经皮耳迷走神经刺激治疗腰椎间盘突出症的临床疗效

Clinical efficacy of transcutaneous auricular vagus nerve stimulation in treatment of lumbar disc herniation

目的探讨经皮耳迷走神经刺激(TaVNS)治疗腰椎间盘突出症的临床疗效。方法选取2022-01至2022-12在海军第971医院中医科就诊的68例腰椎间盘突出症患者为研究对象。按随机数字表法分为常规治疗组和TaVNS组,每组34例。常规治疗组采取常规中医治疗,TaVNS组在常规治疗的基础上进行TaVNS治疗,治疗时间均为2个疗程。记录并进行对比分析两组患者治疗开始前(T_(0))、治疗第7天(T_(1))、治疗结束当天(T_(2))的下腰部VAS疼痛评分、腰椎功能JOA症状积分,判断症状改善情况。结果两组治疗后,与治疗前对比,VAS评分、JOA症状积分均明显改善,差异有统计学意义(F=366.978,P<0.001;F=400.187,P<0.001)。T_(2)时,TaVNS组的VAS评分显著低于常规治疗组(2.24±0.99 vs.2.79±0.88,P=0.016);JOA症状积分显著高于常规治疗组(21.38±4.59 vs.18.56±3.36,P=0.005),差异均有统计学意义。TaVNS组的改善指数、临床疗效优于常规治疗组,差异均有统计学意义(Z=3.325,P=0.001)。结论TaVNS治疗可明显缓解腰椎间盘突出症患者临床症状,值得推广应用。

Objective To investigate the clinical effect of transcutaneous auricular vagus nerve stimulation(TaVNS)in the treatment of lumbar disc herniation(LDH).Methods A total of 68 LDH patients who were treated in the Department of Traditional Chinese Medicine of No.971 Hospital of PLA Navy from January 2022 to December 2022 were selected as the study objects,and were divided into conventional treatment group and TaVNS group according to random number table method,with 34 cases in each group.The conventional treatment group received traditional Chinese medicine treatment,while the TaVNS group received TaVNS on the basis of the conventional treatment group for 2 courses.The VAS pain scores and Japanese Orthopedic Association(JOA)scores of the two groups were recorded before treatment(T_(0)),on the 7th day(T_(1)),and on the end of treatment(T_(2)),and were compared and analyzed to judge the improvement of symptom.Results After treatment,VAS scores and JOA symptom scores were significantly improved compared with before treatment,and the difference was statistically significant(F=366.978,P<0.001;F=400.187,P<0.001).At T_(2),the VAS score of the TaVNS group was significantly lower than that of the conventional treatment group at T_(2)(2.24±0.99 vs 2.79±0.88,P=0.016).The JOA symptom score of the TaVNS group at T_(2)was significantly higher than that of the conventional treatment group(21.38±4.59 vs 18.56±3.36,P=0.005).The improvement index and clinical efficacy of TaVNS group were better than those of conventional treatment group,and the differences were statistically significant(Z=3.325,P=0.001).Conclusions TaVNS can obviously improve the clinical symptoms of patients with lumbar disc herniation,which is worthy of popularization and application.