针药复合麻醉在腰椎间盘臭氧介入术中的应用  

Application of Combined Acupuncture and Drug Anesthesia to Ozone Intervention in Lumbar Intervertebral Disc Herniation

作　　者：杨勇[1] 杨军[1] 刘宜军[1] 孙飞[1] 周友龙[2] YANG Yong;YANG Jun;LIU Yi-jun;SUN Fei;ZHOU You-long(Henan University of Traditional Chinese Medicine Third Hospital,Zhengzhou 450003,China;Henan University of Traditional Chinese Medicine,Zhengzhou 450008,China)

机构地区：[1]河南中医药大学第三附属医院,郑州450003 [2]河南中医药大学,郑州450008

出　　处：《上海针灸杂志》2021年第1期91-94,共4页Shanghai Journal of Acupuncture and Moxibustion

基　　金：河南省中医领军人才项目(HNZYLJ201301008);河南省中医药科学研究专项课题(2016ZY2071)。

摘　　要：目的观察针药复合麻醉应用到包容型腰椎间盘突出症臭氧介入术中的临床疗效。方法120例行射频联合臭氧介入术治疗的包容型腰椎间盘突出症患者,采取随机数字表法随机分为对照1组、对照2组和观察组,每组40例。所有患者行射频治疗后,对照1组直接盘内注射臭氧,对照2组应用较大量的右美托咪定以镇静镇痛,观察组采用小剂量的右美托咪定联合踝三针针刺镇痛。评定患者治疗前、射频治疗后和盘内注射臭氧时3个时间点的VAS评分,并观察术后24 h的不良反应发生情况。结果3组患者射频治疗后VAS评分均较治疗前降低(P<0.05)。对照1组盘内注射臭氧时VAS评分较射频治疗后升高(P<0.05),较治疗前降低(P<0.05)。对照2组和观察组盘内注射臭氧时较治疗前和射频治疗后VAS评分均降低(P<0.05)。观察组和对照2组盘内注射臭氧时VAS评分均较对照1组低(P<0.05)。观察组的不良反应发生率明显低于对照1组和对照2组(P<0.05)。结论针药复合麻醉应用于包容型腰椎间盘突出症臭氧介入术中,可以明显缓解注射时的疼痛,并能够减少右美托咪定引起的不良反应。Objective To investigate the clinical efficacy of the application of combined acupuncture and drug anesthesia to ozone intervention in contained lumbar disc herniation.Method One hundred and twenty patients with contained lumbar disc herniation who would receive radiofrequency treatment plus ozone intervention were allocated,using a random number table,to control 1,control 2 and observation groups,with 40 cases in each group.After all the patients were treated with radiofrequency thermocoagulation,control 1 group received ozone injection into lumbar intervertebral disc;control 2 group,micropump injection of larger dose of dexmedetomidine for sedation and analgesia;the observation group,micropump injection of small dose of dexmedetomidine plus ankle-three-needle acupuncture for analgesia.The VAS score was recorded at three time points:before treatment,after radiofrequency treatment and at ozone injection into the disc.Adverse reactions were observed at 24 hrs after the operation.Result The VAS score decreased in the three groups of patients after radiofrequency treatment compared with before(P<0.05).In control 1 group,the VAS score was higher at ozone injection into the disc than after radiofrequency treatment(P<0.05)and lower than before treatment(P<0.05).In control 2 and the observation groups,the VAS score was lower at ozone injection into the disc than before treatment and after radiofrequency treatment(P<0.05).The VAS score was lower at ozone injection into the disc in the observation and control 2 groups than in control 1 group(P<0.05).The incidence of adverse reactions was significantly lower in the observation than in control 1 and control 2 groups(P<0.05).Conclusion Combined acupuncture and drug anesthesia can markedly relieve pain during injection and reduce the incidence of adverse reactions caused by dexmedetomidine in the application to ozone intervention in contained lumbar disc herniation.

关 键 词：针药并用 针刺麻醉 针药复合麻醉 右美托咪定 踝三针 椎间盘移位 腰椎 臭氧 

分 类 号：R246.2[医药卫生—针灸推拿学]