摘要
目的观察密集型银质针松解术联合中药熏洗治疗腰椎间盘突出症的临床疗效。方法选择2020年7月至2021年7月收治的腰椎间盘突出症患者104例为本次研究对象,按照随机数字表法分为2组,对照组52例予中药熏洗治疗,治疗组52例在对照组基础上联合密集型银质针松懈术治疗。2组均治疗3周后统计疗效,比较2组治疗前后细胞因子血清基质金属蛋白酶3(MMP-3)、肿瘤坏死因子α(TNF-α)及转化生长因子-β_(1)(TGF-β_(1))水平变化情况,比较2组治疗前后疼痛视觉模拟评分(VAS)及日本骨科协会(JOA)评分变化情况,比较2组治疗前后腓总神经及胫神经运动传导速度变化情况。结果治疗组总有效率94.23%(49/52),对照组总有效率80.77%(42/52),治疗组总有效率高于对照组(P<0.05)。与本组治疗前比较,2组治疗后细胞因子血清MMP-3、TNF-α及TGF-β_(1)水平均降低(P<0.05),且治疗组治疗后血清MMP-3、TNF-α及TGF-β_(1)水平均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后疼痛VAS均降低(P<0.05),JOA评分均升高(P<0.05),且治疗组治疗后疼痛VAS低于对照组(P<0.05),JOA评分高于对照组(P<0.05)。与本组治疗前比较,2组治疗后腓总神经及胫神经运动传导速度均增快(P<0.05),且治疗组治疗后腓总神经及胫神经运动传导速度快于对照组(P<0.05)。结论密集型银质针松解术结合中药熏洗治疗腰椎间盘突出症临床疗效确切,可有效缓解患者疼痛症状,提高腰椎功能,改善神经传导功能,其作用机制可能与降低MMP-3、TNF-α及TGF-β_(1)水平,减轻炎性,促进组织修复有关。
Objective To explore the effect of dense silver needle decompression combined with herbal fumigation in the treatment of lumbar disc herniation(LDH).Methods A total of 104 patients with LDH who were treated in our hospital from July 2020 to July 2021 were randomly assigned into the control group(n=52)and the treatment group(n=52),all patients were treated with herbal fumigation,and patients in the treatment group were additionally treated with dense silver needle decompression.The treatment was performed for 3 weeks,aiming to compare the levels of serum matrix metalloproteinase-3(MMP-3),tumor necrosis factor-α(TNF-α)and transforming growth factor-β_(1)(TGF-β_(1)),as well as the scores of visual analogue scale(VAS)and Japanese Orthopaedic Association(JOA)between groups before and after treatment.The changes of motor conduction velocity of common peroneal nerve(CPN)and tibial nerve(TN)before and after treatment were recorded between the two groups.Results The total effective rate in the treatment group was significantly higher than that of the control group(94.23%[49/52]vs 80.77%[42/52],P<0.05).After treatment,the levels of serum MMP-3,TNF-αand TGF-β_(1)in the two groups were significantly decreased(P<0.05),and the decrease was more obvious in the treatment group(P<0.05).Significantly decreased VAS scores(P<0.05)and significantly increased JOA scores(P<0.05)were detected in the both groups,and the treatment group was superior to the control group in VAS and JOA(all P<0.05).The motor conduction velocities of CPN and TN in the two groups increased significantly(P<0.05),and which in the treatment group were more faster than the control group(P<0.05).Conclusion For patients with LDH,dense silver needle decompression combined with herbal fumigation has a definite clinical effect,which can effectively relieve the pain symptoms of patients,improve lumbar function and nerve conduction function by reducing the levels of MMP-3,TNF-αand TGF-β_(1),with reducing inflammation and promoting tissue repair.
作者
谌虎
沈浩
CHEN Hu;SHEN Hao(Department of Pain Rehabilitation Medicine,Second People's Hospital of Jiangyou,Sichuan,Jiangyou 621700)
出处
《河北中医》
2024年第1期109-112,共4页
Hebei Journal of Traditional Chinese Medicine
关键词
椎间盘突出
腰椎
密集型银质针松解术
中药熏洗
Lumbar disc herniation
Dense silver needle decompression
Herbal fumigation
