中药外敷、口服非甾体类消炎药治疗与局部封闭注射治疗腰椎小关节骨关节炎的临床疗效对比分析

Comparative analysis of the clinical effect of external application of TCM medicine,oral nonsteroidal anti-inflammatory drugs and local block injection on lumbar facet joint osteoarthritis

目的:观察中药外敷、口服非甾体类消炎药(NSAIDs)治疗与局部封闭注射治疗腰椎小关节骨关节炎(Lumbar Facet Joint Osteoarthritis,LFJOA)的临床疗效。方法:选取2018年5月-2020年2月在我院诊治的120例LFJOA患者,将其随机分为中药组(40例)、西药组(40例)、注射组(40例),分别予以中药外敷、口服NSAIDs、局部封闭注射治疗,对比三组Oswestry功能障碍指数(ODI)、血清炎性因子水平。结果:治疗后三组患者ODI指数较治疗前均降低,且西药组及注射组均显著低于中药组(P<0.05);治疗后三组患者血清C反应蛋白(C-reactive Protein,CRP)、白细胞介素-6(Interleukin-6,IL-6)、肿瘤坏死因子-α(Tumor Necrosis Factor-α,TNF-α)水平较治疗前均降低,且西药组及注射组均显著低于中药组(P<0.05),注射组显著低于西药组(P<0.05)。结论:口服NSAIDs与局部封闭注射治疗LFJOA效果显著,能有效改善患者腰部功能障碍,且局部封闭注射治疗能更好降低血清炎症指标。中药外敷对LFJOA亦有治疗效果,但疗效较另两组差,较适用于辅助治疗。

Objective:To observe the clinical effect of external application of TCM medicine,oral non steroidal anti-inflammatory drugs(NSAIDs)and local block injection on LFJOA.Methods:120 cases were randomly divided into the TCM medicine group(40 cases),western medicine group(40 cases)and injection group(40 cases).They were treated with external application of TCM medicine,oral NSAIDs and local block injection respectively.The Oswestry dysfunctional index(ODI)and serum inflammatory factor levels were compared among the three groups.Results:After treatment,the ODI index in the three groups was lower than before treatment,and the western medicine group and the injection group were significantly lower than that in the TCM medicine group(P<0.05),the levels of serum CRP,IL-6,TNF-αin the three groups were lower than that before treatment,and those in the western medicine group and the injection group were significantly lower than that in the TCM medicine group(P<0.05),and the injection group was significantly lower than that in the western medicine group(P<0.05)Drug group(P<0.05).Conclusion:NSAIDs and local block injection are effective on LFJOA,which can effectively improve the waist dysfunction,and local block injection can better reduce the serum inflammatory index.External application of TCM medicine also shows therapeutic effect on LFJOA,but the curative effect is worse than the other two groups,so it is suitable for auxiliary treatment.