CT引导下脉冲射频联合补肾活血汤治疗老年退行性腰椎管狭窄症疗效观察  

Clinical efficacy of CT-guided pulsed radiofrequency combined with Bushen Huoxue Decoction in the treatment of degenerative lumbar spinal stenosis in the elderly

作　　者：曾炀 祝永刚[2] 肖辉灯 彭亚[2] 赵思浩 郑皓云 李春根 柳根哲[2] ZENG Yang;ZHU Yonggang;XIAO Huideng;PENG Ya;ZHAO Sihao;ZHENG Haoyun;LI Chungen;LIU Genzhe(Beijing University of Chinese Medicine,Beijing 100029,China;Department of Orthopedics,Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010)

机构地区：[1]北京中医药大学,北京100029 [2]首都医科大学附属北京中医医院骨科,北京100010

出　　处：《北京中医药》2025年第4期435-439,共5页Beijing Journal of Traditional Chinese Medicine

基　　金：首都特色临床诊疗技术研究及转化应用项目(Z221100007422122)。

摘　　要：目的观察CT引导下脉冲射频联合补肾活血汤治疗老年退行性腰椎管狭窄症的疗效。方法选取2022年2月―9月首都医科大学附属北京中医医院骨科治疗的退行性腰椎管狭窄患者60例,采用随机数字表法分为观察组、对照组各30例。对照组给予CT引导下脊神经背根神经节脉冲射频治疗,观察组在对照组基础上联合补肾活血汤治疗2周。对比2组优良率,治疗前及治疗后2周、3个月、6个月、12个月视觉模拟评分(VAS)、日本骨科协会(JOA)评分、中医证候积分、6分钟步行距离、腰椎后伸角度,并发症。结果治疗后12个月,观察组优良率高于对照组(P<0.05)。治疗后各时间点,2组VAS评分、中医证候积分均低于本组治疗前,JOA评分均高于本组治疗前,6分钟步行距离、腰椎后伸角度均大于治疗前(P<0.05);治疗后2周、3个月、6个月,观察组以上指标均优于对照组(P<0.05)。2组患者均未见穿刺部位出血、感染等术后并发症。结论CT引导下脉冲射频联合补肾活血汤治疗退行性老年腰椎管狭窄症安全有效,可减轻患者疼痛,促进腰椎功能恢复。Objective To observe the therapeutic effect of CT-guided pulsed radiofrequency combined with Bushen Huoxue Decoction in the treatment of degenerative lumbar spinal stenosis in elderly patients.Methods A total of 60 patients were selected and randomly divided into an observation group and a control group,with 30 cases in each group using a random number table method.The control group received CT-guided pulsed radiofrequency treatment targeting the dorsal root ganglion of the spinal nerve,while the observation group received Bushen Huoxue Decoction for 2 weeks in addition to the treatment administered to the control group.The excellent and good rates of the two groups were compared.Visual analogue scale(VAS)scores,Japanese Orthopedic Association(JOA)scores,traditional Chinese medicine(TCM)syndrome scores,6-minute walking distance,lumbar extension angle,and complications were recorded before treatment and at 2 weeks,3 months,6 months,and 12 months after treatment.Results At 12 months after treatment,the excellent and good rates of the observation group were significantly higher than those of the control group(P<0.05).After treatment,the VAS scores and TCM syndrome scores of both groups were significantly lower than those before treatment,while the JOA scores,6-minute walking distance,and lumbar extension angle were significantly improved compared with those before treatment(P<0.05).At 2 weeks,3 months,and 6 months after treatment,the observation group showed significantly better results in all indicators compared with the control group(P<0.05).No postoperative complications such as bleeding or infection at the puncture site were observed in either group.Conclusion CT-guided pulsed radiofrequency combined with Bushen Huoxue Decoction is safe and effective for the treatment of degenerative lumbar spinal stenosis in elderly patients,effectively relieving pain and promoting lumbar function recovery.

关 键 词：退行性腰椎管狭窄 老年人 脉冲射频 补肾活血汤 

分 类 号：R681.5[医药卫生—骨科学]