经皮激光椎间盘减压术联合熥敷颈腰痛砂治疗腰椎间盘突出症临床观察  

Clinical Observation on Treatment of Lumbar Intervertebral Disc Herniation by Percutaneous Laser Disc Decompression Combined with Tongfu Jingyaotong Sand

作　　者：蒋鹏 赵继荣[1] 陈文[2] 陈祁青[2] 杨涛[1] 李玮农 张立存 杨文通 史凡凡 JIANG Peng;ZHAO Jirong;CHEN Wen;CHEN Qiqing;YANG Tao;LI Weinong;ZHANG Licun;YANG Wentong;SHI Fanfan(Gansu University of Chinese Medicine,Lanzhou 730030,Gansu,China;Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou 730050,Gansu,China)

机构地区：[1]甘肃中医药大学,甘肃兰州730030 [2]甘肃省中医院,甘肃兰州730050

出　　处：《辽宁中医杂志》2024年第4期103-106,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81760877);甘肃省科技重大项目(21ZD4FA009);中医药循证能力建设项目(2019xzzx-gk005);甘肃省科技厅重点研发计划-社会发展类项目(20YF3FA016);兰州市创新人才项目(2018-RC-99)。

摘　　要：目的观察PLDD联合熥敷颈腰痛砂治疗LDH的临床疗效。方法采用随机数字表法将68例患者分为治疗组(PLDD+熥敷颈腰痛砂)、对照组(单纯PLDD治疗)各34例。组内及组间比较两组受试者治疗前及治疗后1周、1个月、2个月、6个月后的视觉模拟疼痛评分(VAS)、日本骨科协会评估治疗分数(JOA)、Oswestry功能障碍指数(ODI)及改良MacNab疗效的优良率,并进行安全性评价。结果两组治疗前VAS、ODI、JOA比较,差异无统计学意义(P>0.05)。与本组治疗前比较,两组经治疗后VAS、ODI、JOA均明显改善(P<0.05);术后1周、术后1个月、术后2个月治疗组在疼痛缓解程度上优于对照组,差异有统计学意义(P<0.05);治疗组患者术后1周、术后1个月、术后2个月、术后6个月JOA疼痛评分、ODI评分均优于对照组,差异有统计学意义(P<0.05);两组患者术后2个月、术后6个月的有效率比较,差异无统计学意义(P>0.05);治疗组患者术后2个月、术后6个月优良率分别为94.1%、97.1%,优于对照组术后2个月、术后6个月的优良率,差异有统计学意义(P<0.05)。结论PLDD联合熥敷颈腰痛砂治疗LDH疗效显著,能有效缓解下腰痛、下肢放射痛症状,明显改善腰椎活动功能。Objective To observe the clinical efficacy of percutaneous laser disc decompression(PLDD)combined with Tongfu Jingyaotong sand in the treatment of lumbar intervertebral disc herniation(LDH).Methods Sixty-eight patients were randomly divided into treatment group(PLDD+Tongfu Jingyaotong sand)and control group(PLDD alone),34 patients in each group.The visual analog pain score(VAS),Japanese Orthopaedic Association evaluation treatment score(JOA),Oswestry Disability Index(ODI)and the excellent and good rate of modified MacNab were compared before and 1 week,1,2 and 6 months after treatment,and the safety of the two groups was evaluated.Results There were no significant differences in the scores of VAS,ODI or JOA between the two groups before treatment(P>0.05).Compared with those before treatment,the scores of VAS,ODI and JOA in two groups were significantly improved after treatment(P<0.05).The degree of pain relief in the treatment group was better than that in the control group at 1 week,1 and 2 months after surgery with statistical significance(P<0.05).JOA score and ODI score in the treatment group were better than those in the control group at 1 week,1,2 and 6 months after surgery with statistically significant differences(P<0.05).There was no statistical significance in the effective rate of 2 and 6 months after surgery between two groups(P>0.05).Excellent and good rates in the treatment group were 94.1%and 97.1%at 2 and 6 months after surgery,respectively,which were better than those in the control group at 2 and 6 months after surgery with statistical significance(P<0.05).Conclusion PLDD combined with Tongfu Jingyaotong sand is effective in the treatment of LDH,which can effectively relieve the symptoms of low back pain and lower limb radiation pain,and obviously improve the activity of the lumbar spine.

关 键 词：腰椎间盘突出症 经皮激光椎间盘减压术 熥敷颈腰痛砂 临床疗效 

分 类 号：R681.53[医药卫生—骨科学]