醋酸曲安奈德联合甲钴胺对腰椎间盘突出症患者JOA评分及日常生活活动能力的影响

Effects of Triainclnolone Acetonide Acetate Combined with Mecobalamin on JOA Score and Activity of Daily Living in Patients with Lumbar Disc Herniation

目的:探讨醋酸曲安奈德联合甲钴胺治疗腰椎间盘突出症(LDH)患者的临床效果。方法:选取86例赣南医学院第一附属医院龙南医院2021年1月—2023年10月收治的LDH患者,以随机数字表法分为两组,各43例。对照组口服甲钴胺治疗,观察组加用醋酸曲安奈德治疗,两组均持续治疗4周。比较两组临床效果、不良反应、日本骨科协会评估治疗分数(JOA)、视觉模拟评分法(VAS)评分、Barthel指数(BI)、炎症因子水平、生活质量。结果:观察组总有效率高于对照组(P<0.05);观察组治疗后JOA各维度及总分[(7.45±1.13)、(4.94±0.52)、(12.13±1.12)、(24.52±2.14)分]均高于对照组[(6.02±1.04)、(3.87±0.43)、(10.41±1.05)、(20.30±2.11)分],差异均有统计学意义(P<0.05);观察组治疗后VAS评分为(1.54±0.23)分,低于对照组的(1.89±0.26)分,BI评分为(88.31±5.24)分,高于对照组的(81.49±5.22)分,差异均有统计学意义(P<0.05);观察组治疗后炎症因子水平[(50.41±5.13)pg/mL、(5.63±1.12)mg/L、(5.35±1.02)pg/mL]均低于对照组[(55.47±5.36)pg/mL、(7.24±1.18)mg/L、(6.89±1.15)pg/mL],差异均有统计学意义(P<0.05);观察组治疗后生活质量评分[(87.53±5.49)、(89.58±5.14)、(90.31±4.25)、(92.25±4.29)分]均高于对照组[(79.84±5.55)、(82.35±5.29)、(81.64±4.32)、(83.75±5.05)分],差异均有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:醋酸曲安奈德联合甲钴胺可提高LDH治疗效果,加快腰椎功能恢复,减轻疼痛程度,安全可靠。

Objective:To investigate the clinical effect of Triainclnolone Acetonide Acetate combined with Mecobalamin in the treatment of patients with lumbar disc herniation(LDH).Method:A total of 86 patients with LDH admitted to the First Affiliated Hospital of Gannan Medical College,Longnan Hospital from January 2021 to October 2023 were divided into two groups by random number table method,with 43 cases in each group.The control group was treated with Mecobalamin orally,and the observation group was treated with the addition of Triainclnolone Acetonide Acetate,continuous treatment for 4 weeks in two groups.The clinical effect,adverse reactions,Japanese orthopaedic association scores(JOA),visual analogue scale(VAS),Barthel index(BI),inflammatory factors levels and quality of life were compared between two groups.Result:The total effective rate of observation group was higher than that of control group(P<0.05).After treatment,the each dimension and total scores of JOA in the observation group[(7.45±1.13),(4.94±0.52),(12.13±1.12),(24.52±2.14)scores]were higher than those of control group[(6.02±1.04),(3.87±0.43),(10.41±1.05)and(20.30±2.11)scores],the differences were statistically significant(P<0.05).After treatment,the VAS score of observation group[(1.54±0.23)scores]was lower than that of control group[(1.89±0.26)scores],and the BI score[(88.31±5.24)scores]was higher than that of control group[(81.49±5.22)scores],the differences were statistically significant(P<0.05).After treatment,the inflammatory factors levels in observation group[(50.41±5.13)pg/mL,(5.63±1.12)mg/L,(5.35±1.02)pg/mL]were lower than those of control group[(55.47±5.36)pg/mL,(7.24±1.18)mg/L,(6.89±1.15)pg/mL],the differences were statistically significant(P<0.05).After treatment,the quality of life scores of observation group[(87.53±5.49),(89.58±5.14),(90.31±4.25),(92.25±4.29)scores]were higher than those of control group[(79.84±5.55),(82.35±5.29),Medical Innovation of China Vol.21,No.28 October,2024(81.64±4.32),(83.75±5.05)scores],the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between two groups(P>0.05).Conclusion:Triainclnolone Acetonide Acetate combined with Mecobalamin can improve the treatment effect of LDH,accelerate the recovery of lumbar function,reduce the degree of pain,which is safe and reliable.