脊神经根脉冲射频治疗顽固性根性神经痛的疗效分析

Effect of spinal nerve root pulsed radio frequency in treating patients with refractory radicular neuralgia

目的总结脊神经根脉冲射频(pulsed radio frequency,PRF)治疗腰椎间盘突出症(lumbar disc herniation,LDH)顽固性根性神经痛的疗效。方法选取就诊的106例LDH顽固性根性神经痛患者,按随机数字表法分为2组,实验组和对照组,各53例。对照组采用常规药物治疗,实验组采用脊神经根PRF治疗。2组均连续治疗4周,比较2组患者疗效、疼痛程度和腰椎功能障碍程度、血清指标、不良反应。结果实验组治疗优良率高于对照组(P<0.05)。治疗后,实验组数字疼痛评分量表(numerical rating scale,NRS)评分低于对照组(P<0.05),日本矫形外科学会(Japanese OrthopaedicAssociation,JOA)疗效评分高于对照组(P<0.05)。实验组肿瘤坏死因子α(tumor necrosis factor,TNF-α)、白细胞介素1(interleukin-1,IL-1)、白细胞介素6(interleukin-6,IL-6)等炎症因子及一氧化氮(nitric oxide,NO)、前列腺素E2(prostaglandin E2,PGE2)水平低于对照组(P<0.05),超氧化物歧化酶(superoxide dismutase,SOD)水平高于对照组(P<0.05)。2组患者不良反应发生比较差异无统计学意义(P>0.05)。结论脊神经根PRF治疗LDH顽固性根性神经痛患者,能有效提高优良率,降低其疼痛程度和腰椎功能障碍,改善相关血清指标水平,安全性良好。

Objective To explore the effect of spinal nerve root pulsed radio frequency(PRF)in treating refractory radicular neuralgia caused by lumbar disc herniation(LDH).Methods A total of 106 patients with refractory radicular neuralgia caused by LDH were divided into the experimental group and the control group by random number table method with 53 patients in each group,receiving conventional drug treatments and spinal nerve root PRF,respectively.Both groups were treated for 4 weeks.Curative effect,pain degree,degree of lumbar dysfunction,serum indicators and adverse reactions were compared between groups.Results The rate of excellent and good treatment result in the experimental group was higher than that in the control group(P<0.05).After treatment,the Numerical Rating Scale(NRS)scores in the experimental group were lower than those in the control group(P<0.05),and Japanese Orthopaedic Association(JOA)scores were higher than those in the control group(P<0.05).The levels of inflammatory factors such as tumor necrosis factor(TNF-α),interleukin-1(IL-1)and interleukin-6(IL-6),nitric oxide(NO)and prostaglandin E2(PGE2)in the experimental group were lower than those in the control group(P<0.05),and the level of superoxide dismutase(SOD)was higher than that in the control group(P<0.05).The incidence of adverse reactions were similar betwen the two groups(P>0.05).Conclusion Applying spinal nerve root PRF to treat refractory radicular neuralgia caused by LDH can effectively improve the excellent and good rate of curative effect,reduce the degree of pain and lumbar dysfunction,and improve related serum indicators,with good safety.