神经妥乐平联合神经阻滞治疗腰椎间盘突出致根性坐骨神经痛

Effect of Neurotropin Combined with Nerve Block on the Sciatic Neuralgia Caused by Lumbar Disc Protrusion

目的 :神经妥乐平 (neurotropin ,NTP)是家兔皮肤接种牛痘病毒后局部炎症皮肤中提取的生物活性物质 ,本研究旨在观察该药及与神经阻滞疗法联合应用治疗腰椎间盘突出致根性坐骨神经痛的临床效果。方法 :CT或MRI证实的腰椎间盘突出、并有单侧坐骨神经痛的患者 10 2例 ,分 (1)神经阻滞组 (NB ,n =4 5 ) :骶管注射 +L2～ 5椎旁注射 ,每周 1次 ,连续 5周 ;(2 )神经阻滞 +神经妥乐平组 (NB +NTP组 ,n =35 ) :骶管注射 +L2～ 5椎旁注射同NB组 ,每周 1次 ,2周后骶管内追加NTP 6ml,其余同以往治疗 ,在行神经阻滞治疗间隙每天肌肉注射 3ml神经妥乐平。 5周治疗结束后进行疗效评价 ,并观察其中 16例患者治疗前后肌电图的变化 ;(3)神经妥乐平组 (NTP ,n =2 2 ) :前 2周仅给予口服非甾体类消炎止痛药物 (如莫比可、英太青 ) ,2周后开始予神经妥乐平 6ml/d肌肉注射共 2周 ,最后 1周改为 3ml/d肌注 ,比较治疗前后的疼痛缓解情况。结果 :(1)单独使用神经妥乐平可以明显缓解腰椎间盘突出引起的坐骨神经痛 (P <0 .0 5 ) ;(2 )神经妥乐平不仅能明显提高神经阻滞疗法缓解根性坐骨神经痛的作用 ,两者联合应用 ,还可明显缓解神经根受压所致的下肢麻木 (P <0 .0 1) ;(3)除极少数病例出现皮肤过敏反应 ,NTP用于治疗坐骨神经痛无?

Objective: To evaluate the clinical effect of neurotropin, a kind of non-protein extract from the dermis of rabbits inoculated with vaccinia virus. Methods: 102 patients who suffered from sciatic neuralgia and CT or MRI revealed that lumbar disc protrusion is availabe were divided in three groups. (1) Nerve block group (NB group, n =45): patients got sacral canal and paravertebral injection per week for 5 weeks. (2) NB+NTP group( n =35): besides injection NB group got, the patients in this group were administered NTP 6ml into their sacral canal together with nerve block after the third therapy and 3ml i.m. qd. (3) NTP group( n =22): The patients were given NSAIDs for 2 weeks and then NTP 6 ml i.m. qd for 2 weeks, 3ml for the later 1 week. The effect and side effect of the treatment was evaluate at the end of 5 th week. The electromyography (EMG) was evaluated in 16 patients of NB+NTP group. Results: Neurotropin relieved sciatic neuralgia and enhanced the effect of nerve block on neuralgia and numbness of the unilateral lower limb caused by lumbar disc protrusion more markedly. The menifestation of EMG was improved in the patients of NB+NTP group compared with that before therapy. There was no any other side effect were found when NTP was administered except allergy effect in some patients. Conclusion: NTP reinforced the effect of nerve block on the sciatic neuralgia caused by lumbar disc protrusion.