Effect of Yaobikang Granule Combined with Celecoxib on Lumbar Disc Degeneration and Residual Symptoms after Transforaminal Endoscopic Discectomy for Lumbar Disc Herniation
Objective To investigate the effect of Yaobikang Granule combined with celecoxib on lumbar disc degeneration and residual symptoms after transforaminal endoscopic discectomy for lumbar disc herniation.Methods A total of 76 patients with residual symptoms after transforaminal endoscopic discectomy for lumbar disc herniation were randomly divided into traditional Chinese medicine (TCM)group and control group,with 38 patients in each group,and finally,69 patients completed follow-up,with 35 patients in the TCM group and 34 in the control group.The patients in the control group were given oral adminis-tration of celecoxib capsules,while those in the TCM group were given oral administration of Yaobikang Granule in addition to the treatment in the control group;the course of treatment was 1 month for both groups.The two groups were compared in terms of Visual Analogue Scale (VAS)score,Japanese Orthopaedic Association (JOA)score,the serum levels of cell apopto-sis-related indicators [B-cell lymphoma 2 (Bcl-2),Bcl-2-associated X protein(Bax),and caspase-3(CASP3)],and MRI T2 val-ue of the nucleus pulposus (NP)and annulus fibrosus (AF)regions before and after treatment.Results Both groups had a significant reduction in VAS score and a significant increase in JOA score from 1 day to 1 week after surgery (P<0.05),and the TCM group had greater changes than the control group (P<0.05).Both groups had a significant reduction in VAS score and a significant increase in JOA score from 1 week to 1 month after surgery (P<0.05),and the TCM group had greater chan-ges than the control group (P<0.05).From 1 day to 1 month after surgery,both groups had a significant increase in the ser-um level of Bcl-2(P<0.05),and the TCM group had a significantly higher serum level of Bcl-2 than the control group (P<0.05);both groups had significant reductions in the serum levels of Bax and CASP3(P<0.05),and the TCM group had sig-nificantly lower serum levels of Bax and CASP3 than the control group (P<0.05).At 3 months after surgery,both groups had a significant reduction in the MRI T2 value of the NP and AF regions (P<0.05),and the TCM group had a significantly higher MRI T2 value of the NP and AF regions than the control group (P<0.05).Conclusion Yaobikang Granule can effec-tively improve residual symptoms after transforaminal endoscopic discectomy for lumbar disc herniation,possibly by increasing the serum level of Bcl-2,reducing the serum levels of Bax and CASP3,and delaying lumbar disc degeneration.
万方数据
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