椎旁神经阻滞复合臭氧治疗腰椎间盘突出的疗效研究

The research on clinical effect of paravertebral block combined with ozone in patients with lumbar disc herniation

目的：观察椎旁神经阻滞复合臭氧治疗腰椎间盘突出的远期临床疗效。方法90例经临床诊断证实为腰椎间盘突出合并椎管狭窄症患者随机分为两组：A组（n=45）单纯经椎旁间隙穿刺成功后注入消炎镇痛药20 ml；B组（n=45）经椎旁间隙穿刺成功后注入消炎镇痛药20 ml＋40μg/ml臭氧10 ml；每周一次，3~4次为一疗程。对病人治疗后1个月、6个月的疗效进行随访观察，项目包括：①临床疼痛评价：采用疼痛视觉模拟评分法（ VAS）进行评估；②治疗有效率：采用改良的MacNab法评价疗效。结果①VAS疼痛评分：两组组内比较，A组治疗后6个月的疼痛评分高于1个月的评分数值，差异有统计学意义（ P 〈0.05）。组间比较，B组治疗后6个月临床疗效稳定性高于A组，差异有统计学意义（ P 〈0.05）。②治疗总有效率：两组组内比较，A组治疗后6个月的治疗总有效率低于1个月的评分数值，差异有统计学意义（ P 〈0.05）。组间比较显示，B组治疗后6个月治疗总有效率高于A组，差异有统计学意义（ P 〈0.05）。结论椎旁神经阻滞复合臭氧治疗腰椎间盘突出的远期临床稳定性效果明显。

Objective To observe the long-term clinical effect of paravertebral block combined with ozone in patients with lumber disc herniation. Methods Ninety patients with lumber disc herniation accompanied by lumber spinal canal stenosis confirmed by clinical diagnosis were randomly divided into group A（n=45）in which a volume of 20ml analgesic and anti-inflammatory drugs was injected to perform paraverte-bral block and group B（n=45）in which a volume of 20 ml analgesic and anti-inflammatory drugs combined with a volume of 10 ml（40 μg/ml）ozone was injected to perform paravertebral block. There was one paravertebral block in a week and three or four paravertebral blocks in a treatment course. The clinical effect including visual analogue scale（ VAS）and treatment efficiency at 1 month and 6 months after the treatment were observed. Results The VAS at 6 month after the treatment was significantly higher than that at 1 month after the treatment in group A（ P〈0. 05）and there was no such a significant difference in group B. The total treatment efficiency at 6 months after the treatment in group B was significantly higher than that in group A（ P 〈0. 05）. Conclusion The long-term clinical effect of paravertebral block combined with ozone in patients with lumber disc herniation is definite and stable.