冲击波结合电针治疗脊柱内镜术后腰5神经支配区遗留皮肤感觉障碍的效果  

Effect of shock wave combined with electroacupuncture on residual skin sensation disorder in lumbar 5 innervation area after spinal endoscopy

作　　者：李京 王鹏 赵建[1] 赵崇程 卢火炎 LI Jing;WANG Peng;ZHAO Jian;ZHAO Chongcheng;LU Huoyan(The Second Department of Bone Traumatology,the First Affiliated Hospital of Hebei University of Chinese Medicine,Hebei Province,Shijiazhuang 050011,China)

机构地区：[1]河北中医学院第一附属医院骨伤二科,河北石家庄050011

出　　处：《中国医药导报》2020年第36期99-104,共6页China Medical Herald

基　　金：全国老中医药专家学术经验继承工作(国中医药人教发〔2017〕29号);河北省高等教育教学改革研究与实践项目(2017GJJG144)。

摘　　要：目的分析冲击波结合电针治疗脊柱内镜术后腰5神经支配区遗留皮肤感觉障碍的临床效果。方法纳入2018年1月—2019年6月就诊于河北中医学院第一附属医院及医联体医院,曾诊断为L4/5椎间盘突出,行经皮脊柱内镜下腰椎间盘髓核摘除术后腰5神经支配区遗留皮肤感觉障碍的患者75例。按照随机数字表法将其分为电针组、冲击波组和联合组,每组各25例。电针组予以电针治疗,冲击波组予以体外冲击波治疗,联合组予以体外冲击波结合电针治疗。治疗以2周为1个疗程,共治疗2个疗程。记录患者治疗前、治疗1个疗程后、治疗2个疗程后麻木视觉模拟标尺法(VAS)评分、日本骨科协会(JOA)腰痛评定标准评分,评价其治疗效果和临床疗效。结果整体分析发现:组间、时间点及交互作用比较差异均有统计学意义(均P<0.05)。与治疗前比较,三组治疗1、2个疗程后麻木VAS评分降低,JOA评分提高,差异均有统计学意义(均P<0.05)。治疗结束后,联合组麻木VAS评分低于电针组和冲击波组,JOA评分高于电针组和冲击波组。电针组与冲击波组VAS、JOA评分比较,差异无统计学意义(P>0.05)。联合组整体临床疗效高于电针组和冲击波组(P<0.017)。结论冲击波结合电针治疗对经皮脊柱内镜下腰椎间盘髓核摘除术后腰5神经支配区遗留皮肤感觉障碍的临床效果良好,其治疗效果优于其他使用单一疗法的方案,并可显著缓解经皮脊柱内镜下腰椎间盘髓核摘除术后皮肤感觉障碍症状。Objective To analyze the clinical effect of shock wave combined with electroacupuncture on residual skin sensation disorder in lumbar 5 innervation area after spinal endoscopy.Methods From January 2018 to June 2019,seventy-five patients were admitted to the First Affiliated Hospital of Hebei University of Chinese Medicine and the Hospital of medical association who were diagnosed as L4/5 disc herniation and residual skin sensation disorder in lumbar 5 nerve innervation area after percutaneous endoscopic lumbar discectomy were included.According to the random number table method,they were divided into electroacupuncture group,shock wave group and combined group,with 25 cases in each group.The electroacupuncture group received electroacupuncture treatment,the shock wave group received extracorporeal shock wave treatment,and the combined group received extracorporeal shock wave combined electroacupuncture treatment.The treatment took two weeks as one course of treatment,a total of two courses of treatment.Visual analogue scales(VAS)of numbness scores and Japanese orthopaedic association(JOA)lumbar pain assessment standard scores were recorded before treatment,after one course of treatment,and after two courses of treatment.The therapeutic effect and clinical efficacy were evaluated.Results Overall analysis showed that the differences among groups,time points and interactions were statistically significant(all P<0.05).Compared with before treatment,VAS scores of numbness decreased and JOA scores increased after one or two courses of treatment in the three groups,with statistically significant differences(all P<0.05).After treatment,VAS score of numbness in the combined group was lower than that in the electroacupuncture group and shock wave group,and JOA score was higher than that in the electroacupuncture group and shock wave group.There was no significant difference in VAS and JOA scores between the electroacupuncture group and the shock wave group(P>0.05).The overall clinical efficacy of the combined group was hig

关 键 词：腰椎间盘突出 脊柱内镜 皮肤感觉障碍 电针 体外冲击波 

分 类 号：R681.5[医药卫生—骨科学]