腰神经后支脉冲射频联合康复训练治疗非特异性下腰痛的疗效

Pulse radiation frequency on posterior branch of lumbar nerve combined with rehabilitation training for the treatment of patients with nonspecific low back pain

目的评价腰神经后支脉冲射频联合康复训练治疗非特异性下腰痛的疗效。方法收集2019年1月至2019年12月就诊于清华大学附属北京清华长庚医院疼痛科门诊的非特异性下腰痛患者80例,性别不限,年龄≥18岁,按随机数字表法分为射频康复组和康复训练组,每组40例。康复训练组患者在基础治疗的基础上采用康复训练治疗,射频康复组患者在康复训练组治疗的基础上于康复训练前行1次腰神经后支脉冲射频治疗;两组患者疗程均为4周。比较两组患者治疗前与治疗结束时(治疗4周)的视觉模拟评分(VAS)、Oswestry腰痛功能障碍指数(ODI)及日本骨科协会(JOA)评分,以及治疗结束后6、12周时VAS评分变化情况。结果治疗前,两组患者一般资料和VAS、ODI及JOA评分差异均无统计学意义(P均>0.05)。治疗结束时,射频康复组患者VAS、ODI及JOA评分分别为(2.9±0.6)、(16.85±4.75)、(19.63±4.24)分,康复训练组分别为(4.3±0.7)、(19.06±3.89)、(17.13±5.02)分;射频康复组VAS、ODI明显低于康复训练组,JOA明显高于康复训练组(P均<0.05)。随访结果显示,射频康复组在治疗结束后6、12周时其VAS评分明显低于康复训练组,差异均具有统计学意义(P均<0.05)。结论腰神经后支脉冲射频联合康复训练治疗非特异性下腰痛能明显改善患者的临床症状和功能障碍。

Objective To evaluate the effect of pulse radiation on frequency posterior branch of lumbar nerve combined with rehabilitation training for the treatment of patients with nonspecific low back pain.Methods Eighty patients with nonspecific low back pain in Pain Clinic of Tsinghua University Affiliated Beijing Tsinghua Changgeng Hospital from January to December 2019,both sexes,aged≥18 years old,were enrolled in this study,and the patients were divided into radiofrequency rehabilitation group and rehabilitation training group randomly,40 cases in each group.Patients were treated by rehabilitation training based on basic treatment in the rehabilitation training group,and patients were treated with posterior branch pulse radiation frequency based on the rehabilitation group in the radiofrequency rehabilitation group.All patients of both groups received 4 weeks treatment.Visual analogue scale(VAS),Oswestry low back pain disability index(ODI)and Japanese Orthopaedic Association(JOA)scores were recorded before the treatment and at the end of the treatment in the two groups.VAS was also recorded at 6 and 12 weeks after the end of the treatment.Results Before the treatment,there was no significant difference in general information,VAS,ODI and JOA scores between the two groups(all P>0.05).At the end of the treatment,VAS,ODI and JOA were(2.9±0.6),(16.85±4.75),(19.63±4.24)in the radio frequency rehabilitation group respectively,and(4.3±0.7),(19.06±3.89),(17.13±5.02)in the rehabilitation training group respectively.These indexes in the radio frequency rehabilitation group were all superior to the rehabilitation training group(all P<0.05).VAS was reduced obviously in radiofrequency rehabilitation group than that in rehabilitation training group at 6 weeks and 12 weeks after the end of the treatment with statistic significance(all P<0.05).Conclusion Pulse radiation frequency on posterior branch of lumbar nerve combined with rehabilitation training for the treatment of nonspecific low back pain patients could obviously improve the clinical symptoms and dysfunction.