腰脊神经后支阻滞联合体外冲击波对腰椎小关节源性腰痛患者腰椎功能及疼痛程度的影响  

The effect of lumbar spinal nerve posterior branch block combined with extracorporeal shock wave on lumbar function and pain severity in patients with lumbar facet arthrogenic low back pain

作　　者：李欣成 杨俊锁 谭伟 LI Xincheng;YANG Junsuo;TAN Wei(Department of Pain,Zaozhuang Traditional Chinese Medicine Hospital,Zaozhuang,Shandong,277000,China;Department of Anesthesia,Weishan County Traditional Chinese Medicine Hospital,Ji'ning,Shandong,277600,China;Department of Orthopedics,Xuecheng District Traditional Chinese Medicine Hospital,Zaozhuang,Shandong,277000,China)

机构地区：[1]枣庄市中医医院疼痛科,山东枣庄277000 [2]微山县中医院麻醉科,山东济宁277600 [3]薛城区中医院骨科,山东枣庄277000

出　　处：《当代医学》2025年第1期52-56,共5页Contemporary Medicine

摘　　要：目的探讨腰脊神经后支阻滞联合体外冲击波治疗腰椎小关节源性腰痛的效果。方法选取2021年1月至2022年12月枣庄市中医医院收治的86例腰椎小关节源性腰痛患者作为研究对象,按照随机数字表法分为对照组与观察组,各43例。对照组予以腰脊神经后支阻滞治疗,观察组在对照组基础上联合体外冲击波治疗。比较两组临床疗效、腰椎功能[日本骨科协会评估治疗(Japanese Orthopaedic Association scores,JOA)]、腰椎活动度(前屈、后伸)、疼痛程度[视觉模拟评分法(visual analogue scale,VAS)]、日常生活能力[Barthel指数(Barthel index,BI)]、Oswestry功能障碍指数(Oswestry disability index,ODI)评分、生命质量[世界卫生组织生存质量测定量表简表(the World Health Organization quality of life-BREF,WHOQOL-BREF)]、不良反应发生情况。结果观察组治疗总有效率为95.35%,高于对照组的81.40%,差异有统计学意义(P<0.05)。治疗后,两组主观症状、临床体征、日常活动受限评分及总分均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。治疗后,两组前屈、后伸活动度均大于治疗前,且观察组大于对照组,差异有统计学意义(P<0.05)。治疗后,两组VAS、ODI评分均低于治疗前,BI评分均高于治疗前,且观察组VAS、ODI评分均低于对照组,BI评分高于对照组,差异有统计学意义(P<0.05)。治疗后,两组生理、心理、社会、环境评分均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。两组治疗期间均未出现明显不良反应。结论腰脊神经后支阻滞联合体外冲击波治疗腰椎小关节源性腰痛效果显著,可减轻患者腰痛症状,加快腰椎功能恢复,提高腰椎活动能力,改善生命质量。Objective To investigate the effect of lumbar spinal nerve posterior branch block combined with extracorporeal shock wave in the treatment of lumbar facet arthrogenic low back pain.Methods A total of 86 patients with lumbar facet arthrogenic low back pain admitted to Zaozhuang Traditional Chinese Medicine Hospital from January 2021 to December 2022 were selected as the study subjects,and they were divided into the centrol group and the observation group according to random number table method,with 43 cases in each group.The control group was treated with lumbar spinal nerve posterior branch block,and the observation group was treated with extracorporeal shock wave on the basis of the control group.The clinical efficacy,lumbar function(Japanese Orthopaedic Association scores[JOA]),lumbar motion(flexion,extension),pain degree(visual analogue scale[VAS]),ability of daily living(Barthel index[BI]),Oswestry disability index(ODI)score,quality of life(the World Health Organization quality of life-BREF[WHOQOL-BREF])were compared between the two groups.Results The total effective rate in the observation group was 95.35%,which was higher than 81.40%in the control group,the difference was statistically significant(P<0.05).After treatment,the subjective symptoms,clinical signs,daily activity limitation scores and total scores of the two groups were greater than before treatment,and the observation group was greater than the control group,the differences were statistically significant(P<0.05).After treatment,the range of flexion and extension activity of the two groups were higher than before treatment,and the observation group was higher than the control group,the differences were statistically significant(P<0.05).After treatment,VAS score and ODI score of the two groups were lower than before treatment,BI score were higher than before treatment,and VAS score and ODI score in the observation group were lower than those in the control group,BI score were higher than that in the control group,the differences were statistically

关 键 词：腰椎小关节源性腰痛 腰脊神经后支阻滞 体外冲击波 腰椎功能 疼痛 

分 类 号：R681.5[医药卫生—骨科学]