针灸联合经皮椎间孔镜TESSYS技术治疗腰椎间盘突出症60例

Acupuncture and TESSYS in Treating 60 Cases of Lumbar Disc Herniation

目的:观察针灸联合经皮椎间孔镜TESSYS技术治疗腰椎间盘突出症(LDH)的临床疗效。方法:将120例LDH患者随机分为2组,治疗组与对照组各60例,治疗组给予针灸联合经皮脊柱内镜下TESSYS技术治疗,对照组单纯采用经椎间孔镜下TESSYS技术治疗。所有患者于手术前1天、术后1个月、3个月和6个月进行随访,采用下肢疼痛(VAS)评分法及Oswestry功能障碍指数问卷表(ODI)进行临床疗效评估,2组患者均运用改良Mac Nab进行临床疗效的评价。结果:所有患者均顺利完成手术治疗,治疗组术前1天、术后1个月、3个月、6个月的VAS评分分别是(7.87±0.79)分、(1.87±0.94)分、(0.64±0.33)分、(0.21±0.14)分,对照组术前1天、术后1个月、3个月、6个月的VAS评分分别是(7.84±0.77)分、(3.23±0.74)分、(1.89±0.52)分、(0.25±0.13)分;2组患者手术前1天VAS评分进行比较,差异无统计学意义(P>0.05);手术后1个月、3个月、的VAS评分比较,组间差异均有统计学意义(P<0.05);手术后6个月VAS评分进行比较,差异无统计学意义(P>0.05)。治疗组手术前1天和治疗后1个月、3个月、6个月的ODI评分分别是(70.64±9.89)分、(29.63±7.45)分、(9.21±5.32)分、(2.21±1.43)分。对照组手术前1天和手术后1个月、3个月、6个月的ODI评分分别是(69.78±9.66)分、(37.63±9.34)分、(14.64±6.38)分、(2.34±1.51)分。2组患者治疗前ODI评分进行比较,差异无统计学意义(P>0.05);手术后1个月、3个月VAS评分进行比较,组间差异均具有统计学意义(P<0.05);手术后6个月ODI评分进行比较,差异无统计学意义(P>0.05)。术后6个月对2组患者运用改良Mac Nab评价标准进行临床疗效评价,治疗组、对照组优良率分别为94.1%和91.5%。结论:针灸联合经皮椎间孔镜TESSYS技术治疗LDH能够有效缓解缓解患者的临床症状,针灸治疗可以有效缩短患者的术后恢复时间,提高临床疗效。

Objective：To observe clinical effects of acupuncture combined with transforaminal endoscopy spine system（TESSYS） in treating lumbar dic herniation（LDH）.Methods：All 120 LDH patients were randomized into two groups,the treatment group and the control group,60 cases each group,the treatment group were treated by acupuncture and TESSYS,while the control group adopted TESSYS only.All the patients were followed at the day before the surgery,in one month,three months and six months after the surgery,and clinical effects were assessed by VAS scales and Oswestry dysfunction index（ODI）,and modified Mac Nab in both groups.Results：All the patients finished the surgery smoothly,VAS scores of the treatment group at the day before the surgery,in one month,three months and six months after the surgery were（7.87±0.79） points,（1.87±0.94） points,（0.64±0.33） points and（0.21±0.14）points respectively,while VAS scores of the control group in one day before the surgery,one month,three months and six months after the surgery were（7.84±0.77） points,（3.23±0.74） points,（1.89±0.52） points and（0.25±0.13）points; the difference had no statistical meaning in the comparisons of VAS scores at the day before the surgery between both groups（P 〉0.05）; the differences were statistically significant in the comparisons of VAS scoresbetween both group in one month,three months after the surgery（P〈0.05）,the difference had no statistical meaning in the comparisons of VAS scales in six months between both groups（P〉0.05）.ODI scores of the treatment group at the day before the surgery,in one month,three months and six months after the surgery were（70.64 ±9.89）,（29.63±7.45）,（9.21±5.32） and（2.21±1.43）,while ODI scores of the control group at the day before the surgery,in one month,three months and six months after the surgery were（69.78 ±9.66）,（37.63 ±9.34）,（14.64 ±6.38） and（2.34±1.51）.The difference had no statistical meaning in the comparisons of ODI scores before the surgery between both groups（P〉0.05）; the difference was statistically significant in the comparisons of VAS scores in one month,three months after the surgery between both groups（P 〈0.05）; the difference had no statistical meaning in the comparisons of ODI scores in six months after the surgery（P〉0.05）.Clinical effects of both groups were assessed by modified Mac Nab in six months after the surgery,the excellent rate of the treatment group and the control group were 94.1% and 91.5% respectively.Conclusion：Acupuncture combined with TESSYS in treating LDH could effectively relieve clinical symptoms of the patients,acupuncture could effectively shorten postoperative recovery time of the patients and raise clinical effects.