椎间盘内注射富血小板血浆与射频热凝治疗盘源性腰痛的疗效比较

Comparison of the efficacy of platelet-rich plasma intradiscal injection and radiofrequency thermocoagulation in the treatment of discogenic low back pain

目的:比较椎间盘内注射富血小板血浆与射频热凝术治疗盘源性腰痛的疗效。方法:采用随机对照试验设计,67例盘源性腰痛病人采用随机数字表法分为治疗组(PRP组)37例和对照组(RFT组)30例,其中PRP组接受椎间盘内注射富血小板血浆,RFT组接受射频热凝术治疗。两组于治疗前、治疗后1周、3周及1年进行疼痛视觉模拟评分法(visual analogue scale,VAS)评分、脊柱功能评定指数(functional rating index,FRI)评分及简明健康调查问卷(short-form 36 item health survey,SF-36)评分。比较两组在上述指标、治疗有效率及安全性方面的差异。结果:两组病人的FRI评分在各时间点比较差异均无统计学意义;治疗后1年,PRP组VAS评分及SF-36评分较RFT组有显著降低(P<0.05),且PRP组有效率明显高于RFT组(P<0.05)。结论:椎间盘内注射富血小板血浆较射频热凝术对治疗盘源性腰痛具有更显著的疗效。

Objective:To evaluate the effects of intradiscal injection of platelet-rich plasma(PRP)and radiofrequency thermocoagulation(RFT)in the treatment of discogenic low back pain.Methods:Using a randomized controlled trial design,67 patients with discogenic low back pain were randomly divided into a treatment group(PRP group)with 37 cases and a control group with 30 cases(RFT group),in which PRP group treated with PRP intradiscal injection,and RFT group treated with radiofrequency thermocoagulation.The two groups were evaluated for visual analogue scale(VAS),function rating index(FRI),and short-form 36 item health survey(SF-36)at baseline,1 week,3 weeks,and 1 year after treatment.The differences between the two groups in the above indicators,treatment efficiency,and safety were compared.Results:There was no significant difference in FRI scores between the two groups at each time point.One year after treatment,the VAS score and SF-36 score in the PRP group were significantly lower than those in the RFT group(P<0.05).The curative rate of PRP group was significantly higher than that of RFT group(P<0.05).Conclusion:Intradiscal injection of platelet-rich plasma is more effective than radiofrequency thermocoagulation on discogenic low back pain.