益气活血方治疗巨大破裂型腰椎间盘突出症的中长期疗效:一项倾向性评分匹配观察研究OA

Objective:Observation of the medium-to-long-term clinical efficacy of the Yiqi Huoxue formula in treating mas-sive ruptured lumbar disc herniation(LDH).Methods:A total of 130 eligible patients were consecutively enrolled from May 2017 to June 2022.They were divided into two groups based on treatment regimens:the Yiqi Huoxue formula com-bined with basic conservative treatment group(referred to as the Yiqi Huoxue formula group)and the basic conservative treatment alone group(referred to as the control group).Propensity score matching(PSM)was employed to achieve a 1∶1 balance between groups in terms of baseline characteristics(including age,gender,herniation rate,herniation area,percentage of spinal canal involvement,and JO A scores,VAS scores,and ODI scores),resulting in 48 patients per group.Pre-treatment and post-treatment VAS scores,ODI scores,and JO A scores at 3,6,and 12 months,as well as imaging parameters at 1 year,were compared be-tween groups.Results:After matching,baseline characteris-tics were balanced between the two patient groups.Repeated measures ANOVA revealed significant improvements in JOA scores,VAS scores,and ODI scores over time for all patients(main effect of time,P＜0.001 for all).The Yiqi Huoxue formula group showed a superior trend in JOA scores and VAS scores improvement compared to the control group(inter-action P＜0.001),with consistently higher JOA scores and lower VAS scores at all follow-up time points(all P＜0.001).Both groups showed significant improvement in ODI scores,but there was no statistically significant difference in the trend of improvement between groups(interaction P=0.998).After 12 months of treatment,the Yiqi Huoxue formu-la group demonstrated superior improvements in all imaging parameters compared to the control group(all P＜0.001).There was no significant difference in the incidence of adverse reactions between the two groups during treatment(P＞0.05),with both groups experiencing only mild gastrointestinal discomfort that resolved after symptomatic management.Conclusion:The Yiqi Huoxue formula demonstrates reliable medium-to-long-term efficacy in treating massive ruptured lumbar disc herniation.It significantly outperforms conventional conservative treatment in improving neurological func-tion,alleviating pain,and promoting reabsorption of the herniated material,establishing itself as an effective conservative therapeutic approach for this condition.