后路管状位穿刺靶点法射频热凝治疗腰椎间盘突出症对外周血中一氧化氮和前列腺素E_2的影响

Effects of Target Ablation with Radiofrequency Thermocoagulation on the Levels of NO and PGE_2 in Peripheral Blood of Patients with Lumbar Disc Herniation

目的探讨后路管状位穿刺靶点法射频热凝治疗腰椎间盘突出症的临床疗效及作用机制。方法将180例腰椎间盘突出症的患者随机分为观察组和对照组,每组各90例,观察组采用射频热凝靶点治疗;对照组采用臭氧注射治疗。采用改良Macnab评估临床疗效前列腺素E_2(PGE_2),测定采用酶联免疫法。一氧化氮(NO)采用化学显色和比色法(Griess反应法)测定,观察两组治疗前后临床疗效及外周血中NO和PGE_2的变化。结果治疗组优良率显著高于对照组(P<0.05);两组血中PGE_2及NO含量较治疗前显著减低(P<0.01);与对照组比较,治疗组血中PGE_2及NO含量明显降低(P<0.05);结论表明本法对腰椎间盘突出症患者外周血中NO和PGE_2含量有明显的良性调节作用。这可能是射频热凝靶点治疗本病的作用机理之一。

Objective To investigate the clinical efficacy and mechanism of target ablation with radiofrequency thermocoagulation by posterior approach for tubular position in treatment of lumbar disc herniation （LDH）. Methods 180 cases of patients with LDH were randomly divided into two groups. Treatment group was treated with radiofrequeney thermocoagulation by posterior approach for tubular position. Control group was treated with ozone injection therapy. Clinical efficacy was assessed by modified Macnab. PGE2 and NO were determined by enzyme -linked immunosorbent assay and chemical color and colorimetric determination. Results The total effective rate of treatment groups was higher than that of control group （P 〈 0. 05 ） ; the blood PGE2 and NO in both groups were significantly lower than those before treatment （P 〈 0.01 ）. Compared with control group, the blood PGE2 and NO were significantly decreased in treatment group （ P 〈 0.05 ）. Conclusion The benign regulation effect of this method on NO and PGE2 levels in peripheral blood of patients with LDH. This may be one of the mechanisms of the treatment of this disease by radiofrequeney thermoeoagulation by posterior approach for tubular position.