高能量激光对椎间盘源性下腰痛患者的疗效评价

Efficacy evaluation of high-energy laser in patients with discogenic low back pain

目的:了解高能量激光(HEL)对椎间盘源性下腰痛(DLBP)患者的疗效。方法:回顾性分析因DLBP就诊的100例患者,评价治疗前后数字模拟疼痛(NPRS)评分和Oswestry残疾指数(ODI)评分。进行HEL治疗为治疗组,未进行HEL治疗为对照组。自变量为性别、年龄及其他常规治疗方法(中频电、超短波、红外线、腰部推拿、核心肌群稳定性训练、牵引),因变量为治疗前后NPRS与ODI评分之差,应用单因素及多元线性回归模型(最优子集法)进行分析。结果:100例患者中,有56例(56.00%)患者接受了HEL治疗。HEL治疗组推拿比例要高于非HEL治疗组。对于NPRS评分差值,红外线、核心肌群稳定性训练、牵引是HEL治疗的混杂影响变量(P<0.05)。对于ODI评分差值,未发现HEL治疗的混杂影响变量(P>0.05)。HEL治疗可降低NPRS评分差值0.353分,超短波治疗会增加NPRS评分差值0.374分,核心肌群稳定性训练会增加NPRS评分差值0.757分,牵引治疗会增加NPRS评分差值1.403分。调整超短波、核心肌群稳定性训练及牵引治疗后,HEL治疗可降低NPRS评分差值0.379分。HEL治疗可降低ODI评分差值-0.043分。结论:HEL治疗可缓解DBLP患者疼痛,改善腰椎功能,具有临床推广价值。

Objective:To investigate the effect of high energy laser(HEL)in patients with discogenic low back pain(DLBP).Methods:100 patients with DLBP were retrospectively analyzed,and the Numerical pain rating scale(NPRS)score and Oswestry disability index(ODI)score were evaluated before and after treatment.Patients treated with HEL were put in Treatment Group while those without HEL were put in Control Group.The independent variables are gender,age and other conventional treatment methods(intermediate frequency electric,ultrashort wave,infrared,massage,core muscle group[CMG]stability training,traction),and the dependent variables are the differences of NPRS and ODI scores before and after treatment.Univariate and multivariate linear regression model were used for analysis.Results:Among 100 patients,56(56.00%)received HEL therapy.The ratio of massage in the HEL therapy group was higher than that in the non-HEL therapy group(P=0.018).For difference of NPRS scores,infrared,CMG stabilization training,and traction were confounding effects for HEL therapy(P<0.05).For difference of ODI scores,no confounding variables of HEL therapy were found(P>0.05).HEL therapy could reduce the difference of NPRS scores by 0.353 points,ultrashort wave therapy could increase the difference of NPRS scores by 0.374 points,and CMG stability training could increase the difference of NPRS scores by 0.757 points,and traction therapy could increase the difference of NPRS scores by 1.403 points.After adjusting ultrashort wave therapy,CMG stability training and traction therapy,HEL therapy could reduce the difference of NPRS scores by 0.379 points.HEL therapy could reduce the difference of ODI scores by-0.043 points.Conclusion:HEL therapy could relieve pain and improve lumbar spine function in patients with DBLP,which has clinical value.