腰椎间盘突出症的3种不同治疗方法疗效分析

The Comparative Analysis of Three Different Methods for Treatment of Lumbar Intervertebral Disc Herniatied

目的：比较采用腰椎牵引＋中药治疗、骶管冲击疗法以及腰椎牵引＋骶管封闭3种不同方法治疗方法的临床疗效。方法：自2006年5月-2011年12月,同期住院115例非手术治疗腰椎间盘突出症患者。其中男68例,女47例,年龄18~65岁,平均38.7岁。病程1月~123月,平均3.2月。全部病例均根据临床症状、体征及经CT、MRI检查为腰椎间盘突出症。分别采用上述3种方法治疗,治疗前、治疗后2周以及4周均采用Oswestry功能障碍指数评定。结果：各组治疗前后相比差异有高度显著性（P均〈0.01）;治疗后2周与4周差异无显著性差异（P〉0.01）;治疗后2周及4周Ⅰ组与Ⅱ、Ⅲ组有显著性差异（P〈0.05）。结论：腰椎牵引＋中药治疗的疗效稍差,骶管冲击治疗以及牵引＋骶管封闭疗效相当。骶管冲击有一定副作用,而骶管封闭仅一次即可。笔者建议：在保守治疗的腰椎间盘突出症患者中尽量选用腰椎牵引＋骶管封闭治疗。

Objective To compare curative effects of three different methods for treatment of lumbar intervertebral disc herniation,These methods are the lumbar traction ＋ Chinese medicine therapy,the sacral canal impact therapy and lumbar traction ＋ sacral canal local injection.Methods 115 patients had been treated with the same period in hospital nonoperative treatment of lumbar intervertebral disc herniatied patients since May 2006 to December 2011.The male 68 cases,female 47 cases,aged 18 to 65 years old,an average of 38.7 years.The course of disease were1 to 123 months,an average of 3.2 months.All patients were according to the clinical symptoms,signs and the CT,MRI inspection for prolapse of lumbar intervertebral disc.The three methods were used to treatment,before treatment,two weeks after 4 weeks and all use Oswestry dysfunction index evaluation.Results The before and after treatment group than a highlys ignificant difference（P 0.01）;Two weeks after treatment with 4 weeks no significant difference（P 0.01）;Two weeks after treatment and 4 weeks Ⅰ group and Ⅱ,Ⅲ group significant difference（P 0.05）.Conclusion The therapeutic effect of lumbar spine traction ＋ the traditional Chinese medicine is a bit poor,sacral canal impact therapy and lumbar traction ＋ sacral canal local injection are the same curative effects.The sacral canal impact therapy has a certain side effects,and sacral canal local injection is only one.The authors suggest that：in the conservative treatment of lumbar intervertebral disc herniatied patients try choosing lumbar traction ＋ sacral canal local injection treatment.