中频电刺激联合牵引治疗坐骨神经痛效果观察

Effect of medium⁃frequency electrical stimulation combined with traction in treatment of sciatica

目的 探讨中频电刺激对腰椎间盘突出(LDH)致坐骨神经痛患者疼痛程度、腰部肌群功能及步行能力的影响。方法 选取2021年2月—2022年11月本院收治的156例LDH致坐骨神经痛患者,按照抽签法分2组,每组各78例。对照组患者采用牵引治疗,观察组患者于牵引治疗基础上加用中频电刺激治疗,2组均维持治疗30 d。对比治疗前后2组患者的简化麦吉尔疼痛问卷(MPQ)、腰背伸肌群生物力学性能、日本骨科协会评分(JOA)、Oswestry功能障碍指数(ODI)、步行功能、健康调查简表(SF-36量表)评分的变化情况。结果 治疗30 d后,观察组视觉模拟量表(VAS)评分为(2.15±0.98)分、疼痛分级指数(PPI)为(1.05±0.73)分、现有疼痛强度(PRI)为(0.79±0.28)分、腰背屈伸比为(71.77±8.03)%、Oswestry功能障碍指数(ODI)为(9.24±1.11)分,均低于对照组的(3.79±1.21)分、(2.21±0.94)分、(1.26±0.31)分、(80.66±8.15)%、(14.38±1.56)分,差异均有统计学意义(t分别为9.302、8.608、9.937、6.862、23.710,P均<0.001);观察组腰背伸状态下峰力矩为(88.02±9.71)Nm、平均功率为(43.25±5.55)W、积分肌电为(128.14±17.84)μV、平均功率频率为(49.19±6.21)Hz、日本骨科协会评分(JOA)为(24.76±3.08)分、Holden步行功能为(4.30±0.58)级、总体健康为(81.28±5.81)分、情感职能为(78.57±4.88)分、生命活力为(79.77±4.28)分、生理职能为(80.25±3.79)分、躯体疼痛为(69.72±7.09)分、社会功能为(82.53±3.86)分、生理功能为(81.07±6.81)分、心理健康为(85.61±8.14)分,均高于对照组的(75.43±8.72)Nm、(32.66±4.16)W、(114.16±15.36)μV、(42.05±5.33)Hz、(19.49±2.72)分、(3.39±0.5)级、(72.33±5.08)分、(69.88±4.01)分、(70.26±4.01)分、(72.47±3.15)分、(62.17±6.48)分、(76.18±3.28)分、(72.39±6.07)分、(76.17±8.03)分,差异均有统计学意义(t分别为8.520、13.485、5.245、7.705、11.327、10.317、10.242、12.151、14.321、13.943、6.942、11.072、8.403、7.292,P均<0.001)。结论 相对于牵引治疗,中频电刺激治疗更能够缓解患者LDH致坐骨神经痛患者的疼痛程度,促进患者腰部肌群功能的提升,进一步提高患者的生活质量。

Objective To investigate the effects of medium⁃frequency electrical stimulation on pain degree,lumbar muscle function and walking ability in patients with sciatica caused by lumbar disc herniation(LDH).Methods A total of 156 patients with LDH⁃induced sciatica admitted to our hospital from February 2021 to November 2022 were enrolled and divided into two groups,with 78 cases in each group.The patients in the control group were treated with traction,and the patients in the observation group were treated with medium⁃frequency electrical stimulation on the basis of traction therapy,and both groups were maintained for 30 days.The changes in the Simplified McGill Pain Questionnaire(MPQ),biomechani⁃cal properties of the lumbar and dorsal extensor muscles,Japanese Orthopaedic Association score(JOA),Oswestry Dysfunc⁃tion Index(ODI),walking function,and Health Questionnaire Short Form(SF-36)scores were compared between the two groups before and after treatment.Results After 30 days of treatment,the visual analogue scale(VAS)score(2.15±0.98),the pain grading index(PPI)(1.05±0.73),the existing pain intensity(PRI)(0.79±0.28),the lumbar dorsiflexion and extension ratio(71.77±8.03)%,and the Oswestry dysfunction index(ODI)(9.24±1.11)in the observation group,were lower than those of the control group:(3.79±1.21)(2.21±0.94)(1.26±0.31)(80.66±8.15)%,and(14.38±1.56),and the differences were statisti⁃cally significant(t=9.302,8.608,9.937,6.862,23.710,all P<0.001).In the observation group,the peak moment(88.02±9.71)Nm,the average power(43.25±5.55)W,the integral EMG(128.14±17.84)μV,the average power frequency(49.19±6.21)Hz,the JOA score(24.76±3.08),the Holden walking function(4.30±0.58),and the overall health(81.28±5.81), the emotional function (78.57±4.88), life vitality (79.77±4.28), physiological functions (80.25±3.79), physical pain(69.72±7.09), social function (82.53±3.86), physiological function (81.07±6.81) and mental health (85.61±8.14) were higherthan those of the control group: (75.43±8.72) Nm and (32.66±4.16) W, (114.16±15.36) μV, (42.05±5.33) Hz, (19.49±2.72),(3.39±0.5) class, (72.33±5.08) points, (69.88± 4.01) points, (70.26±4.01) points, (72.47±3.15 points), (62.17±6.48) points,(76.18±3.28) points, (72.39±6.07) points, (76.17±8.03), and the differences were statistically significant (t=8.520, 13.485,5.245, 7.705, 11.327, 10.317, 10.242, 12.151, 14.321, 13.943, 6.942, 11.072, 8.403, 7.292, all P<0.001). ConclusionCompared with traction therapy, medium⁃frequency electrical stimulation can better relieve the pain degree of patients withLDH⁃induced sciatica, promote the improvement of lumbar muscle function, and further improve the quality of life ofpatients.