[1]张征,章媛,邹佳华.射频热凝靶点消融减压术联合中药穴位注射治疗腰椎间盘突出临床研究*[J].陕西中医,2019,(11):1548-1551.
 ZHANG Zheng,ZHANG Yuan,ZOU Jiahua..Radiofrequency thermocoagulation target ablation and decompression combined with acupoint injection in the treatment of lumbar disc herniation[J].,2019,(11):1548-1551.
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射频热凝靶点消融减压术联合中药穴位注射治疗腰椎间盘突出临床研究*
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2019年11期
页码:
1548-1551
栏目:
临床研究
出版日期:
2019-11-05

文章信息/Info

Title:
Radiofrequency thermocoagulation target ablation and decompression combined with acupoint injection in the treatment of lumbar disc herniation
文章编号:
DOI:10.3969/j.issn.10007369.2019.11.017
作者:
张征章媛邹佳华
湖北省黄冈市中医医院(黄冈 438000)
Author(s):
ZHANG ZhengZHANG YuanZOU Jiahua.
Huanggang Traditional Chinese Medicine Hospital in Hubei Province(Huanggang 438000)
关键词:
腰椎间盘突出射频热凝靶点消融减压术穴位注射炎症反应介质白细胞介素17肿瘤坏死因子α
Keywords:
Key words Lumbar disc herniationRadiofrequency thermocoagulation target ablation decompressionAcupoint injectionInflammatory mediators IL17TNFα
分类号:
R681.5
文献标志码:
A
摘要:
摘要目的:探讨射频热凝靶点消融减压术联合中药穴位注射治疗腰椎间盘突出的临床疗效及对白细胞介素17(IL17)、肿瘤坏死因子α(TNFα)及干扰素γ(IFNγ)水平的影响。方法:采用前瞻性随机对照试验法将136例腰椎间盘突出患者分为观察组与对照组,每组各68例。对照组采用射频热凝靶点消融减压术,观察组在对照组的基础上联合中药穴位注射治疗。观察两组患者的临床疗效,对比治疗前后疼痛视觉模拟评分(VAS)、Oswestry 功能障碍指数(ODI)、日本骨科协会下腰痛功能评价表评分(JOA)及TNFα、IFNγ和IL17水平。结果:观察组的治疗有效率显著高于对照组;治疗后观察组VAS及ODI指数下降幅度高于对照组,差异均有统计学意义(P<005);治疗后观察组JOA各项评分优于对照组,差异均具有统计学意义(P<005);治疗后观察组血清TNFα、IFNγ和IL17水平低于对照组,差异均有统计学意义(P<005)。结论:射频热凝靶点消融减压术联合中药穴位注射治疗腰椎间盘突出可显著提高临床疗效,改善症状,缓解疼痛,减轻全身炎症反应。
Abstract:
AbstractObjective:To investigate the clinical effect of radiofrequency thermocoagulation target ablation and decompression combined with acupoint injection of traditional Chinese medicine on lumbar disc herniation and its influence on the levels of IL17,TNFα and IFNγ.Methods:136 patients were divided into observation group and control group with 68 cases in each group.The control group was treated with radiofrequency thermocoagulation target ablation and decompression,while the observation group was treated with acupoint injection of traditional Chinese medicine on the basis of the control group.The clinical efficacy of the two groups was observed,and the levels of pain visual analogue score (VAS),Oswestry dysfunction index (ODI),JOA,TNFa,IFNgamma and IL17 were compared before and after treatment.Results:The effective rate of the observation group was significantly higher than that of the control group.After treatment,the VAS and ODI index of the observation group decreased more than that of the control group,with statistical significance (P<005);after treatment,the JOA scores of the observation group were better than those of the control group,with statistical significance (P<005);after treatment,the serum TN of the observation group was significantly higher than that of the control group (P<005).The levels of Falpha,IFNgamma and IL17 in the control group were lower than those in the control group (P<005).Conclusion:Radiofrequency thermocoagulation target ablation and decompression combined with acupoint injection of traditional Chinese medicine in the treatment of lumbar disc herniation can significantly improve clinical efficacy,improve symptoms,alleviate pain and reduce systemic inflammatory response.

