摘要
目的 探讨经皮射频椎间盘消融联合针刀对腰椎间盘突出症的疗效.方法 选择符合诊断标准的腰椎间盘突出症患者60例,随机分为经皮射频椎间盘消融减压联合针刀组(联合治疗组)和经皮射频椎间盘消融减压组(对照组),每组各30例.对照组应用经皮射频消融治疗,联合治疗组,在常规治疗的基础上采用针刀多裂肌、回旋肌刺激、关节突松解,辅助予以下肢神经循行部位针刀松解等,分别于治疗前后,采用临床疗效评估、JOA评分、VAS评分及血清CRP、铜蓝蛋白测定.结果 联合治疗组总有效率为96.64%,高于对照组的72.81%(P<0.01),两组治疗前后的VAS评分、JOA评分比较差异显著(P<0.01),两组治疗前后血清CRP及血清铜蓝蛋白差异显著(P<0.01).结论 经皮射频椎间盘消融减压联合针刀治疗腰椎间盘突出症疗效确切,通过消除椎间盘髓核相关炎性刺激,达到消炎镇痛和内外间接减压的目的,可能系经皮射频联合针刀治疗腰椎间盘突出症的机理之一.
Objective To explore the effect of percutaneous radio frequency nuclear decompression combined with acupotomy on lumbar disc herniation.Methods According to the inclusive criteria,60 cases were chosen by using randomized,controlled,blinded study method.60 cases were randomly divided into Percutaneous radiofrequency nuclear decompression combined with a Needle Knife group(Combined treatment group)(n=30)and Percutaneous radiofrequency nuclear decompression group(control group)(n=30)by random number table and Measurement and statistics were used by blind method.The control treatment group was treated with Percutaneous radiofrequency radiofrequency ablation,and the combined treatment group acupotomology was applied in the combined into a Needle Knife on the basis of conventional treatment,treatments included the stimulation of lumbar multifidus,and release in the articular process and the lower limb nerve circulation.The therapeutic effect evaluation,JOA score,VAS score,serum CRP,copper blue protein measurement were analyzed in selected patients preoperatively and after treatment.Results The total effective rate of the combined treatment group was 96.64%,higher than 72.81%of the control group(P<0.01).There were significant differences in VAS score and JOA score between the two groups before and after treatment(P<0.01),and in CRP and ceruloplasmin before and after treatment(P<0.01).Conclusion The needle knife combined with percutaneous radiofrequency nuclear decompression is effective in the treatment of lumbar disc herniation.It was one of the possible mechanism of the needle knife of LDH through eliminate inflammation of the nerve root edema,which achieves the purpose of anti-inflammatory and analgesia and internal and external indirect decompression.
出处
《浙江临床医学》
2019年第12期1651-1653,共3页
Zhejiang Clinical Medical Journal
基金
杭州市卫生计生委科技计划项目(2018B036)。
关键词
腰椎间盘突出症
经皮射频椎间盘消融
相关炎性反应
针刀
病例对照研究
Lumbar disc herniation
Percutaneous radiofrequency nuclear decompression
LDH—associated inflammation
Needle knife
Case control study
