基于CT定位与解剖定位下针刀松解治疗腰椎小关节病的临床研究  

Clinical Study of Acupotomy Debonding Based on CT Positioning and Anatomical Positioning in Treating Lumbar Facet Joint Disease

作　　者：祝丰奎 孙淑霞 王弟红 丁勇 ZHU Fengkui;SUN Shuxia;WANG Dihong;DING Yong(Jiulongpo District Hospital of Traditional Chinese Medicine,Chongqing 400080,China)

机构地区：[1]重庆市九龙坡区中医院,重庆400080

出　　处：《针灸临床杂志》2021年第9期34-39,共6页Journal of Clinical Acupuncture and Moxibustion

基　　金：重庆市卫生计生委中医药科技项目,编号:ZY201802017。

摘　　要：目的:比较CT定位与解剖定位下针刀松解治疗腰椎小关节病的疗效及安全性。方法:选取2018年8月—2020年3月本院收治的符合相关纳排标准的患者240例,分别采用CT定位下针刀松解的方法(治疗组)和解剖定位针刀松解的方法(对照组)松解病变腰椎小关节治疗腰椎小关节病,采用VAS评分(VAS)和ODI指数(ODI)来进行术前和术后各时间点的评分比较,通过评价疼痛缓解程度、腰椎活动功能、白细胞介素-1β(IL-1β)和肿瘤坏死因子-α(TNF-α)来评价治疗组和对照组的临床疗效及组间疗效差别。结果:治疗后治疗组患者VAS评分、ODI评分、TNF-α及IL-1β均较对照组下降,差异具有统计学意义(P<0.05);治疗组治疗总有效率高于对照组,差异具有统计学意义(P<0.05)。结论:CT定位下行针刀松解治疗腰椎小关节病,可明显缓解患者疼痛程度,具有临床可行性,与解剖定位相比疗效更明显,且CT具有安全性高、无损等优点,值得在临床中积极推广。Objective:To compare the efficacy and safety of acupotomy debonding based on CT positioning and anatomical positioning in the treatment of lumbar facet joint disease.Methods:240 patients,who met the inclusion criteria,were randomly divided into the treatment group and the control group.The control group was treated with acupotomy based on anatomical positioning,whereas the treatment group was treated with acupotomy based on CT positioning.The scores of VAS and ODI and the levels of IL-1βand TNF-αwere used to evaluate the clinical efficacy,pain relief and lumbar motor function between the two groups.Results:The scores of VA and ODI scores,as well as the levels of IL-1βand TNF-αwere significantly decreased in the treatment group compared to those in the control group after the treatment(P<0.05).The total effective rate of the treatment group was higher than that of the control group(P<0.05).Conclusion:Acupotomy debonding based on CT positioning can significantly alleviate pain in the treatment of lumbar facet joint disease.It is clinically feasible and more effective than acupotomy debonding based on anatomical positioning,also CT has the advantages of high safety and non-destructive,which is worthy of clinical promotion.

关 键 词：针刀松解 腰椎小关节病 CT定位 解剖定位 

分 类 号：R246.2[医药卫生—针灸推拿学]