电针治疗腰椎间盘突出症椎间孔镜术后残留症状

Electroacupuncture for residual symptoms secondary to percutaneous endoscopic lumbar discectomy for lumbar disc herniation

[目的]探讨病变节段电针治疗腰椎间盘突出症椎间孔镜术后残留症状的临床疗效。[方法]将2015年1月~2018年12月经皮内镜下腰椎间盘摘除(PELD)治疗的单节段腰椎间盘突出症术后仍存在同侧腰部及下肢神经症状的69例患者纳入本研究,随机分为两组,其中35例采用电针治疗,34例采用常规非甾体抗炎止痛药物及神经营养药物治疗。比较两组疼痛视觉模拟评分(VAS评分)、Oswestry功能障碍指数(ODI)和BMRC下肢感觉分级。[结果]治疗2周和4周后两组患者的VAS评分均较治疗前显著降低(P<0.001)。治疗前两组患者VAS评分的差异无统计学意义(P>0.05);治疗后电针组VAS评分低于常规组,2周时差异无统计学意义(P>0.05),但4周时差异有统计学意义(P<0.05)。治疗2周和4周后两组患者的ODI评分均较治疗前显著降低,差异有统计学意义(P<0.05),治疗2周和4周后,电针组ODI显著低于常规组(P<0.05)。电针组治疗后4周感觉评级较治疗前显著改善(P<0.05),但是常规组感觉评级无显著变化(P>0.05)。治疗4周后,电针组感觉评级显著优于常规组(P<0.05)。[结论]病变节段电针治疗能够显著减轻PELD术后病变节段疼痛,有利于神经功能的恢复。

[Objective]To explore the clinical outcomes of electroacupuncture for residual symptoms secondary to percutaneous endoscopic lumbar discectomy(PELD)for lumbar disc herniation.[Methods]From January 2015 to December 2018,a total of 69 patients who suffered from residual pain and low limb sensation disturbance were enrolled in this study,and divided into two groups randomly.Of them,35 patients received electroacupuncture therapy,while the remaining 34 patients underwent conventional therapy involving nonsteroidal anti-inflammatory and analgesic drugs.The visual analogue scale(VAS)for pain,Ostwestry disability index and British Medical Research Council(BMRC)sensation grade were compared between the two groups.[Results]At 2 and 4 weeks after therapy the VAS score significantly decreased in both groups compared those before therapy(P<0.001).The electroacupuncture group proved superior to the conventional group in VAS score,which was not statistically significant at 2 weeks(P>0.05),and became statistically significant at 4 weeks after treatment(P<0.05).The ODI scores significantly decreased in both groups at 2 and 4 weeks after treatment compared with those before treatment(P<0.05).The electroacupuncture group was superior to the conventional group in ODI score at 2 and 4 weeks after therapy(P<0.05).In term of low extremity sensation,the BMRC grade for sensation significantly improved at 4 weeks after therapy in the electroacupuncture group(P<0.05),whereas remained unchanged in the conventional group(P>0.05).The electroacupuncture group proved significantly superior to the conventional group in BMRC grade at 4 weeks after treatment(P<0.05).[Conclusion]The electroacupuncture does considerably relieve residual pain,and facilitate to recover neurological function after PELD for lumbar disc herniation.