体外冲击波取穴防治腰椎间盘突出症射频消融术后残余痛的疗效观察

发布时间：2018-11-24 08:35

【摘要】：目的：观察体外冲击波取穴防治腰椎间盘突出症射频消融术后残余痛的临床疗效,并探讨体外冲击波取穴的可能治疗机制,为使用中医方法防治微创术后并发症提供依据。方法：选择2014年7月-2015年3月于我院骨科住院治疗并符合纳入标准的60名L4/5腰椎间盘突出症患者,随机分成两组：对照组30人,试验组30人。对照组入院后采用射频消融术治疗,试验组入院后治疗同对照组,从射频消融术后第5天开始予体外冲击波取穴治疗,治疗频率每3天1次,每位患者共治疗3次。所有患者术后随访1年,对比两组患者术前、术后1周、17天、3个月、6个月、1年的疼痛评分、腰椎功能障碍评分,并采用改良MacNab疗效评定方法比较两组治疗方式的总体治疗效果。结果：60人均得到完整随访,随访时间至少1年。两组患者的平均年龄、性别、患侧、病程经过对比具有可比性,P0.05。两组患者术前的VAS评分比较有可比性,P0.05：术后1周、17天、3个月、6个月、1年,两组的VAS评分比较有意义,P0.05。术前两组患者腰椎ODI评分有可比性,P0.05：两组术后17天、3个月、6个月、1年有统计学意义,P0.05。根据改良MacNab疗效评定比较,对照组：优9例,良15例,可4例,差2例,优良率80.00%,总有效率93.33%；试验组：优17例,良10例,可2例,差1例,优良率90.00%,总有效率96.67%,两组的总有效率对比明显不同,P0.05。结论：体外冲击波取穴能缓解腰椎间盘突出症射频消融术后的残余痛,改善腰椎功能,对射频消融术后的残留症状有预防作用。
[Abstract]:Objective: to observe the therapeutic effect of extracorporeal shock wave (ESWL) on residual pain after radiofrequency ablation of lumbar intervertebral disc herniation, and to explore the possible therapeutic mechanism of extracorporeal shock wave (ESWL) for the prevention and treatment of postoperative complications by traditional Chinese medicine (TCM). Methods: from July 2014 to March 2015, 60 patients with L4 / 5 lumbar disc herniation who were admitted to our hospital from July 2014 to March 2015 were randomly divided into two groups: control group (n = 30) and experimental group (n = 30). The control group was treated with radiofrequency ablation after admission, the experimental group was treated with the same control group after admission, and the treatment group was treated with extracorporeal shock wave acupoint extraction from the 5th day after radiofrequency ablation. The treatment frequency was once every 3 days, and each patient was treated for 3 times. All patients were followed up for 1 year. The pain score, lumbar dysfunction score and lumbar dysfunction score were compared between the two groups before operation, 1 week, 17 days, 3 months, 6 months, and 1 year after operation. The overall therapeutic effect of the two groups was compared with the modified MacNab method. Results: 60 patients were followed up for at least one year. The average age, sex, affected side and course of disease were comparable between the two groups (P 0.05). The preoperative VAS scores of the two groups were comparable (P0.05: 1 week, 17 days, 3 months, 6 months, 1 year after operation). The VAS scores of the two groups were significant (P0.05). ODI scores of lumbar vertebrae were comparable between the two groups before operation (P0.05: 17 days, 3 months, 6 months, 1 year after operation, P 0.05). According to the evaluation of modified MacNab, the control group: excellent 9 cases, good 15 cases, fair 4 cases, poor 2 cases, excellent and good rate 80.005, total effective rate 93.33; In the trial group, 17 cases were excellent, 10 cases were good, 2 cases were fair, 1 case was poor, the excellent and good rate was 90.00m, the total effective rate was 96.677.The total effective rate of the two groups was obviously different (P 0.05). Conclusion: extracorporeal shock wave extraction can relieve residual pain after radiofrequency ablation of lumbar intervertebral disc herniation, improve lumbar function and prevent residual symptoms after radiofrequency ablation.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R274.9

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