学会(JOA)评分、血液流变学、疼痛介质，对比两组治疗前、治疗后1个月的生活质量变化。结果：研究组的临床总有效率高于对照组（P<0.05）。治疗2周后，研究组VAS评分低于对照组，JOA评分高于对照组（P<0.05）。治疗2周后，两组凝血因子Ⅰ、全血低切黏度、红细胞压积、红细胞聚集指数、全血高切黏度水平下降，且研究组低于对照组（P<0.05）。治疗2周后，两组前列腺素E2 (PGE2)、5-羟色胺(5-HT)、P物质（SP）、神经肽Y（NPY）水平下降，且研究组低于对照组（P<0.05）。治疗后1个月，两组社会关系、生理健康、周围环境、心理健康评分升高，且研究组高于对照组（P<0.05）。结论：补阳还五汤辅助治疗可有效缓解LDH术后患者疼痛症状，促进腰椎功能恢复，改善机体血液流变学，提升患者生活质量。

Effects of Buyang Huanwu Decoction on Hemorheology, Pain Mediators and Quality of Life in Postoperative Patients with Lumbar Disc Herniation

ABSTRACT Objective: To explore the effect of Buyang Huanwu decoction on hemorheology, pain mediators and quality of life in postoperative patients with lumbar disc herniation (LDH). Methods: Clinical data of postoperative LDH patients admitted to China-Japan Friendship Hospital from January 2015 to December 2019 were retrospectively selected, and a total of 180 patients met the requirements. The selected patients were numbered according to the sequence of surgical treatment, and they were randomly divided into control group and study group, with 90 cases in each group. The patients in the control group received routine treatment, and the study group was treated with Buyang Huanwu decoction on the basis of the control group, treatment for 2 weeks. The total clinical effective rate of the two groups at 2 weeks after treatment was observed. The pain visual analogue (VAS) score, Japanese orthopaedic association (JOA) score, hemorheology and pain mediators were compared between the two groups before and 2 weeks after treatment. The changes of quality of life before and 1 month after treatment were compared between the two groups. Results: The total clinical effective rate of the study group was higher than that of the control group(P<0.05). 2 weeks after treatment, the VAS score of the study group was lower than that of the control group, and the JOA score was higher than that of the control group(P<0.05). 2 weeks after treatment, the levels of coagulation factor I, whole blood low shear viscosity, hematocrit, erythrocyte aggregation index and whole blood high shear viscosity in two groups decreased, and the study group was lower than the control group(P<0.05). 2 weeks after treatment, the levels of prostaglandin E2 (PGE2), 5-hydroxytryptamine (5-HT), substance P (SP) and neuropeptide Y (NPY) in two groups decreased, and the study group was lower than the control group (P<0.05). 1 month after treatment, the scores of social relationship, physical health, surrounding environment and mental health in two groups increased, and the study group was higher than the control group(P<0.05). Conclusion: The adjuvant treatment of Buyang Huanwu decoction can effectively relieve the pain symptoms of postoperative patients after LDH, promote the recovery of lumbar function, improve the body''s hemorheology, and improve the quality of life of patients.