超声导引下针刀松解腰神经后内侧支及关节囊治疗腰椎骨性关节炎的临床研究  

Analysis on Clinical Efficacy of Decompression of Lumbar Dorsal Rami Nerve and Articular Capsule by Ultrasound-Guided Needle-Knife on the Treatment of Lumbar Osteoarthritis

作　　者：王智耀[1] 王荣田 陈月峰 杨剑英[1] 朱瑜琪[1] 姚晖[1] WANG Zhiyao;WANG Rongtian;CHEN Yuefeng;YANG Jianying;ZHU Yuqi;YAO Hui(Eye Hospital,China Academy of Chinese Medical Sciences,Beijing 100040,China;The Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]中国中医科学院眼科医院,北京100040 [2]北京中医药大学第三附属医院

出　　处：《中国中医骨伤科杂志》2023年第1期25-29,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：中国中医科学院基本科研业务费自主选题项目(ZZ11-036)。

摘　　要：目的:通过观察针刀松解腰神经后内侧支及关节囊治疗腰椎骨性关节炎的临床疗效,为腰椎骨关节病的治疗提供一种有效的治疗方法。方法:将120例腰椎骨性关节炎患者随机分为两组,每组60例。治疗组给予超声导引下针刀松解腰神经后内侧支及关节囊,对照组给予腰神经后内侧支及关节囊注射糖皮质激素,每周1次,共治疗3次。分别于治疗前、治疗后及治疗后4周,以视觉模拟量表(VAS)及Oswestry功能障碍指数(ODI)评分评价患者腰部疼痛及腰椎活动功能,作为疗效评价指标。结果:VAS评分:治疗前,两组VAS评分差异无统计学意义(t=0.09,P>0.05)。治疗后,治疗组VAS评分为(3.17±1.79)分,较治疗前(6.12±2.62)分显著降低,差异有统计学意义(t=2.89,P<0.05);治疗后4周VAS评分为(1.85±0.86)分,较治疗后有显著降低,差异有统计学意义(t=0.94,P<0.05)。对照组治疗后VAS评分为(3.24±2.01)分,较治疗前(6.23±2.33)分显著降低(t=2.29,P<0.05);治疗后4周VAS评分为(3.55±1.56)分,与治疗后相比差异无统计学意义(t=0.17,P>0.05)。组间对比显示,治疗后两组VAS评分差异无统计学意义(t=0.22,P>0.05);治疗后4周治疗组VAS评分显著低于对照组,差异有统计学意义(t=0.83,P<0.05)。ODI评分:治疗前,两组ODI评分相比差异无统计学意义(t=0.02,P>0.05)。治疗后,治疗组ODI评分为(24.37±4.54)分,显著低于治疗前(39.15±7.22)分,差异有统计学意义(t=5.38,P<0.05);治疗后4周ODI评分为(20.22±3.22)分显著低于治疗后,差异有统计学意义(t=2.87,P<0.05)。治疗后对照组ODI评分为(30.57±5.16)分,较治疗前(38.87±7.69)分显著降低,差异有统计学意义(t=2.82,P<0.05);但治疗后4周ODI评分为(31.41±4.68)分与治疗后相比差异无统计学意义(t=0.36,P>0.05)。组间对比显示,治疗后治疗组ODI评分显著低于对照组,差异有统计学意义(t=3.41,P<0.05);治疗后4周治疗组ODI评分显著低于对照组,差异有统计学意义(t=7.55Objective:To observe the clinical efficacy of needle-knife decompression of lumbar dorsal rami nerve and articular capsule on the treatment of lumbar osteoarthritis.Methods:120 lumbar osteoarthritis cases were randomly assigned into treatment group and control group evenly. Patients in treatment group were intervened by needle-knife decompression of lumbar dorsal rami nerve and articular capsule once a week for three times. Participants in control group were treated with nerve block and intra-articular injection of corticosteroid(ropivacaine hydrochloride, triamcinolone acetonide and normal saline) once a week for three consecutive weeks. For all participants, visual analogue scale(VAS) and the Oswestry disability index(ODI) were used to evaluate their pain and lumbar function before, after treatment and 4 weeks after treatment. Results:There is no statistical difference of VAS score between two groups before intervention. VAS score in treatment group decreased significantly after treatment(3.17±1.79 vs 6.12±2.62, t=2.89, P<0.05). It further decreased with statistical difference 4 weeks later(1.85±0.86, t=0.94, P<0.05). The VAS score in control group decreased significantly(3.24±2.01 vs 6.23±2.33,t=2.29, P<0.05). The result of 4 weeks after intervention did not vary significantly(3.55±1.56, t=0.17, P>0.05). Inter-group comparison showed that VAS score of two groups was of no statistical difference after treatment(t=0.22, P>0.05) but result of treatment group was significantly lower than that in control group(t=0.83, P<0.05). ODI score of two groups showed no statistical difference before treatment(t=0.02, P>0.05). Intra-group comparison showed that result of treatment group decreased significantly after intervention(24.37±4.54 vs 39.15±7.22,t=5.38, P<0.05) and ODI score further decreased with statistical difference 4 weeks after intervention(20.22±3.22,t=2.87, P<0.05). While in control group, ODI score decreased significantly after treatment(30.57±5.16 vs 38.87±7.69, t=2.82, P<0.05) but it did not expe

关 键 词：腰椎骨关节炎 腰椎小关节 针刀 随机对照试验 

分 类 号：R681.5[医药卫生—骨科学]