陈文坚;林阳;
CHEN Wenjian;LIN Yang;Orthopedics Department,the Affiliated Tongji Hospital of Huazhong Science & Technology University;

• 1:华中科技大学同济医学院附属同济医院骨科

摘要(Abstract)：

目的:探讨神经妥乐平联合神经节苷脂对脊髓型颈椎病患者术后残留神经症状的疗效。方法:脊髓压迫症状手术治疗后、有术后残留神经症状的脊髓型颈椎病患者74例,随机均分为观察组和对照组;对照组患者给予神经妥乐平注射液静脉注射,观察组患者在对照组的基础上在给予单唾液酸四己糖神经节苷脂钠静脉注射,两周为1疗程;记录术后第1天、第1、2、3及4周时的患者视觉模拟评分(VAS),术前、术后3月、6月及1年时的日本骨科协会评估治疗分数(JOA)评分;于治疗前和治疗1个疗程时,采用酶联免疫吸附法测定患者血清丙二醛(MDA)、总抗氧化能力(T-AOC)、去甲肾上腺素(NE)及皮质醇(Cor)水平。结果:VAS评分显示,治疗后随着观察时间延长,两组患者的VAS评分都低于治疗前(P<0.05),观察组评分低于同时点对照组评分(P<0.05);JOA评分结果显示,治疗后随着观察时间延长,两组JOA评分均高于治疗前(P<0.05),观察组高于同时段对照组(P<0.05);治疗前两组患者血清MDA、T-AOC、NE及Cor水平比较差异无统计学意义(P>0.05),治疗后观察组血清MDA、NE及Cor水平显著低于对照组,T-AOC水平显著高于对照组(P<0.05)。结论:神经妥乐平联合神经节苷脂治疗脊髓型颈椎病患者效果优于单用神经妥乐平治疗。
Objective: To study the curative effects of ganglioside combined with neurotrophin in the postoperative treatment of patients with cervical spondylotic myelopathy. Methods: Seventy-four cases of cervical spondylotic myelopathy in our hospital from January 2015 to December 2016 were chosen as the subjects,which were randomly divided into observation group( group O) and control group( group C) with 37 cases in each. Patients in group C were given intravenous injection of ganglioside once a day,while those in group O received ganglioside combined with neurotrophin intravenous injection once a day. Two weeks were as a course of treatment. The visual analogue scale( VAS) was recored on the first day and at the 1 ^(st),2 (st),2 ^(nd),3 (nd),3 ^(rd),and 4 thweeks after the operation,and the Japanese orthopaedic association evaluation treatment scores( JOA) were recorded before and in 3 months,6 months and1 year after the operation. Serum MDA,the totall antioxidant capacity( T-AOC),noradrenaline( NE)and cortisol( Cor) were tested before the treatment and after 1 course of treatment. All of the data collected were compared between the 2 groups. Results: Along with the observation,the VAS scores of the 2 groups after treatment were both getting lower than those before( P < 0. 05),and that in group O was even lower than in group C( P < 0. 05); as well,JOA scores of the 2 groups after treatment were both getting higher than those before( P < 0. 05),and that of group O was higher than that of group C at the same period( P < 0. 05). There was no significant difference in serum levels of MDA,T-AOC,NE and Cor between the 2 groups before treatment. After the treatment,the serum levels of MDA,NE and Cor in group O were significantly lower than those in group C,and the T-AOC level was significantly higher than that in group C( P < 0. 05). Conclusions: The curative effect of ganglioside-neurotrophin combination to cervical spondylotic myelopathy is better than that of neurotrophin used alone.

关键词(KeyWords)： 神经妥乐平;神经节苷脂;脊髓型颈椎病;视觉模拟评分;日本骨科协会评估治疗分数;氧化应激
ganglioside;neurotrophin;cervical spondylotic myelopathy;visual analogue score;japanese orthopaedic association scores;stress indexes

Abstract:

Keywords:

基金项目(Foundation): 湖北省自然科学基金(2012FFB02405、2016CFB659)

作者(Authors): 陈文坚;林阳;
CHEN Wenjian;LIN Yang;Orthopedics Department,the Affiliated Tongji Hospital of Huazhong Science & Technology University;

DOI: 10.19367/j.cnki.1000-2707.2017.10.017

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