选择性神经阻滞配合鹿瓜多肽注射液治疗腰椎椎管狭窄症临床疗效及机理探讨

Clinical Effect of Nerve Block Combined with Cervus and Cucumis Polypeptide Injection in Treatment of Lumbar Spinal Stenosis Disease and Its Mechanism

目的:观察选择性神经阻滞配合鹿瓜多肽注射液治疗腰椎椎管狭窄症临床疗效并对机理进行探讨。方法:将我院骨伤科2014年1月至2015年1月住院的LSS患者60例按随机数字表法分为试验组30例,对照组30例,2组患者入院后均给予蜡疗、中药熏洗、腰背肌功能锻炼、平卧硬板床休息等治疗,试验组给予选择性神经阻滞+鹿瓜多肽注射液+骨筋丸胶囊;对照组给予选择性神经阻滞+骨筋丸胶囊。2组均以7 d为1个疗程,连续治疗2个疗程。分别于治疗前、治疗后2个疗程2组治疗前后JOA症状评分、临床疗效进行比较。结果:2组治疗前JOA症状积分比较,t=0.687,P=0.210<0.05,差异有统计学意义;治疗后比较,t=3.672,P=0.001<0.05,差异有统计学意义。2组组间治疗前后比较,均有统计学意义(P<0.05);试验组总有效率93.34%,对照组总有效率83.34%,试验组与对照组总有效临床比较,χ2=3.210,P=0.001<0.05,差异有统计学意义。结论:选择性神经阻滞配合鹿瓜多肽注射液治疗腰椎椎管狭窄症能够确切"责任椎体",使药物直接作用于治疗靶点,改善局部血液循环,抑制炎性物质释放缓解临床症状,方法简便,患者依存性好,值得推广。

Objective：To observe the clinical effect of nerve block combined with cervus and cucumis polypeptide injection in the treatment of lumbar spinal stenosis disease and to discuss its mechanism.Methods：Sixty patients with LSS who received treatment during January 2014 to January 2015 in Department of Orthopedics were selected and randomly divided into observation group and control group （n =30）.Patients in the two groups were treated with kerotherapy,traditional Chinese medicine fumigation,waistlumbar muscle functional exercise,and lying down on hard bed for rest.The observation group was additionally given nerve block combined with cervus and cucumis polypeptide injection and Gujinwan capsules,and the control group was given nerve block and Gujinwan capsules.Seven days were set as a course and patients received continuous 2 course of treatment.JOA symptom scores and clinical curative effect of the two groups before and after treatment were respectively compared.Results：The comparison of JOA symptoms integral in the two groups before the treatment showed statistically significant difference （t =0.687,P =0.210 〈0.05）.The difference was also statistically significant after treatment （t =3.672,P =0.001 〈0.05）.The comparison between the two groups before and after treatment also indicated statistically significant difference （P 〈0.05）.The total effective rate of the treatment group was 93.34% and that of the control group was 83.34%,showing statistically significant difference （χ^2 =3.210, P =0.001 〈0.05）.Conclusion：Nerve block combined with cervus and cucumis polypeptide injection in the treatment of lumbar spinal stenosis disease may exactly treat the affected vertebral body and have direct effects on drug therapeutic targets.It also may improve local blood circulation,inhibit inflammatory substances and relieve clinical symptoms,simple and having good reliance from patient,which is worth promoting.