陶熔，王静，夏令杰，李海芹，刘琳，马松鹤.非手术脊柱减压联合椎间孔注射治疗腰椎间盘突出症的疗效观察[J].中华物理医学与康复杂志,2018,40(12):923-927
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| 非手术脊柱减压联合椎间孔注射治疗腰椎间盘突出症的疗效观察 |
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| DOI： |
| 中文关键词: 腰椎间盘突出症 非手术脊柱减压 椎间孔注射 炎性疼痛 |
| 英文关键词: Lumbar disc herniation Spinal decompression systems Foramen Inflammation Pain |
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| 中文摘要: |
| 目的 观察非手术脊柱减压联合椎间孔注射治疗腰椎间盘突出症的临床疗效及安全性。 方法 采用随机数字表法将96例腰椎间盘突出症患者分为对照组、减压组、注射组及联合组，4组患者均常规给予依托考昔、马栗种子提取物等药物治疗；减压组患者在此基础上给予非手术脊柱减压治疗；注射组患者给予椎间孔注射治疗；联合组患者则给予非手术脊柱减压及椎间孔注射治疗。于治疗前、治疗后2d、1个月、6个月及12个月时分别观察各组患者疼痛、生活质量、腰椎功能障碍等改善情况。 结果 治疗前4组患者疼痛视觉模拟评分（VAS）、生活质量评估量表（QOL-SF36）评分、腰椎功能障碍指数（ODI）评分及日本骨科学会下腰疾患量表（JOA）评分组间差异均无统计学意义（P>0.05）。治疗后1个月、6个月及12个月时发现减压组、注射组、联合组患者疼痛VAS、QOL-SF36、ODI、JOA评分均较治疗前显著改善（P<0.05）。治疗后1个月、6个月及12个月时联合组疼痛VAS评分［分别为（1.4±1.2）分、（1.3±1.2）分和（1.1±1.1）分］、QOL-SF36评分［分别为（104.1±19.5）分、（105.2±22.2）分和（106.3±22.1）分］、ODI评分［分别为（8.6±6.5）分、（8.3±6.6）分和（7.5±5.8）分］及JOA评分［分别为（6.9±4.4）分、（6.3±4.5）分和（6.0±4.3）分］均显著优于其他各组结果（P<0.05）。治疗后6个月时联合组疼痛VAS、QOL-SF36、ODI及JOA评分较治疗后1个月时无明显改变（P>0.05）；治疗后12个月时联合组疼痛VAS、QOL-SF36、JOA评分较治疗后1个月时无明显变化（P>0.05）。 结论 非手术脊柱减压联合椎间孔注射治疗腰椎间盘突出症患者具有协同作用，能进一步提高康复疗效，同时还具有疗效持久、安全性好、并发症少等优点，值得临床推广、应用。 |
| 英文摘要: |
| Objective To observe the clinical efficacy and safety of non-surgical spinal decompression combined with intervertebral foramen injection in the treatment of lumbar intervertebral disc herniation. Methods Ninety-six patients were randomly divided into a control group, a decompression group, an injection group and a combined group. All of the subjects were given loxoprofen sodium and chestnut seed extract. The decompression group was treated with non-operative spinal decompression. The injection group received intervertebral foramen injections. The combined group received both treatments. Pain perceptions, quality of life perceptions and lumbar dysfunction were observed before the treatment, and 2 days, 1 month, 6 months and 12 months afterward. Results There were no significant differences among the groups in average pain perceptions quantified using a visual analogue scale (VAS) before the treatment. The average scores on a 36-item short-form health survey, the Oswestry disability index and a Japanese Orthopedic Association instrument also were not significantly different. All of those indicators had improved significantly in the decompression, injection and combined groups at 1, 6 and 12 months after the treatment, but the combined group′s average indicators were all significantly better than the other groups′ averages at the same time points. All of the significant improvements in the combined group′s averages occurred in the first month after the combined treatment. Conclusion Non-operative spinal decompression has a synergistic effect with intervertebral foramen injection in treating patients with lumbar disc herniation. Their combined effect is better than either treatment alone. Their combined effect is lasting, safe and has few complication risks. It is worthy of clinical application. |
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