腕踝针联合夹脊穴糖皮质激素注射治疗PLIF术后腰背残余痛的效果

Effect of Wrist and Ankle Needle Combined with Glucocorticoid Injection at Jiaji Point on Residual Pain of Low Back after PLIF

目的:评价腕踝针联合夹脊穴糖皮质激素注射治疗后路腰椎椎间融合术(PLIF)术后腰背残余痛的效果。方法:回顾性收集福州市第二医院2020年12月-2022年6月接受PLIF的50例患者,根据治疗措施分为试验组和对照组,每组25例。对照组术后予洛索洛芬钠片口服,试验组采用腕踝针联合夹脊穴糖皮质激素注射治疗。评价两组治疗前及治疗3、10 d后腰背疼痛[视觉模拟评分法(VAS)]、日本骨科协会评估治疗分数(JOA);治疗10 d后比较两组JOA改善率。比较治疗前、治疗10 d后β-内啡肽(β-EP)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)指标。结果:两组性别、年龄、术中出血量、手术时间、手术节段比较,差异均无统计学意义(P>0.05)。治疗前,两组VAS、JOA评分、β-EP、IL-6、IL-10指标比较,差异均无统计学意义(P>0.05)。治疗3、10 d后,试验组VAS评分均低于对照组,JOA评分均高于对照组,差异均有统计学意义(P<0.05),且治疗10 d后试验组JOA改善率明显高于对照组(P<0.05)。治疗10 d后,两组β-EP、IL-6、IL-10指标均有不同程度的好转,且试验组的β-EP、IL-6、IL-10指标差异值与对照组比较,差异均有统计学意义(P<0.05)。结论:腕踝针联合夹脊穴糖皮质激素注射治疗PLIF术后腰背残余痛效果确切,短期内疗效明显优于单独使用洛索洛芬钠治疗。

Objective:To evaluate the efficacy of wrist and ankle needle combined with glucocorticoid injection at Jiaji point in the treatment of residual low back pain after posterior lumbar interbody fusion(PLIF).Method:A total of 50 patients who underwent PLIF surgery in Fuzhou Second Hospital from December 2020 to June 2022 were retrospectively collected and divided into the experimental group and the control group according to treatment measures,with 25 cases in each group.The control group was treated with Loxoprofen Sodium Tablets,while the experimental group was treated with wrist and ankle needle combined with glucocorticoid injection at Jiaji point.The lumbago and back pain[visual analogue scale(VAS)],Japanese orthopaedic association(JOA)scores before treatment,3 and 10 days after treatment in the two groups were evaluated,and 10 days after treatment,the improvement rate of JOA was compared between the two groups.The indexes ofβ-endorphin(β-EP),interleukin-6(IL-6)and interleukin-10(IL-10)were compared before treatment and 10 days after treatment.Result:There were no significant differences in gender,age,intraoperative bleeding volume,operation time,and surgical segment between the two groups(P>0.05).Before treatment,there were no statistically significant differences in VAS,JOA scores,β-EP,IL-6 and IL-10 indexes between the two groups(P>0.05).After 3 and 10 d of treatment,the VAS scores of the experimental group were lower than those of the control group,the JOA scores of the experimental group were higher than those of the control group,and the differences were statistically significant(P<0.05),and the improvement rate of JOA in the experimental group was significantly higher than that in the control group after 10 d of treatment(P<0.05).After 10 d of treatment,theβ-EP,IL-6,and IL-10 indexes in both groups showed different degrees of improvement,and the difference values ofβ-EP,IL-6,and IL-10 indexes in the experimental group were statistically significant compared with those in the control group(P<0.05).Conclusion:Wrist and ankle needle combined with Jiaji point glucocorticoid injection is effective in the treatment of residual low back pain after PLIF,and the short-term effect is significantly better than that of Loxoprofen Sodium alone.