脊神经后内侧支注射不同浓度臭氧或臭氧水治疗腰椎关节突源性腰痛患者的疗效及安全性  

Safety and efficacy of injecting different concentrations of ozone or ozone water into posterior medial branch of spinal nerve for patients with facet arthrogenic low back pain

作　　者：杨勇[1] 孙飞[1] 张丽[1] 周友龙[1] Yang Yong;Sun Fei;Zhang Li;Zhou Youlong(Department of Pain Medicine,The Third Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou City,Henan Province 450003,China)

机构地区：[1]河南中医药大学第三附属医院疼痛科,郑州市450003

出　　处：《中华疼痛学杂志》2023年第3期420-425,共6页Chinese Journal Of Painology

基　　金：河南省中医药科学研究专项课题(20-21ZY2077);河南省特色骨干学科中医学学科建设项目(STG-ZYX02-202115)。

摘　　要：目的探讨脊神经后内侧支注射不同浓度的臭氧气体或臭氧水治疗腰椎关节突源性腰痛患者的临床疗效及安全性。方法前瞻性收集2018年12月至2021年12月河南中医药大学第三附属医院疼痛科门诊腰椎关节突源性腰痛患者120例,采用随机数字表法将其随机分为4组。分别接受经脊神经后内侧支注射不同浓度臭氧或臭氧水,A组(23μg/ml臭氧水注射)、B组(13μg/ml臭氧水注射)、C组(35μg/ml臭氧气体注射)和D组(45μg/ml臭氧气体注射),5 d治疗1次,2次为1个疗程,共治疗3个疗程,疗程之间间隔1周。记录所有患者在治疗前及治疗1、3个疗程后视觉模拟评分(VAS)及VAS≤3分的例数;治疗3个疗程时评定优良率及半年后复发率。结果VAS评分组别及不同时点存在交互作用(F=12.33,P<0.001);进行单独效应分析,与治疗前比较,4组患者治疗后各时点VAS评分均降低,VAS≤3分例数均升高(P均<0.05);与治疗1个疗程后比较,4组患者3个疗程后VAS评分均降低,VAS≤3分例数均较高(P均<0.05)。治疗1、3个疗程后,A、C组VAS评分及VAS≤3分例数差异无统计学意义,且VAS评分低于B、D组,VAS≤3分例数多于B、D组(P均<0.05)。4组优良率分别为86.2%(25/29例)、63.3%(19/30例)、90.0%(27/30例)和71.4%(20/28例),差异有统计学意义(χ^(2)=8.06,P=0.045),且A、C组临床疗效明显高于B、D组(P均<0.05)。4组的复发率差异无统计学意义(χ^(2)=5.49,P=0.139)。结论经脊神经后内侧支注射不同浓度的臭氧水及臭氧气体时,应用23μg/ml臭氧水及35μg/ml臭氧气体注射临床疗效较13μg/ml臭氧水及45μg/ml臭氧气体佳,且安全。Objective To investigate the clinical efficacy and safety of injecting different concentrations of ozone water or ozone into the posterior medial branch of the spinal nerve in the treatment of patients with low back pain induced by lumbar facet.Methods One hundred and twenty outpatients from the Department of Pain Medicine,the Third Affiliated Hospital of Henan University of Traditional Chinese Medicine from December 2018 to December 2021 were randomly divided into four groups.Patients were received different concentrations of ozone water or ozone into the posterior medial branch of the spinal nerve,group A(23μg/ml ozone water injection),group B(13μg/ml ozone water injection),group C(35μg/ml ozone injection)and group D(45μg/ml ozone injection),once in 5 days,twice as a course of treatment,with an interval of one week.Visual analogue scale(VAS)and the number of patients with low back pain of VAS≤3 were recorded before the treatment,and 1 course and 3 courses of the treatment.The excellent and good rate,recurrence rate were evaluated at 6 months after the treatment.Results There was an interaction between group and different time point of VAS(F=12.33,P<0.001),and the VAS in the four groups were lower after three courses of treatment than those before the treatment(P<0.05).Compared with the pretreatment,VAS was decreased and the number of VAS≤3 cases was increased at each time point after the treatment in 4 groups(all P<0.05).Compared with one course of treatment,VAS was lower and the number of VAS≤3 cases was higher after 3 courses of treatment in four groups(all P<0.05).After 1 and 3 courses of treatment,there was no statistical significance in VAS and VAS≤3 cases in group A and C,but VAS was lower,VAS≤3 cases was in group A and C more than those in group B and D(all P<0.05).The excellent and good rate were 89%(25/29 cases),63%(19/30 cases),90%(27/30 cases)and 71%(20/28 cases)in the 4 groups respectively,with statistically significant(χ^(2)=8.06,P=0.045).The clinical efficacy was significantly highe

关 键 词：腰痛 腰椎关节突关节 臭氧 脊神经后内侧支 

分 类 号：R681.5[医药卫生—骨科学]