参考文献/References:

[1]Cong L,ZhuY,Tu GJ.A metaanalysis of endoscopic discectomy versus open discectomy for symptomatic lumbar disk herniation [J].Eur Spine J, 2016,25(1):134143.
[2]徐宝山,马信龙,胡永成, 等.腰椎间盘突出症伴椎体后缘骨软骨病的内镜手术治疗[J].中华骨科杂志,2017,37 (11):683690.
[3]吴青坡,刘志平,孙国绍.腰椎间盘突出症术后腰痛的临床研究[J].中国疼痛医学杂志,2018,24(3):235236,240.
[4]王峰,崔玉蓬.腰椎间盘突出症患者椎间盘组织炎性因子、TGFβ_1、PGE_2表达及意义[J].山东医药,2016,56(32):5658.
[5]高志成,尹锦楠,余文惠,等.钩活术联合红花注射液穴位注射对腰椎间盘突出症患者炎症因子的影响[J].陕西中医,2016,37(3):348350.
[6]瞿群威,沈玉杰.低温等离子靶点消融术联合臭氧治疗腰椎间盘突出症的临床研究[J].中国疼痛医学杂志,2017,23(2):144147.
[7]梅求安,王刚,林晓波,等.靶点射频热凝术结合桃红四物汤加减治疗气滞血瘀型腰椎间盘突出症的疗效研究[J].现代中西医结合杂志,2017,26(19):21132115.
[8]国家中医药管理局.中医病证诊断疗效标准\[S\].南京:南京大学出版社,1994:214216.
[9]梅江涛,戴先文,尚辉辉.经皮椎间孔镜对腰椎间盘突出症的临床预后及安全性分析[J].陕西医学杂志,2018,47(10):13001302.
[10]李柱海,曾建成,聂鸿飞,等.普瑞巴林联合塞来昔布治疗腰椎间盘突出症经皮内镜术后神经病理性疼痛的疗效观察[J].中国修复重建外科杂志,2017,31(2):215221.
[11]Sun Z,Liu ZH,Chen YF,et al.Molecular immunotherapy might shed a light on the treatment strategies for disc degeneration and herniation[J].Med Hypotheses,2013,81(3):477480.
[12]张鸿嫣,杨敏,岳容兆,等.刮痧对腰椎间盘突出症模型大鼠背根神经节炎性细胞因子和血清疼痛物质的影响[J].时珍国医国药,2017,28(2):500503.
[13]王辉,李娜,王锁良,等.射频热凝靶点消融减压术对腰椎间盘突出症患者血清TNFα、IFNγ和IL17水平的影响[J].西安交通大学学报:医学版,2017,38(2):261265.
[14]刘焱,鲍自立,黄桂成.补肾活血方联合经皮椎间孔镜治疗腰椎间盘突出症临床研究[J].陕西中医,2018,39(9):11981200.
[15]韩福胜,杨文珍,刘宝勋,等.经皮腰椎间盘摘除术与射频热凝术分别联合臭氧消融治疗腰椎间盘突出疗效比较[J].河北医药,2016,38(10):15631564.
[16]卢帆,樊宇超,梁琳,等.射频热凝联合臭氧消融治疗腰椎间盘突出症的Meta 分析[J].中国疼痛医学杂志,2015,21(6):441448.
[17]Hu XX,Liu LM.Progress on the cause and mechanism ofa separation of clinical symptoms and signs and imaging features in lumbar disk herniation[J].China Journal of Orthopaedics & Traumatology,2015,28(10):970975.
[18]项俊,喻立.丹红注射液四联穴穴位注射治疗腰椎间盘突出症的疗效观察[J].中国康复,2016,31(6):433.
[19]陈诚,丁吉林,资昌艳,等.穴位注射治疗腰椎间盘突出症的应用概况[J].湖南中医杂志,2017,33(8):207209.
[20]王智耀,朱瑜琪,鲁超,等.以穴位注射为主中医综合疗法治疗腰椎间盘突出症的临床研究[J].世界中西医结合杂志,2016,11(12):16941697.
[21]韩广敬.中医综合治疗方案对不同突出节段腰椎间盘突出症患者临床疗效分析[J].中华中医药学刊,2016,34(7):17111714.
[22]Ohtori S,Inoue G,Eguchi Y,et al.Tumor necrosis factorαimmunoreactive cells in nucleus pulposus in adolescent patients with lumbar disc herniation[J].Spine,2013,38(6):45962.

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备注/Memo

备注/Memo:
*湖北省科学技术厅资助项目(EK2013D210063001645) 湖北省卫生健康委员会科研项目(WJ2019M090)
更新日期/Last Update: 2019-11-15