椎旁神经阻滞联合整脊手法治疗对腰椎间盘突出症患者疼痛及腰椎功能的影响

Effects of paravertebral nerve block combined with chiropractic manipulation on pain and lumbar function in patients with lumbar disc herniation

目的椎旁神经阻滞联合整脊手法治疗对腰椎间盘突出症患者疼痛及腰椎功能的影响.方法选取2019年7月-2020年9月在本院确诊的206例腰椎间盘突出症患者,采用简单随机分组将患者分为对照组和观察组各103例。对照组患者采用整脊手法治疗,观察组采用椎旁神经阻滞(盐酸利多卡因+倍他米松)联合整脊手法治疗,均持续治疗一个月.记录其治疗后的临床疗效。分别于治疗前后,采用日本骨科协会(JOA)评分评价运动功能障碍;视觉模拟评分法(VAS)评价疼痛程度;腰痛评分量表(ODI)测评腰椎功能性。结果治疗后,观察组总有效率明显高于对照组(F<0.05);观察组VAS、0DI评分相对于对照组下降的更加显著(P<0.05),J0A评分相对于对照组升高的更加显著(P<0.05).结论椎旁神经阻滞联合整脊手法治疗对治疗腰椎间盘突出症患者疗效显著,能够降低患者治疗的痛苦,促进腰椎功能的恢复.

Objective To explore the effects of paravertebral nerve block combined with chiropractic manipulation on pain and lumbar function in patients with lumbar disc herniation.Methods A total of 206 patients confirmed with lumbar disc herniation in the hospital were enrolled between July 2019 and September 2020.According to simple random grouping method,they were divided into control group and observation group,103 cases in each group.The control group was treated with chiropractic manipulationj while observation group was additionally treated with paravertebral nerve block(lidocaine hydrochloride combined with betamethasone).Both groups were continuously treated for 1 month.The clinical curative effect after treatment was recorded.Before and after treatment,motor dysfunction was evaluated by Japanese Orthopaedic Association(JOA).The pain level was evaluated by visual analogue scale(VAS).The lumbar function was evaluated by Oswestry disability index(ODI).Results After treatment,total response rate o£observation group was significantly higher than that of control group(P<0.05).After treatment,VAS and ODI scores in observation group were significantly lower than those in control group(P<0.05),while JOA score was significantly higher than that in control group(P<0.05).The recurrence rate in observation group was significantly lower than that in control group(P<0.05).Conclusion The curative effect of paravertebral nerve block combined with chiropractic manipulation is significant on patients with lumbar disc herniation,which can relieve pain and promote the recovery of lumbar function.