核心稳定性训练对脊髓损伤后神经性疼痛的效果及血清炎症因子的影响

The effects of core stability training on neuropathic pain after spinal cord injury and serum inflammatory factors

目的分析核心稳定性训练联合普瑞巴林口服对创伤致脊髓损伤后神经性疼痛(SCIP)患者的应用效果,以及对血清炎症因子表达的影响,探讨相关治疗机制。方法选择2019年1月至2021年1月我院确诊的SCIP患者共88例,以下腰痛为主,随机数字法分为对照组和观察组各44例,对照组应用普瑞巴林75~300 mg/d口服,观察组联合应用核心稳定性训练,两组疗程均为8周。比较两组治疗前和治疗8周疼痛视觉模拟量表(VAS)评分和日常生活能力量表(ADL)评分,并评估临床疗效,检测治疗前和治疗8周血清炎症因子包括白介素(IL)-6、肿瘤坏死因子(TNF)-α和前列腺素的表达水平。结果治疗8周后,两组疼痛VAS评分均较治疗前明显降低,ADL评分增加,且两组间比较差异有统计学意义(P<0.05)。观察组临床总有效率高于对照组(P<0.05)。两组治疗8周血清IL-6、TNF-α和前列腺素水平均低于治疗前,且观察组明显低于对照组(P<0.05)。结论核心稳定性训练联合普瑞巴林对SCIP有较好的临床疗效,能够明显缓解疼痛,提高生活能力,可能与抑制机体多种炎症因子的表达有关。

Objective To analyze the application effects of core stability training combined with oral administration of pregabalin on patients with neuropathic pain after spinal cord injury(SCIP)induced by trauma and its influence on the expression of serum inflammatory factors in order to explore the related treatment mechanisms.Methods A total of 88 patients with SCIP from January2019 to January 2021 were selected.The patients mainly had low back pain.The patients were randomly divided into a control group and an observation group,44 in each group.The control group was given pregabalin 75~300 mg/d orally while the observation group was given pregabalin 75~300 mg/d orally combined with core stability training.The course of treatment for the two groups was 8 weeks.Visual analogue scale(VAS)scores and activity of daily living scale(ADL)scores were compared before and after 8 weeks of treatment between the two groups.The clinical efficacy was evaluated.The levels of serum inflammatory factors such as interleukin(IL)-6,tumor necrosis factorα(TNF)-αand prostaglandin(PG)were measured before and after 8 weeks of treatment.Results After 8 weeks of treatment,the VAS scores were lower while the ADL scores were higher than before treatment in both groups.There were statistically significant differences between two groups(P<0.05).The total clinical effective rate in the observation group was higher than that in the control group(P<0.05).The serum levels of IL-6,TNF-αand PG in the two groups after treatment were lower than before and the levels in the observation group were all significantly lower than those in the control group(P<0.05).Conclusion The core stability training combined with pregabalin has a good application effect on SCIP patients.It can greatly relieve the pain and improve the living ability.The mechanisms of treatment may be related to inhibition of inflammatory factors.