牛痘疫苗接种家兔炎症皮肤提取物不同给药方式预防性治疗腰椎间盘突出术后残余神经症状的疗效  

Efficacy of neurotropin through different routes in preventive treating residual neurological symptoms after lumbar disc herniation

作　　者：陈雪青[1] 张金源[1] 陈雪吟 王祥瑞 CHEN Xue-Qing;ZHANG Jin-Yuan;CHEN Xue-Yin;WANG Xiang-Rui(Department of Anesthesiology,Renji Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200127,China;Department of Anesthesiology,Union Medical College,School of medicine,Huazhong University of Science and Technology,Wuhan 430000,China;Department of Anesthesiology,Dongfang hospital,Tongji University,Shanghai 200120,China)

机构地区：[1]上海交通大学医学院附属仁济医院麻醉科,上海200127 [2]湖北华中科技大学医学院附属协和医学麻醉科,武汉430000 [3]上海同济大学医学院附属东方医院麻醉科,上海200120

出　　处：《中国疼痛医学杂志》2020年第1期53-57,共5页Chinese Journal of Pain Medicine

基　　金：上海交通大学医学院高原学科建设百人计划（hlgy17100qnhb）

摘　　要：目的:比较牛痘疫苗接种家兔炎症皮肤提取物(neurotropin,NTP)连续椎旁阻滞和静脉给药预防性治疗腰椎间盘突出术后残余神经症状的疗效。方法:研究比较椎旁组与静脉组治疗91例腰椎间盘突出术后残余神经症状。采用疼痛数字评分(numeral score of pain,NRS)及日本骨科协会评估治疗分数(Japanese orthopaedic association scores,JOA)对疼痛及手术有效性进行评估。采用Oswestry功能障碍指数(Oswestry disability index,ODI)及病人健康问卷(patient health questionnaire-9,PHQ-9)评估病人术后腰腿功能改善程度,病人抑郁程度。结果:与治疗前比较,治疗后两组病人NRS,JOA,ODI及PHQ-9评分均较术前改善(P<0.01)。出院1月随访,椎旁组NRS,JOA及PHQ-9评分改善好于静脉组,差异具有统计学意义。随访3月、6月,各指标组间比较差异无统计学意义。结论:NTP连续椎旁给药预防性治疗腰椎间盘突出术后残余神经症状在早期对于疼痛、腰椎功能和情绪改善方面疗效优于静脉用药,而远期疗效相当。Objective:To compare the therapeutic effect of paravertebral neurotropin(NTP)injection with that of intravenous administration on patients suffered from residual neurological symptoms after lumbar disc hernia.Methods:a total of 91 patients with residual neurological symptoms were enrolled in this study and randomly divided into two groups:paravertebral group and intravenous group.Numeral score of pain(NRS)and japanese orthopaedic association scores(JOA)were applied to assess the intensity of pain and efficiency of the surgery;Oswestry disability index(ODI),patient health questionnaire-9(PHQ-9)were used to evaluate the improvement of the lumbar and leg function and the depression of the patients after the surgery.Results:The NRS,ODI and PHQ-9 score decreased significantly in both of the groups compared with the time before the treatment,while the JOA score increased significantly.At the 1 month follow-up,the NRS and PHQ-9 score in the paravertebral group decreased significantly in comparison with intravenous group;The JOA score in the paravertebral group increased significantly in comparison with intravenous group.However,there was no significance between the two groups in the long term follow-up.Conclusion:paravertebral neurotropin injections exhibits greater efficacy in the aspect of pain,lumbar function and mood improvement than intravenous NTP injections for pain management of residual neurological symptoms after lumbar disc hernia in the early stage,but the long-term efficacy is comparable.

关 键 词：腰椎间盘突出症 牛痘疫苗接种家兔炎症皮肤提取物 椎旁阻滞 静脉用药 

分 类 号：R687.3[医药卫生—骨科学]