Effect of Modified Buyang Huanwu Tang on Patients with Lumbar Disc Herniation After Percutaneous Foramen Endoscopy Based on Collateral Disease Theory / 中国实验方剂学杂志

ABSTRACT

Objective:To observe the clinical efficacy of modified Buyang Huanwu Tang on patients with lumbar disc herniation (LDH) after percutaneous foramen endoscopy by the collateral disease theory, and its effect on inflammatory factors and pain-inducing mediators. Method:One hundred and forty-four patients were randomly divided into control group (72 cases) and observation group (72 cases) by random number table. Both groups’ patients were treated with percutaneous endoscopic lumbar discectomy(PELD), and symptomatic treatment dehydration and anti-inflammation were also given to those patients after the operation. Patients in observation group got modified Buyang Huanwu Tang, 1 dose/day. The course of treatment was 4 weeks, and a 12-week fellow-up was recorded. Before the operation and at the 3rd day, the 4th and 16th week after the operation, scores of visual analogue score of pain degree (VAS) were recorded. And before the operation and at the 1st, 4th and 16th week after the operation, scores of dysfunction index (ODI) of Oswestry were recorded. Failed back surgery syndrome of LDH was recorded during 16 weeks after the operation. And Japanese orthopaedic association (JOA) and Qi deficiency and blood stasis syndrome were scored. And the levels of prostaglandin E2 (PGE2), thromboxane B2 (TXB2), interleukin-1beta (IL-1beta), tumor necrosis factor-alpha (TNF-alpha) and serotonin (5-HT) were all detected, and the effect was assessed by improved Macnab. Result:At the 1st day and the 1st, 4th and 16th week after treatment, scores of VAS were all lower than those in control group (P<0.01). And at the 1st, 4th and 16th week after treatment, scores of ODI were lower than those in control group (P<0.01). The rate of incidence was 18.06%(13/72), which was lower than 37.5%(27/72) in control group (χ2=6.784, P<0.01). Scores of the total JOA and subjective symptoms, objective signs and daily activities were all higher than those in control group (P<0.01). And scores of symptom scores and total scores of deficiency and blood stasis syndrome were all lower than those in control group (P<0.01). After treatment, levels of TNF-α, IL-1β, PGE2, TXB2 and 5-HT were lower than those in control group (P<0.01). According to the rank sum test, the effect of modified Macnab was better than that in control group (Z=2.151, P<0.05). Conclusion:Based on Luobing theory, modified Buyang Huanwu Tang can alleviate pain and other symptoms, promote the recovery of lumbar vertebral function, inhibit the expressions of inflammatory factors and pain-causing mediators, alleviate the residual symptoms after recent operation, reduce the incidence of FBSS, promote the rehabilitation of patients after operation, and improve the efficacy.