侧隐窝及腰椎旁注射强的松龙及来比林对腰椎间盘突出症患者血浆β-内啡肽与P物质的影响

EFFECTS OF EPIDURAL AND PERIRADICULAR METHYLPREDNISOLONE AND LYSINIPIRIUM INJECTION ON LUMBAR DISC HERNIATION AND ON SERUM β-ENDORPHIN AND SUBSTANCE P

目的 :检测腰椎间盘突出症疼痛患者血浆β 内啡肽及P物质水平的变化 ;观察侧隐窝及腰椎旁椎间孔注射强的松龙及来比林对腰椎间盘突出症的治疗效果。方法 :腰椎间盘突出症患者 4 8例 ,随机分为三组 ,采用不同药物及注射方法治疗。每次治疗前测定血浆 β 内啡肽与P物质含量。结果 :三组患者治疗前血浆 β 内啡肽含量均显著低于正常人 (P <0 .0 1) ,而P物质水平显著高于正常人 (P <0 .0 1)。治疗过程中 ,随疼痛症状改善 ,各指标逐渐趋向正常水平。结论 :β 内啡肽及P物质在腰椎间盘突出症引发的疼痛中可能起一定作用。

Objectives: To evaluate the effect of epidural and periradicular injection of methylprednisolone and lysinipirium on lumbar disc herniation patients, and on serum β endorphin (β EP) and Sbstance P (SP). Methods: Forty eight patients with radiculopathy or low back pain were divided into three groups randomly. Group A(n=16) : 25mg methylprednisolone+50mg lidocaine was injected in lateral epidural space; group B(n=15): 25mg methylprednisolone+50mg lidocaine+0.9g lysinipirium was injected in lateral epidural space; group C(n=17): 25mg methylprednisolone + 50mg lidocaine was injected at perivertebral foramen. The clinical effect of the treatment was assessed. Blood samples were collected to determine serum β EP and SP levels. Blood samples from eleven healthy volunteers were taken to determine β EP and SP levels as controls. Results: Straight leg raising angle in group B recovered more quickly than in group A. There was no difference between group A and C. Before treatment, the serum SP levels were significantly higher, while β EP levels significantly lower in three groups than those in the control. Conclusion: The effects of epidural and periradicular injection of methylprednisolone on lumbar disc herniation patients are comparable. β EP and SP may play a role in the mechanism of pain in lumbar disc herniation.