经皮椎间孔镜手术联合针刺运动疗法治疗腰椎间盘突出症疗效观察

Observation on the clinical effect of percutaneous transforaminal endoscopic discectomy combined with acupuncture-movement therapy on lumbar intervertebral disc herniation

目的观察经皮椎间孔镜手术联合针刺运动疗法治疗腰椎间盘突出症(LDH)的临床疗效。方法将72例LDH患者按照随机数字表法分为2组。对照组36例行经皮椎间孔镜手术治疗,治疗组36例在对照组治疗基础上联合针刺运动疗法治疗2周。2组均随访12周。比较2组手术前后疼痛视觉模拟评分(VAS)、日本骨科协会(JOA)腰痛评分、Oswestry功能障碍指数(ODI),并统计疗效。结果术后2、4、12周2组疼痛VAS均较本组术前降低(P <0. 05),JOA腰痛评分均升高(P <0. 05);术后2周治疗组疼痛VAS低于对照组(P <0. 05),JOA评分高于对照组(P <0. 05)。术后2、4、12周2组ODI各项评分均较本组术前降低(P <0. 05),术后2周治疗组ODI各项评分均低于对照组(P <0. 05)。治疗组优良率88. 9%(32/36),对照组优良率86. 1%(31/36),2组疗效比较差异无统计学意义(P> 0. 05)。结论经皮椎间孔镜手术联合针刺运动疗法治疗LDH短期内临床疗效优于单纯椎间孔镜手术治疗。

Objective To observe the clinical effect of percutaneous transforaminal endoscopic discectomy combined with acupuncture-movement therapy on lumbar intervertebral disc herniation.Methods Seventy two patients with lumbar intervertebral disc herniation were assigned according to the random number table into the control group(n=36)with percutaneous transforaminal endoscopic discectomy and the treatment group(n=36)with acupuncture-movement therapy for 2 weeks based on the treatment of the control group.The follow-up period for patients in the two groups was 12 weeks.The scores of Visual Analogue Scale(VAS),Japanese Orthopaedic Association Low Back Pain Score(JOA),and Oswestry Disability Index(ODI)were compared in the two groups before and after the treatment.And the curative effect in the two groups was evaluated.Results The scores of VAS and DOI in the two groups at the post-operation of week 2,4,and 12 were lower than those before the operation(P<0.05),while the scores of JOA were higher(P<0.05).The scores of VAS and DOI in the treatment group at the post-operation of week 2 were lower than those of the control group(P<0.05),while the score of JOA was higher than that of the control group(P<0.05).The rate of good outcomes for patients was 88.9%(32/36)in the treatment group while 86.1%(31/36)in the control group.And there was no statistical significance on the curative effect between the two groups(P>0.05).Conclusion The clinical effect of percutaneous transforaminal endoscopic discectomy combined with acupuncture-movement therapy is superior to the single percutaneous transforaminal endoscopic discectomy during the short-term treatment of patients with lumbar intervertebral disc herniation.