超声药物导入疗法治疗坐骨神经痛的临床对照研究

Clinical Controlled Study of Ultrasound Drug Import Therapy on Sciatica

目的探讨超声药物导入疗法治疗坐骨神经痛的临床疗效及最佳的疗程和介入时机。方法 145例患者随机分成对照组和超声治疗组两组。对照组给予一般处理并口服药物治疗,超声治疗组在对照组基础上同时加超声药物导入治疗。两组均以5 d为1个疗程。第1、第2疗程结束时观察对坐骨神经痛的临床疗效。结果第1、2疗程后,超声治疗组中医疗效优于对照组(P <0.05)。两组治疗前基线VAS评分比较差别不大(P> 0.05)。第1及第2疗程治疗后两组VAS评分与治疗前比较均降低(均P <0.05),且治疗组VAS评分均优于对照组同期(均P <0.05)。纳入多因素进行二项分类Logistic回归分析校正混杂因素后,分析发现在第1疗程时药物加超声药物的治疗方法有效(P <0.05),第2疗程后并未见到这种效果(P> 0.05)。治疗过程中,超声治疗组有6例患者出现治疗局部皮肤轻微发红,无皮损、疱疹、瘙痒等,7例口服药物(其中超声治疗组4例,药物对照组3例)出现轻度胃肠道副作用,均在3 d内消失,未予以特殊处理,未终止治疗。结论超声药物导入疗法安全、有效性高,可推荐为坐骨神经痛患者急性发作的治疗选择。

Objective: To investigate the clinical effect of ultrasound drug introduction therapy on sciatica and the best treatment course and timing of intervention. Methods: 145 patients were randomly divided into the control group and ultrasound treatment group. The control group was given general treatment and oral medication. Ultrasound treatment group was treated with ultrasound drug introduction on that basis. At the end of the first and second courses of treatment,the clinical efficacy of sciatica was observed. Results: After the first and second courses of treatment,the curative effect of TCM in the ultrasound treatment group was better than that in the control group(P < 0.05). There was no significant difference in baseline VAS scores between the two groups before treatment(P > 0.05). After the first and second courses of treatment,the VAS scores of the two groups were lower than those before treatment(all P < 0.05),and those of the treatment group were better than those of the control group at the same time(all P < 0.05). After adjusting for confounding factors by binomial logistic regression analysis,it was found that the treatment of drugs plus ultrasound drugs was effective in the first course of treatment(P < 0.05),but not after the second course of treatment(P > 0.05). In the course of treatment,6 patients in the ultrasound treatment group had mild redness of local skin,no skin lesions,herpes,pruritus,etc. 7 patients in the oral medicine group(4 in the ultrasound treatment group and 3 in the drug control group) had mild gastrointestinal side effects,which disappeared within 3 days without special treatment and no termination of treatment. Conclusion: Ultrasound drug delivery therapy is safe and effective,and can be recommended for the treatment of acute episodes of sciatica.