射频热凝靶点消融减压术联合中药穴位注射治疗腰椎间盘突出临床研究

Radiofrequency thermocoagulation target ablation and decompression combined with acupoint injection in the treatment of lumbar disc herniation

目的:探讨射频热凝靶点消融减压术联合中药穴位注射治疗腰椎间盘突出的临床疗效及对白细胞介素-17(IL-17)、肿瘤坏死因子-α(TNF-α)及干扰素-γ(IFN-γ)水平的影响。方法:采用前瞻性随机对照试验法将136例腰椎间盘突出患者分为观察组与对照组,每组各68例。对照组采用射频热凝靶点消融减压术,观察组在对照组的基础上联合中药穴位注射治疗。观察两组患者的临床疗效,对比治疗前后疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、日本骨科协会下腰痛功能评价表评分(JOA)及TNF-α、IFN-γ和IL-17水平。结果:观察组的治疗有效率显著高于对照组;治疗后观察组VAS及ODI指数下降幅度高于对照组,差异均有统计学意义(P<0.05);治疗后观察组JOA各项评分优于对照组,差异均具有统计学意义(P<0.05);治疗后观察组血清TNF-α、IFN-γ和IL-17水平低于对照组,差异均有统计学意义(P<0.05)。结论:射频热凝靶点消融减压术联合中药穴位注射治疗腰椎间盘突出可显著提高临床疗效,改善症状,缓解疼痛,减轻全身炎症反应。

Objective:To investigate the clinical effect of radiofrequency thermocoagulation target ablation and decompression combined with acupoint injection of traditional Chinese medicine on lumbar disc herniation and its influence on the levels of IL-17,TNF-αand IFN-γ.Methods:136 patients were divided into observation group and control group with 68 cases in each group.The control group was treated with radiofrequency thermocoagulation target ablation and decompression,while the observation group was treated with acupoint injection of traditional Chinese medicine on the basis of the control group.The clinical efficacy of the two groups was observed,and the levels of pain visual analogue score(VAS),Oswestry dysfunction index(ODI),JOA,TNF-a,IFN-gamma and IL-17 were compared before and after treatment.Results:The effective rate of the observation group was significantly higher than that of the control group.After treatment,the VAS and ODI index of the observation group decreased more than that of the control group,with statistical significance(P<0.05);after treatment,the JOA scores of the observation group were better than those of the control group,with statistical significance(P<0.05);after treatment,the serum TN of the observation group was significantly higher than that of the control group(P<0.05).The levels of F-alpha,IFN-gamma and IL-17 in the control group were lower than those in the control group(P<0.05).Conclusion:Radiofrequency thermocoagulation target ablation and decompression combined with acupoint injection of traditional Chinese medicine in the treatment of lumbar disc herniation can significantly improve clinical efficacy,improve symptoms,alleviate pain and reduce systemic inflammatory response.