中药热敷联合射频消融术治疗腰椎间盘突出症临床研究

Clinical Study on Hot Medicinal Compress Combined with Radiofrequency Ablation for Lumbar Disc Herniation

目的:观察中药热敷联合射频消融术治疗腰椎间盘突出症的疗效及对患者腰背伸肌群功能与肌肉抗疲劳能力的影响。方法:选择94例腰椎间盘突出症患者作为研究对象,按随机数字表法分为观察组和对照组各47例。对照组给予射频消融术治疗,观察组在对照组基础上辅以中药热敷治疗。评价2组临床疗效,比较2组视觉模拟评分(VAS)、日本骨科学会腰痛评价量表(JOA)评分、Oswestry功能障碍指数(ODI)、腰背伸肌群生物学指标与血清炎性因子含量,通过腰背肌疲劳测试及腹肌耐力测试评价肌肉抗疲劳功能。结果:观察组总有效率为91.49%,高于对照组74.47%(P<0.05)。治疗后,2组VAS、ODI评分较治疗前降低,JOA评分较治疗前升高(P<0.05),且观察组VAS、ODI评分低于对照组,JOA评分高于对照组(P<0.05)。治疗后,2组腰背伸状态下峰力矩(PT)、平均功率(AP)较治疗前升高,腰背屈伸比(F/E)较治疗前降低(P<0.05);且观察组PT、AP高于对照组,F/E低于对照组(P<0.05)。治疗后,2组腰背肌疲劳测试时间、腹肌耐力测试时间较治疗前升高(P<0.05),且观察组腰背肌疲劳测试时间、腹肌耐力测试时间均长于对照组(P<0.05)。治疗后,2组血清肿瘤坏死因子-α (TNF-α)、白细胞介素-6 (IL-6)水平较治疗前降低(P<0.05),且观察组血清TNF-α、IL-6水平低于对照组(P<0.05)。结论:中药热敷联合射频消融治疗可以缓解腰椎间盘突出症疼痛,修复受损的腰椎功能,改善腰背伸肌群功能,提高肌肉抗疲劳能力。

Objective:To observe the curative effect of hot medicinal compress combined with radiofrequency ablation for lumbar disc herniation and its effect on the function of the back extensor muscle group and the anti-fatigue ability of the muscle.Methods:A total of 94 cases of patients with lumbar disc herniation were selected as the study objects and divided into the observation group and the control group according to the random number table method,with 47 cases in each group.The control group was treated with radiofrequency ablation,and the observation group was additionally treated with hot medicinal compress based on the treatment of the control group.The clinical effects were evaluated in the two groups.The scores of Visual Analogue Score(VAS),Japanese Orthopaedic Association(JOA) and Oswestry Dysfunction Index(ODI),biological indexes of the back extensor muscle group and the content of serum inflammatory mediators were compared between the two groups.The anti-fatigue function of muscle was evaluated by the fatigue test of trunk extensors and the endurance test of abdominal muscle.Results:The total effective rate was 91.49% in the observation group,higher than that of 74.47% in the control group(P<0.05).After treatment,the scores of VAS and ODI in the two groups were decreased when compared with those before treatment,and the JOA scores were increased(P<0.05);the scores of VAS and ODI in the observation group were lower than those in the control group,and JOA score was higher(P<0.05).After treatment,peak torque(PT) and average power(AP) at the extension of the trunk extensors in the two groups were increased when compared with those before treatment,and the ratios of flexion and extension(F/E) of the trunk extensors were decreased(P<0.05);PT and AP in the observation group were higher than those in the control group,and the F/E was lower(P<0.05).After treatment,the time of fatigue test of trunk extensors and the endurance test of abdominal muscle was increased when compared with those before treatment(P<0.05),and the time of fatigue test of trunk extensors and the endurance test of abdominal muscle in the observation group was longer than that in the control group(P<0.05).After treatment,levels of tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) in serum in the two groups were decreased when compared with those before treatment(P<0.05),and the two levels in the observation group were lower than those in the control group(P<0.05).Conclusion:Hot medicinal compress combined with radiofrequency ablation can relieve the pain of lumbar disc herniation,repair the damaged lumbar function,and improve the function of the back extensor muscle group and anti-fatigue ability of the muscle.