文章摘要
| 刘新权 陶志强 刘欢 熊杰 周龙殿 于江涛.基于ERAS 理念的黄芪桂枝五物汤加减对腰椎间盘突出症脊柱内镜术后康复的
疗效观察[J].江西中医药大学学报,2026,38(1):42-45/50. |
| 基于ERAS 理念的黄芪桂枝五物汤加减对腰椎间盘突出症脊柱内镜术后康复的
疗效观察 |
| Efficacy Observation of Modified Huangqi Guizhi Wuwu Decoction Based on ERAS Concept in Postoperative Rehabilitation of Lumbar Disc Herniation after Spinal Endoscopy |
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| DOI：10.20140/j.2095-7785.2026.01.10 |
| 中文关键词: 腰椎间盘突出症；脊柱内镜术；黄芪桂枝五物汤；普瑞巴林；加速康复外科 |
| 英文关键词: Lumbar Disc Herniation; Spinal Endoscopy; Huangqi Guizhi Wuwu Decoction; Pregabalin; Enhanced Recovery After Surgery |
| 基金项目:江西省中医药管理局科技计划项目（2023B0316） |
| 作者 | 单位 | | 刘新权 陶志强 刘欢 熊杰 周龙殿 于江涛 | 南昌市洪都中医院 南昌 330006 |
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| 中文摘要: |
| 目的：基于加速康复外科（ERAS）理念探究黄芪桂枝五物汤加减方对腰椎间盘突出症（LDH）脊柱内镜术后康复的
临床疗效。方法：选取2023 年1 月—2024 年10 月于南昌市洪都中医院接受脊柱内镜治疗的80 例LDH 患者，术后均遗留
不同程度的腰腿痛症状，采用随机数字表法分为对照组和观察组，各40 例。对照组采用常规康复联合普瑞巴林治疗，观察
组在对照组基础上加用黄芪桂枝五物汤加减方治疗，疗程均为1 个月。比较2 组治疗前后视觉模拟量表（VAS）、Oswestry
功能障碍指数（ODI）、日本骨科协会（JOA）、简明健康调查表（SF-36）评分，炎症因子（CRP、IL-6、TNF-α）水平
及临床康复指标（平均每天下床行走时间、术后首次下床时间及住院时间）等。结果：期间观察组脱落2 例，对照组脱
落1 例。治疗前，2 组VAS、ODI、JOA、SF-36 评分及CRP、IL-6、TNF-α水平比较无统计学差异；治疗后，2 组VAS、
ODI、JOA、SF-36 评分及CRP、IL-6、TNF-α水平均有改善，且观察组优于对照组，差异均有统计学意义（P<0 .05）。观
察组平均每天下床行走时间、术后首次下床时间及住院时间均优于对照组。结论：基于ERAS 理念的黄芪桂枝五物汤加减方
对LDH 患者脊柱内镜术后康复具有积极影响，可有效减轻术后炎症反应，缓解疼痛，增强腰部功能，提升患者生活质量，加
速患者术后康复进程。 |
| 英文摘要: |
| Objective: To explore the clinical efficacy of modified Huangqi Guizhi Wuwu Decoction based on the concept of Enhanced
Recovery After Surgery (ERAS) in the postoperative rehabilitation of patients with lumbar disc herniation (LDH) who underwent spinal
endoscopy. Methods: A total of 80 LDH patients with varying degrees of residual lumbocrural pain after spinal endoscopy in Nanchang
Hongdu Hospital of Traditional Chinese Medicine from January 2023 to October 2024 were selected. They were divided into a control
group and an observation group using the random number table method, with 40 cases in each group. The control group was treated with
conventional rehabilitation combined with pregabalin, while the observation group was given modified Huangqi Guizhi Wuwu Decoction
on the basis of the control group's regimen, with a treatment course of 1 month for both groups. The Visual Analogue Scale (VAS) scores,
Oswestry Disability Index (ODI) scores, Japanese Orthopaedic Association (JOA) scores, Short Form 36 Health Survey Questionnaire (SF-
36) scores, levels of inflammatory factors (C-reactive protein [CRP], interleukin-6 [IL-6], tumor necrosis factor-α[TNF-α]), and clinical
rehabilitation indicators (average daily ambulation time, time to first ambulation after surgery, and length of hospital stay) were compared
between the two groups before and after treatment. Results: During the study, 2 cases were lost to follow-up in the observation group and 1
case in the control group. Before treatment, there were no statistically significant differences in VAS, ODI, JOA, SF-36 scores, or CRP, IL-
6, TNF-αlevels between the two groups (P>0.05). After treatment, the VAS, ODI, JOA, SF-36 scores, and CRP, IL-6, TNF-αlevels
were improved in both groups,with the observation group showing significantly better outcomes than the control group (P<0.05).The average
daily ambulation time, time to first ambulation after surgery, and length of hospital stay in the observation group were also superior to those
in the control group. Conclusion: Modified Huangqi Guizhi Wuwu Decoction based on the ERAS concept exerts a positive effect on the
postoperative rehabilitation of LDH patients after spinal endoscopy. It can effectively alleviate postoperative inflammatory response, relieve
pain, improve lumbar function, enhance patients' quality of life, and accelerate the postoperative rehabilitation process. |
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