神经根管松解术治疗腰椎间盘突出症临床研究

Clinlic Study of Neurolysis of Spinal Nerve Canal Treating Lumbar Disc Protrusion

目的观察小针刀神经根管松解术治疗腰椎间盘突出症临床疗效及安全性。方法40例腰椎间盘突出症患者随机分为2组。治疗组20例给予小针刀神经根管松解术、牵引、针灸、推拿及中药辨证施治内服;对照组20例给予小针刀神经根管假松解术,其他治疗与治疗组完全相同。以疼痛、麻木等根性症状完全消失或退出试验为观察终点,试验中每天观察疗效及治疗反应,记录试验第7天及半月时主症缓解情况,并随访半年。结果治疗组总有效率与对照组无显著差异(P>0.05),显效率明显优于对照组(P<0.01);治疗组显效时间明显缩短(P<0.001);同时,治疗组发生沿神经分布的串麻感明显多于对照组,未见神经损害发生,且串麻感沿受压神经支配区的出现与疗效有正相关关系。结论小针刀神经根管松解术治疗腰椎间盘突出症具有显效快、疗效好、操作简便、痛苦少且潜在风险低的优势。

Objective To observe the effect and security of neumlysis of spinal nerve root canal with acupotomy treating lumbar disc protrusion. Methods 40 cases were randomly divided into two groups： the treatment group（20 cases） and the control group（20 cases）.The patients of treatment group were treated by neumlysis of spinal nerve root canal with acupotomy,traction,acupuncture,massage and traditional chinese drags based on differentiation; The patients of control group were treated by the same therapy as that of treatment group except pseudo acupotomy. The curative effect and reaction were observed every day during the treatment, especially the seventh and 15th days after the treatment. The studying was end when the pain and numbness was disappearing or refused treatment/withdraw consent. The period of visiting patients after treatment was half a year. Results The total effective rate was no significant differences between the two groups （P 〉 0.05）, but the excellent rate of treatment group was obviously superior to that of control group （P〈 0.01）. The time of excellent effect was shorter in treatment group than that in control group（P〈 0.001）; At the same time, the occurrence of the electric feeling that follow the never distribution in the treatment group was obviously higher than that of the control group, and the feeling was just related with the curative effect, but the potential risk of nerve damages was not higher in the treatment group. Conclusion Neumlysis of spinal nerve root canal with acupotomy treating lumbar disc protrusion had the obvious advantage of good and rapid effect, convenient operation, less painfulness and the lower potential risk.