银质针综合疗法联合DSA介导椎间孔注射治疗血瘀型腰椎间盘突出症的临床研究

Clinical Study of Silver Needle Combined with DSA Mediated Intervertebral Foramen Injection for the Treatment of Blood Stasis Type Lumbar Disc Herniation

目的:分析银质针综合疗法联合数字减影血管造影(DSA)介导椎间孔注射在血瘀型腰椎间盘突出症(LDH)患者中的效果。方法:选取2021年9月—2023年10月九江市第一人民医院收治的60例血瘀型LDH患者,随机分为两组,各30例。对照组行DSA介导椎间孔注射,观察组加以银质针综合疗法。对比两组临床疗效、中医证候评分、疼痛程度、腰椎功能。结果:观察组治疗总有效率高于对照组,有统计学差异(P<0.05);治疗前,两组腰腿痛如刺、痛有定处、日轻夜重、腰部板硬评分与视觉模拟疼痛评分法(VAS)、日本骨科协会评估治疗(JOA)与Oswestry功能障碍指数(ODI)评分相比,无统计学差异(P>0.05);治疗后,观察组腰腿痛如刺、痛有定处、日轻夜重、腰部板硬评分与VAS、ODI评分低于对照组,JOA评分高于对照组,有统计学差异(P<0.05);两组不良反应相当,无统计学差异(P>0.05)。结论:银质针综合疗法联合DSA介导椎间孔注射可减轻血瘀型LDH患者症状,缓解疼痛,促进腰椎功能恢复,临床可推广应用。

Objective:To analyze the effect of silver needle combined with digital subtraction angiography(DSA)mediated intervertebral foramen injection in patients with blood stasis type lumbar disc herniation(LDH).Methods:Sixty patients with blood stasis type LDH admitted to the First People’s Hospital of Jiujiang City from September 2021 to October 2023 were randomly divided into two groups,with 30 cases in each group.The control group received DSA mediated intervertebral foramen injection,while the observation group received comprehensive silver needle therapy.Compare the clinical efficacy,traditional Chinese medicine syndrome score,pain level,and lumbar spine function between two groups.Results:The total effective rate of the observation group was higher than that of the control group,with a statistical difference(P<0.05);Before treatment,there was no statistically significant difference(P>0.05)between the two groups in terms of lower back and leg pain scores such as pricking,localized pain,day and night severity,lower back stiffness,visual analogue pain scale(VAS),Japanese Orthopedic Association Assessment of Treatment(JOA),and Oswestry Dysfunction Index(ODI)scores;After treatment,the observation group had lower back and leg pain such as stings,localized pain,mild day and heavy night,lower lumbar stiffness scores,VAS and ODI scores than the control group,and higher JOA scores than the control group,with statistical differences(P<0.05);The adverse reactions in the two groups were comparable and there was no statistically significant difference(P>0.05).Conclusion:The combination of silver needle comprehensive therapy and DSA mediated intervertebral foramen injection can alleviate symptoms,alleviate pain,and promote lumbar functional recovery in patients with blood stasis type LDH.It can be widely promoted and applied in clinical practice.