射频消融术联合小针刀治疗椎间盘突出的临床效果分析

Clinical effects of radiofrequency ablation combined with small needle knife in the treatment of intervertebral disc herniation

目的探讨射频消融术(RFA)联合小针刀治疗腰椎间盘突出症(LDH)的临床效果。方法将2016年8月至2019年2月于该院诊治的320例LDH患者纳入研究,随机分为联合组与对照组,各160例。对照组给予小针刀治疗,联合组给予RFA联合小针刀治疗,记录两组的治疗效果与疼痛情况。结果治疗后4周联合组的疗效优良率为98.13%,高于对照组的87.50%(P<0.05)。联合组治疗后1、2、4周的疼痛评分都低于对照组(P<0.05)。治疗后4周,两组的腰屈曲范围(LFR)都高于治疗前(P<0.05),联合组的LFR高于对照组(P<0.05)。治疗后4周,两组的血清转化生长因子-β1(TGF-β1)、前列腺素E2(PGE2)水平都低于治疗前(P<0.05),联合组这两项指标的水平低于对照组(P<0.05)。结论RFA联合小针刀治疗LDH能抑制TGF-β1、PGE2的释放,改善腰椎功能,有助于镇痛,提高治疗效果。

Objective To investigate the clinical effects of radiofrequency ablation(RFA)combined with small needle knife in the treatment of intervertebral disc herniation.Methods From August 2016 to February 2019,320 patients with disc herniation treated in the hospital were enrolled in the study and were equally and randomly divided into combination group and control group.The control group were treated with small needle knife,and the combination group were treated with RFA combined with small needle knife.The therapeutic effect and pain symptoms of the two groups were recorded.Results The excellent and good rate of the combination group was 98.13%after treatments for 4 weeks,which was significantly higher than that in the control group(87.50%,P<0.05).The pain scores after treatments for 1,2,and 4 weeks in the combination group were significantly lower than those in the control group(P<0.05).The lumbar flexion range(LFR)in the two groups after treatments for 4 weeks were significantly higher than those before treatment(P<0.05),and the combination group were significantly higher than the control group(P<0.05).The levels of serum transforming growth factor-β1(TGF-β1)and prostaglandin E2(PGE2)in the two groups after treatments for 4 weeks were significantly lower than those before treatment(P<0.05),and the combination group were significantly lower than the control group(P<0.05).Conclusion RFA combined with small needle knife can inhibit the release of TGF-β1 and PGE2,improve lumbar function,improve analgesic and therapeutic effect.