超声引导下针刀松解黄韧带治疗腰椎间盘突出症的临床效果

Clinical effect of ultrasound-guided acupotomy to dissolve ligamentum flavum in treatment of lumbar disc herniation

目的观察超声引导下针刀松解黄韧带治疗腰椎间盘突出症的临床效果。方法选取2019年3月至2020年12月安徽省中西医结合医院针刀康复科诊治的腰椎间盘突出症患者60例,将其按照随机数字表法分为对照组与治疗组,每组各30例。对照组采用超声引导下常规针刀治疗,治疗组在对照组的基础上加以突出节段患侧黄韧带的松解,每7天治疗1次,连续4次。比较两组治疗前后改良日本骨科协会腰痛评分表(M-JOA)评分、视觉模拟评分法(VAS)评分及临床综合疗效。结果治疗前两组M-JOA、VAS评分比较,差异无统计学意义(P>0.05);治疗后两组M-JOA、VAS评分均较治疗前显著降低,且治疗组低于对照组,差异有统计学意义(P<0.05或P<0.01)。治疗组临床疗效优于对照组,差异有统计学意义(P<0.05)。结论两组治疗腰椎间盘突出症均有效果,但采用超声引导下针刀松解黄韧带治疗效果更显著。

Objective To observe the clinical effect of ultrasound-guided acupotomy to dissolve ligamentum flavum in treatment of lumbar disc herniation.Methods A total of 60 patients with lumbar disc herniation diagnosed and treated in Department of Acupotomy Rehabilitation,Anhui Hospital of Integrated Traditional Chinese and Western Medicine from March 2019 to December 2020 were selected and they were divided into control group and treatment group according to random number table method,with 30 patients in each group.The control group was treated with conventional ultrasound-guided acupotomy.The treatment group was additionally treated with the dissolution of ligamentum flavum of the affected side of the prominent segment on the basis of the control group,once every seven days for four consecutive times.Modified Japanese orthopaedic association scale(M-JOA)score,visual analogue scale(VAS)score and clinical efficacy were compared between the two groups before and after treatment.Results Before treatment,there was no significant difference in M-JOA and VAS scores between the two groups(P>0.05).After treatment,M-JOA and VAS scores in the two groups were significantly lower than those before treatment,and the treatment group was lower than the control group,the differences were statistically significant(P<0.05 or P<0.01).The clinical efficacy of the treatment group was better than that of the control group,and the difference was statistically significant(P<0.05).Conclusion The treatment of lumbar disc herniation is effective in both groups,but the treatment of ultrasound-guided acupotomy to dissolve ligamentum flavum is more effective.