小针刀治疗PVP术后残余腰痛的临床观察

发布时间：2018-10-05 15:57

【摘要】：目的观察小针刀治疗PVP术后残余腰痛的临床疗效。方法收集行椎体成形术并在术后出现残余痛的患者43例,按随机数字法分为3组,针刀+药物组运用小针刀治疗配合口服阿法骨化醇片和钙尔奇;针刀组单纯应用小针刀治疗;药物组仅口服阿法骨化醇片和钙尔奇。在针刀治疗前、针刀处理后、术后1、6、12个月行VAS评分及ODI评分以评价患者生活质量。纪录每次针刀治疗前的压痛点个数。结果压痛点方面,第一次针刀治疗前,3组间差异无统计学意义(P0.05);第二次针刀治疗前,针刀+药物组与针刀组间差异无统计学意义(P0.05),药物组与针刀+药物组、针刀组间差异有统计学意义(P0.05);第三次针刀治疗前,针刀组与针刀+药物组、药物组间差异无统计学意义(P0.05),针刀+药物组与药物组间差异有统计学意义(P0.05);3组各组组内比较,治疗前后差异均有统计学意义(P0.05)。对于VAS评分,3组在针刀处理前,VAS评分差异无统计学意义(P0.05);在针刀处理后,3组两两比较,差异有统计学意义(P0.05);术后1、6个月,针刀+药物组与针刀组差异无统计学意义(P0.05),药物组与针刀+药物组、针刀组差异有统计学意义(P0.05);术后12个月,针刀+药物组与药物组差异有统计学意义(P0.05),而针刀+药物与针刀组,针刀组与药物组间差异无统计学意义(P0.05);药物组、针刀组VAS评分组内比较,各时间点间差异均有统计学意义(P0.05),且评分呈下降趋势;在针刀+药物组组内,针刀处理后、术后1、6、12个月与针刀处理前对比,差异有统计学意义(P0.05),而在术后6个月与术后12个月间,差异无统计学意义(P0.05)。对于ODI评分,在针刀处理前,各组ODI评分差异无统计学意义,针刀处理后、术后1个月3组两两间差异均有统计学意义(P0.05);术后6、12个月的ODI评分,针刀+药物组与针刀组、药物组间差异有统计学意义(P0.05),而针刀组与药物组间差异无统计学意义(P0.05);各组组内比较,各时间点前后比较差异有统计学意义(P0.05)。结论小针刀疗法处理PVP术后残余痛,可明显缓解疼痛,提高生活质量,疗效肯定,在临床当中值得推广。
[Abstract]:Objective to observe the clinical effect of small needle knife on residual low back pain after PVP. Methods Forty-three patients with residual pain after vertebroplasty were divided into 3 groups according to the random number method. The small needle knife group was treated with small needle knife combined with oral Alfacalciol tablets and calcium, and the needle knife group was treated with small needle knife only. The drug group only took Alfacalciol tablets and calcium. The quality of life was evaluated by VAS and ODI scores 1 and 12 months before and after needle knife treatment. The number of tenderness points before treatment was recorded. Results in terms of tenderness point, there was no significant difference among the three groups before the first needle knife treatment (P0.05), but there was no significant difference between the needle knife drug group and the needle knife group before the second needle knife therapy (P0.05), the drug group and the needle knife drug group had no significant difference (P0.05), and there was no significant difference between the drug group and the acupuncture knife group before the second acupuncture knife treatment (P0.05). Before the third acupuncture knife treatment, there was no significant difference between the needle knife group and the needle knife drug group (P0.05), the difference between the needle knife drug group and the drug group was statistically significant (P0.05), the difference between the acupuncture knife group and the drug group was statistically significant (P0.05), and there was no significant difference between the three groups before the third acupuncture knife treatment (P0.05). The differences before and after treatment were statistically significant (P0.05). There was no significant difference in VAS score between the three groups before the needle knife treatment (P0.05); after the needle knife treatment, the differences were statistically significant (P0.05); 1, 6 months after operation, the difference was significant (P0.05). There was no significant difference between the drug group and the needle knife group (P0.05), but there was a significant difference between the drug group and the needle knife group (P0.05); 12 months after operation, there was no significant difference between the drug group and the needle knife group (P0.05). The difference between the drug group and the drug group was statistically significant (P0.05), but there was no significant difference between the needle knife drug group and the needle knife group, the needle knife group and the drug group (P0.05); the drug group, needle knife group VAS score group comparison, There were significant differences between each time point (P0.05), and the score showed a downward trend; in the needle scalpel drug group, after needle knife treatment, 1 and 12 months after the needle treatment compared with before the needle knife treatment, The difference was statistically significant (P0.05), but there was no significant difference between 6 months and 12 months after operation (P0.05). For the ODI score, there was no significant difference in ODI score between the three groups before the needle knife treatment, but there were significant differences between the three groups one month after the needle knife treatment (P0.05); the ODI score of the 6, 12 months after operation, the needle knife drug group and the needle knife group, There was significant difference between the drug group (P0.05), but there was no significant difference between the needle knife group and the drug group (P0.05); within the group comparison, the differences before and after each time point were statistically significant (P0.05). Conclusion the treatment of residual pain after PVP with small needle knife therapy can obviously relieve the pain and improve the quality of life. It is worth popularizing in clinical practice.
【作者单位】：柳州市中医医院脊柱外科;
【基金】：柳州市科学研究与技术开发计划课题(编号:2014J030 415)
【分类号】：R687.3

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