摘要
目的探讨腰椎间盘突出症 (lumbar disc herniation,LDH) 患者术后核心肌肉训练干预效果。方法选取 2017 年 1 月至 2019 年 1 月我院收治的 90 例 LDH 患者进行单盲、随机临床对照研究。根据随机数字表将 90 例分为观察组及对照组,每组各 45 例。对照组进行常规康复训练,观察组在常规康复训练中增加核心肌肉训练。测定 LDH 患者不同时间点疼痛视觉模拟评分 (visual analogue scale,VAS)、Oswestry 功能障碍指数 (oswestry disability index,ODI)。采用酶联免疫吸附法 (enzyme-linked immunosorbent assay,ELISA) 检测高敏 C-反应蛋白 (high sensitivity c-reactive protein,hs-CRP)、肿瘤坏死因子α (Tumor necrosis factor-α,TNF-α)、白介素 (interleukin,IL)-1、IL-6、IL-10、IL-18。结果观察组患者术后 3 个月腰背部 VAS(1.75±0.36) vs.(2.01±0.46)、下肢 VAS (1.24±0.46) vs.(2.66±0.48) 和 ODI (17.33±2.08) vs.(21.18±2.41)及术后 6 个月腰背部 VAS (1.04±0.37) vs.(1.41±0.39)、下肢 VAS (1.04±0.38) vs.(1.36±0.52) 和 ODI(15.65±1.92) vs.(17.35±1.88) 低于对照组,差异有统计学意义 (P<0.05)。观察组术后 3 个月 IL-1[(35.47±21.22) pg / ml vs.(48.47±19.72) pg / ml]、IL-18[(38.54±10.77) pg / ml vs.(47.12±11.15) pg / ml]及 6 个月 IL-1[(20.14±20.51) pg / ml vs.(47.12±11.15) pg / ml]、IL-18[(17.12±9.55) pg / ml vs.(25.12±10.11) pg / ml]均低于对照组,差异有统计学意义 (P<0.05)。结论 LDH 患者经皮内镜经椎间孔椎间盘切除术 (percutaneous endoscope transforaminal discectomy,PETD) 术后进行核心肌肉训练可以降低腰背部及下肢疼痛,改善腰背部功能,降低炎症因子水平。
Objective To investigate the effect of postoperative core muscle training in patients with lumbar disc herniation (LDH).Methods A single-blind and controlled clinical study was conducted on 90 LDH patients from January 2017 to January 2019.Ninety cases were divided into the observation group (n=45) and control group (n=45) according to the random number table.The control group received routine rehabilitation training only,while the observation group routine rehabilitation training and core muscle training.Visual Analogue Scale (VAS) and Oswestry disability index (ODI) were measured at different time points.Enzyme linked immunosorbent assay (ELISA) was used to detect high-sensitivity C-reactive protein (hs-CRP),tumor necrosis factor-α (TNF-α),interleukin (IL)-1,IL-6,IL-10,and IL-18.Results Low back VAS,lower limb VAS,and ODI 3 months[(1.75±0.36) vs.(2.01±0.46),(1.24±0.46) vs.(2.66±0.48),(17.33±2.08) vs.(21.18±2.41)]and 6 months[(1.04±0.37) vs.(1.41±0.39),(1.04±0.38) vs.(1.36±0.52),(15.65±1.92) vs.(17.35±1.88)]postoperatively of the observation group were lower than those of the control group 3 months and 6 months postoperatively (P < 0.05).IL-1 and IL-18 levels of the observation group were lower than those of the control group 3 months[(35.47±21.22) pg / ml vs.(48.47±19.72) pg / ml,(38.54±10.77) pg / ml vs.(47.12±11.15) pg / ml]and 6 months[(20.14±20.51) pg / ml vs.(47.12±11.15) pg / ml,(17.12±9.55) pg / ml vs.(25.12±10.11) pg / ml]postoperatively (P < 0.05).Conclusions Core muscle training after PETD can reduce low back and lower limb pain of LDH patients,improving lower back functions and reduce inflammatory factors.
作者
袁宁
翟树玉
刘凯
YUAN Ning;ZHAI Shu-yu;LIU Kai(Department of Orthopaedics,Zouping People's Hospital,Zouping,Shandong,256200,China)
出处
《中国骨与关节杂志》
CAS
2020年第9期716-720,共5页
Chinese Journal of Bone and Joint
关键词
椎间盘移位
康复
细胞因子类
白细胞介素类
Intervertebral disc displacement
Rehabilitation
Cytokines
Interleukins
