椎间孔神经根注射臭氧治疗腰椎间盘突出症所致坐骨神经痛的疗效及对MCP-1和炎性因子的影响  

Curative effect of intervertebral foramen nerve root injection with ozone in the treatment of lumbar disc herniation with sciatica and its influence on MCP-1 and inflammatory factors

作　　者：陆吉利[1] 陆文忠[1] 韦文[1] 麦荫文[1] 黄承夸[1] 华树良[1] 隆振学 

机构地区：[1]广西百色市人民医院脊柱骨病外科,百色533000

出　　处：《中国实用神经疾病杂志》2016年第11期14-16,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨椎间孔神经根注射臭氧治疗腰椎间盘突出症所致坐骨神经痛的临床疗效及对单核细胞趋化蛋白-1(monocyte chemotactic protein 1,MCP-1)和炎性因子的影响。方法选取2010-02—2014-03我院诊治的68例腰椎间盘突出症致坐骨神经痛患者为研究对象,X线透视下经椎间孔神经根缓慢注射浓度60μg/mL的臭氧气体20mL。利用腿痛和腰痛的视觉模拟评分(visual analogue scale,VAS)、罗兰-莫里斯残疾问卷(Roland-Morris disability questionnaire,RMDQ)、日本矫形外科疼痛评分标准和SF-36生活质量量表评估术后的治疗效果并检测MCP和炎性因子的水平。结果术后1周、4周、3个月和6个月,腿痛、腰痛VAS评分和RMDQ量表评分均随着时间的推移逐渐降低(P<0.05);但术后不同时间点之间优良率比较差异无统计学意义(P>0.05);患者的生活质量各项指标均在术后不同时间点出现显著改善(P<0.05);且与术前相比,术后患者炎症因子IL-4、IL-6、IL-8、TNF-α、hs-CRP和MCP-1的含量均出现显著降低(P<0.05)。结论椎间孔神经根注射臭氧能显著改善腰椎间盘突出症所致坐骨神经痛症状,并可降低炎性因子和MCP-1水平。Objective To explore the clinical curative effect of intervertebral foramen nerve root injection with ozone in the treatment of lumbar disc herniation with sciatica and its influence on MCP-1and inflammatory factors.Methods Sixty-eight cases of lumbar disc herniation with sciatica from February 2010 to March 2014 in our hospital were selected as the research objects.20 mL ozone at the concentration of 60μg/mL was injected slowly via transforaminal nerve root by X-ray guided.The leg pain and back pain visual analogue scale（VAS）,Roland-Morris disability questionnaire（RMDQ）,the Japanese orthopedic pain score standards and SF-36 quality of life scale were used to evaluate the postoperative therapeutic effects and the levels of MCP and inflammatory factors were detected.Results One week,four weeks,three months and six months after postoperative,the leg pain,back pain,VAS scores and RMDQ scale scores were decreased gradually（P〈0.05）.But no statistical significance difference was observed on the improvement rate between the different postoperative time points（P〉0.05）.Each indicator of life quality were improved significantly at different postoperative time points（P〈0.05）.Compared with the preoperative,the levels of inflammatory factor,IL-4,IL-6,IL-8,TNF-α,hs-CRP and MCP-1after postoperative were significantly decreased（P〈0.05）.Conclusion The transforaminal nerve root injection with ozone can significantly improve the symptoms of lumbar disc herniation sciatica,and reduce the levels of inflammatory factors and MCP-1.

关 键 词：腰椎间盘突出症 坐骨神经痛 炎症因子 MCP-1 

分 类 号：R681.53[医药卫生—骨科学]