陶熔，王静，李海芹，夏令杰.体外冲击波联合椎间孔注射治疗腰椎小关节综合征的疗效观察[J].中华物理医学与康复杂志,2017,39(1):34-37
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| 体外冲击波联合椎间孔注射治疗腰椎小关节综合征的疗效观察 |
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| DOI： |
| 中文关键词: 腰椎小关节综合征 体外冲击波 椎间孔 注射治疗 |
| 英文关键词: Lumbar facet joint syndrome Extracorporeal shock wave Intervertebral foramen Injection |
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| 中文摘要: |
| 目的观察体外冲击波联合椎间孔注射治疗腰椎小关节综合征的临床疗效。 方法采用随机数字表法将93例腰椎小关节综合征患者分为联合组、冲击波组及对照组。3组患者均给予非甾体抗炎镇痛药治疗，冲击波组在此基础上给予体外冲击波治疗，联合组患者在服用非甾体抗炎镇痛药基础上给予体外冲击波及腰椎间孔注射治疗。于治疗前、治疗1周、4周及8周时分别采用视觉模拟评分法（VAS）、Oswestry功能障碍指数(ODI)、下背痛功能障碍调查问卷(RMDQ)以及生活质量评估量表(QOL-SF36)对各组患者进行疗效评定。 结果治疗后3组患者疼痛VAS、ODI、RMDQ及QOL-SF36量表评分均较治疗前有所改善。在治疗1周时，发现联合组患者疼痛VAS评分［(2.6±1.4)分］、ODI评分［(15.9±8.3)分］、RMDQ评分［(9.9±5.4)分］及QOL-SF36评分［(74.6±17.1)分］均显著优于对照组水平（P<0.05），并且这种差异持续保持至治疗8周观察结束时；在治疗4周时冲击波组患者疼痛VAS评分［(2.5±1.3)分］、ODI评分［(15.1±7.3)分］、RMDQ评分［(9.8±5.1)分］及QOL-SF36评分［(76.8±16.8)分］与对照组间差异才具有统计学意义（P<0.05），且该差异持续保持至治疗8周观察结束时。 结论体外冲击波联合腰椎间孔注射治疗腰椎小关节综合征具有协同作用，能进一步缓解患者疼痛，增强腰椎功能，提高生活质量，该联合疗法值得临床推广、应用。 |
| 英文摘要: |
| Objective To observe the effect of extracorporeal shock wave (ESW) combined with intervertebral foramen injection on the lumbar facet joint syndrome. Methods Ninety-three patients presenting the syndrome were randomly divided into acombined group,ashock wave group and acontrol group, each of 31， according to a random number tab. All three groups were given a nonsteroidal anti-inflammatory drug,the shock wave group was additionally treated with a course of ESW, while the combined group received the shock wave treatment and lumbar intervertebral foramen injection. The three groups were assessed using theOswestry disability index (ODI), theRoland Morris Disability Questionnaire (RMDQ)and a life quality scale (QOL-SF36) beforetreatment and after 1, 4 and 8 weeks of treatment. Pain was reported using a visual analogue scale (VAS). ResultsTheaverage VAS, ODI, RMDQ and QOL-SF36 scores of the three groups had all improved after the treatment. After one week the average scores of VAS (2.6±1.4),ODI (15.9±8.3), RMDQ (9.9±5.4) and QOL-SF36 (74.6±17.1) of the combined group had improved significantly more than those of the control group ［VAS (4.3±1.3), ODI(22.8±6.9), RMDQ (14.9±7.7) and QOL-SF36 (61.6±17.7)］. Fourweeks after the treatment, the average VAS,ODI, RMDQ and QOL-SF36 scores ［(2.5±1.3), (15.1±7.3), (9.8±5.1) and (76.8±16.8)］ of the shock wave group had improved significantly more than those of the control group ［(3.9±1.4), (20.3±8.2), (13.9±8.1) and (67.2±20.6)］. Such significant improvements lasted until 8 weeks after the treatment.ConclusionsESW combined with intervertebral foramen injection can relieve the pain oflumbar facet joint syndrome, improve lumbar vertebral function and patients′ quality of life. It is worthy of clinical application. |
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