射频消融术联合臭氧注射治疗腰椎关节突关节源性腰痛的临床疗效研究  

Clinical Therapeutic Effect of Radiofrequency Thermocoagulation Ablation Combined With Ozone Injection in the Treatment of Lumbar Zygapophysial Joint Pain

作　　者：张家立[1] 王东洋[2] 伍亮[1] 张洪安[2] 

机构地区：[1]广西中医药大学第一附属医院骨一科,广西南宁市530023 [2]广西中医药大学

出　　处：《中国全科医学》2016年第5期585-588,共4页Chinese General Practice

基　　金：广西科学研究与技术开发计划项目(桂科攻1140003B-56);广西教育厅自然科学基金课题(200911LX240);2014年广西研究生教育创新计划资助项目(YCSZ2014170)

摘　　要：目的观察脉冲射频消融术联合臭氧注射治疗腰椎关节突关节源性腰痛的临床治疗效果。方法选取2013年7月—2015年8月在广西中医药大学第一附属医院住院的腰椎关节突关节源性腰痛患者66例,根据患者意愿将其分为手术组(n=34)和非手术组(n=32)。手术组患者采用射频热凝靶点消融术联合臭氧注射,根据患者需要可重复治疗;非手术组患者给予塞来昔布口服,1次/d,200 mg/次,2周后停药。记录所有患者在治疗前及治疗后1个月、6个月、1年、2年时腰痛视觉模拟评分(VAS);治疗后2年时进行腰椎功能Mac Nab疗效评定,分为优、良、可、差。结果治疗时间和治疗方法对患者VAS存在交互作用(P<0.05),治疗时间对患者VAS的影响有统计学意义(P<0.05),治疗方法对患者VAS的影响有统计学意义(P<0.05)。两组患者腰椎功能Mac Nab疗效比较,差异有统计学意义(U=65,P<0.01)。两组患者均无严重不良反应发生。结论脉冲射频消融术联合臭氧注射是治疗腰椎关节突关节源性腰痛的一种创伤小、相对安全、疗效明确稳定的方法。Objective To observe the clinical therapeutic effect of radiofrequency thermocoagulation ablation combined with ozone injection in the treatment of lumbar zygapophysial joint pain. Methods From July 2013 to August 2015,we enrolled66 inpatients with lumbar zygapophysial joint pain in the First Affiliated Hospital of Guangxi University of Chinese Medicine. According to patients＇ intension,the patients were divided into two groups： surgery group（ n = 34） and non- surgery group（ n = 32）. The surgery group was administrated with radiofrequency thermocoagulation ablation combined with ozone injection,and repeated treatment was made as patients required; non- surgery group was orally administrated with celecoxib by one time per day and 200 mg per time for 2 weeks. Before treatment,one month,six months,one year and two years after treatment,VAS was evaluated; 2 years after treatment,the Mac Nab efficacy of lumbar vertebra function was evaluated,and the efficacy was be classified into excellent,good,barely good and poor. Results Time and groups had interaction effect on VAS（ P 〈0. 05）; time had significant influence on VAS（ P 〈0. 05）; different groups were significantly different on VAS（ P 〈0. 05）. The two groups were significantly different in the Mac Nab efficacy of lumbar vertebra function（ U = 65,P 〈0. 01）.The two groups had no severe adverse reaction. Conclusion Radiofrequency thermocoagulation ablation combined with ozone injection is a safe therapy for lumbar zygapophysial joint pain with little trauma and has effective and stable efficacy.

关 键 词：腰痛 椎关节突关节 脉冲射频术 臭氧 

分 类 号：R681.55[医药卫生—骨科学]