射频消融联合通络益肾方治疗腰椎间盘突出症近期疗效观察

Curative Effects Observation of Radiofrequency Ablation Combined with Tongluo Yishen Fang in the Treatment of Lumbar Disc Herniation and Effects on the Levels of IL-1β,MMP-3 and TNF-α

目的:探讨射频消融联合通络益肾方治疗腰椎间盘突出症(LDH)的近期临床疗效及对血清IL-1β、MMP-3及TNF-α水平的影响。方法:选取2012年6月至2016年5月三门峡武强颈肩腰腿痛医院收治的LDH患者144例,随机分为对照组与观察组,每组72例,对照组给予射频消融治疗,观察组在对照组的基础上联合通络益肾方治疗,2组均连续治疗4周。统计2组临床疗效,检测并比较治疗前及治疗后1、3个月2组血清IL-1β、MMP-3及TNF-α水平;比较治疗前后2组疼痛及焦虑状况;评价并比较2组治疗前后腰椎功能及生命质量。结果:观察组临床总有效率为93.06%(67/72),较对照组的76.39%(55/72)显著提高(P<0.05);治疗后2组血清IL-1β、MMP-3及TNF-α水平较治疗前降低(P<0.01),治疗后1个月至治疗后3个月2组VAS、SAS评分降低,且观察组均显著低于对照组(P<0.01);与治疗前比较,治疗后3个月2组ODI均明显降低,且观察组显著低于对照组(P<0.01);而2组腰椎功能评分及SF-36评分均明显升高,且观察组显著高于对照组(P<0.01)。结论:射频消融联合通络益肾方治疗LDH疗效显著,可明显抑制机体炎性反应及椎间盘退变,促进腰椎功能的恢复;同时还可显著减轻机体疼痛,缓解患者焦虑情绪,提高患者生命质量,预后良好。

Objective： To explore the clinical efficacy of radiofrequency ablation combined with Tongluo Yishen Fang in the treatment of Lumbar disc herniation（ LDH） and its effects on the levels of IL-1β,MMP-3 and TNF-α. Methods： A total of 144 cases LDH patients who were admitted and treated in our hospital from June 2012 to May 2016 were selected and randomly divided into control group and observation group,with 72 cases in each group. The Control group was treated with radiofrequency ablation,while the observation group was treated with Tongluo Yishen Fang based on the control group. 2 groups were treated continuously for 4 weeks. The total efficacy rate of 2 groups was recorded,and the serum IL-1β,MMP-3,TNF-α levels before and 1,3 months after treatment in 2 groups were detected. The pain and anxiety of 2 groups were compared. The lumbar function and life quality before and after treatment were evaluated and compared. Results： The clinical total effective rate of observation group was 93. 06%（ 67/72）,which was higher than that 76. 39%（ 55/72） of control group（ P 0. 05）; Compared with before treatment,the levels of serum IL-1β,MMP-3,TNF-α levels of 2 groups decreased significantly（ P 0. 01）. The VAS and SAS scores from 1 to 3 months decreased significantly,and which in observation group were lower than that in control group（ P 0. 01）; Compared with before treatment,the ODI of 2 groups 3 months after treatment decreased significantly,and there was significant difference between2 groups（ P 0. 01）; while the lumbar function score and SF-36 score increased significantly,and there was significant difference between 2 groups（ P 0. 01）. Conclusion： The clinical efficacy of radiofrequency ablation combined with Tongluo Yishen Fang is significant in the treatment of LDH,which can inhibit inflammatory response and Lumbar disc degeneration,promote the lumbar functional recovery,and can relief the pain and patients＇ anxiety effectively,as well as improve the patients quality of life with favorable prognosis.