Clinical Study on Early Surgery Combined with Buyang Huanwu Tang for Central Pain Secondary to Spinal Cord Injury Complicated with Cervical Disc Herniation
Abstract:Objective:To observe the curative effect of early surgery combined with Buyang Huanwu tang for central pain (CP) secondary to spinal cord injury(SCI) complicated with cervical disc herniation. Methods:A total of 88 cases of patients with cervical disc herniation complicated with SCI secondary to CP were selected and divided into the experiment group,the simple surgery group and the conservative group according to patients'willingness to receive treatment,25 cases,30 cases and 33 cases in each group respectively. The experiment group and the simple surgery group were given anterior cervical discectomy and fusion(ACDF) during the first three days of hospitalization; the experiment group was given such symptomatic treatment as Buyang Huanwu tang and nerve- nourishing after surgery; the conservative group was given immobilization and mecobalamin tablets. The scores of Tanaka Yasuhisa's Cervical Spondylosis Symptom Scale, Neck Disability Index(NDI) and Short- form of McGill Pain Questionnaire(SF- MPQ) were compared among the three groups.Results:During the one- month treatment,as well as six- month and twelve- month follow- ups,the scores of Cervical Spondylosis Symptom Scale in the three groups were increased when compared with those before treatment(P<0.05),and the NDI were decreased when compared with those before treatment(P<0.05). During the one- month treatment and sixmonth follow-up,the scores of Cervical Spondylosis Symptom Scale in the experiment group were higher than those in the simple surgery group and the conservative group(P<0.05),the NDI were lower than those in the simple surgery group and the conservative group(P<0.05); compared with those in the conservative group, the scores of Cervical Spondylosis Symptom Scale in the simple surgery group were higher(P<0.05), and the NDI were lower(P<0.05). During the twelvemonth follow- up, the scores of Cervical Spondylosis Symptom Scale and NDI in the experiment group and the simple surgery group were better than those in the conservative group(P<0.05), and when compared the above two scores between the experiment group and the simple surgery group,there was no significance in the difference(P>0.05). During the one- month treatment, six- month and twelve- month follow- ups, the scores of Pain Rating Index(PRI) including the sensory and affective dimensions, Visual Analogue Scale(VAS) and present pain intensity(PPI) in the three groups were decreased when compared with those before treatment(P<0.05). During the one-month treatment and six-month follow-up, the scores of PRI, VAS and PPI in the experiment group and the simple surgery group were lower than those in the conservative group(P<0.05), and the above three scores in the experiment group were lower than those in the simple surgery group(P<0.05). During the twelve- month follow- up,the scores of PRI- sensory,VAS and PPI in the experiment group and the simple surgery group were lower than those in the conservative group(P<0.05), and when compared the above three scores between the experiment group and the simple surgery group,there was no significance in the difference (P>0.05). Conclusion:For senile patients with cervical disc herniation complicated with CP secondary to SCI,the therapy of early surgery combined with Buyang Huanwu tang can effectively alleviate the pain and accelerate the recovery of the function of cervical vertebra.