硬膜外封闭联合针药疗法治疗腰椎间盘突出症伴继发性椎管狭窄症临床观察

Efficacy of Epidural Block Combined with Acupuncture in the Treatment of Lumbar Disc Herniation with Secondary Spinal Stenosis

目的探讨硬膜外封闭联合针药疗法治疗腰椎间盘突出症伴继发性椎管狭窄症的临床疗效。方法选取腰椎间盘突出症伴继发性椎管狭窄症患者120例,随机分为对照组60例和观察组60例。对照组采用硬膜外封闭疗法,观察组采用硬膜外封闭联合针药疗法,2组均治疗14d后比较临床疗效、治疗前后的Oswestry功能障碍指数问卷表(ODI)和视觉模拟量表(VAS)的评分以及血清基质金属蛋白酶-3(MMP-3)、肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)水平。结果治疗后,2组腰椎ODI和VAS评分均较治疗前明显改善,且观察组改善程度优于对照组(P<0.01);2组血清MMP-3、TNF-α、IL-1β水平均较治疗前明显下降(P<0.05),且观察组血清MMP-3、TNF-α、IL-1β水平下降程度大于对照组(P<0.05)。观察组的临床疗效明显优于对照组(96.66%vs 65.00%)(P<0.05)。结论硬膜外封闭联合针药疗法治疗腰椎间盘突出症伴继发性椎管狭窄症具有较好的临床疗效,其疗效优于单用一种疗法。

Objective To explore the clinical effect of epidural block combined with acupuncture in the treatment of lumbar disc herniation with secondary spinal stenosis.Methods One hundred and twenty patients with lumbar disc herniation and secondary spinal stenosis were randomly divided into observation group（n=60）and control group（n=60）.Oswestry disability index（ODI）and visual analogue scale（VAS）were used to evaluate the degree of pain,the levels of serum matrix metalloproteinase-3（MMP-3）,interleukin-1β（IL-1β）and tumor necrosis factor-α（TNF-α）were measured.The clinical efficacy was compared between the two groups.Results After treatment,the ODI and VAS scores of lumbar vertebrae were significantly improved,and the observation group was better than the control group（P〈0.01）.The levels of serum MMP-3,TNF-αand IL-1βwere significantly decreased in the two groups（P〈0.05）,and the levels of MMP-3,TNF-αand IL-1βin the observation group were significantly lower than those in the control group（P〈0.05）.The clinical efficacy of the observation group was better than that of the control group（96.66% vs 65.00%）（P〈0.05）.Conclusion The use of epidural block combined with acupuncture therapy in the treatment of lumbar disc herniation with secondary spinal stenosis has a good clinical efficacy,better than a single therapy.