【摘要】：目的：觀察體外沖擊波取穴防治腰椎間盤突出癥射頻消融術(shù)后殘余痛的臨床療效,并探討體外沖擊波取穴的可能治療機制,為使用中醫(yī)方法防治微創(chuàng)術(shù)后并發(fā)癥提供依據(jù)。方法：選擇2014年7月-2015年3月于我院骨科住院治療并符合納入標準的60名L4/5腰椎間盤突出癥患者,隨機分成兩組：對照組30人,試驗組30人。對照組入院后采用射頻消融術(shù)治療,試驗組入院后治療同對照組,從射頻消融術(shù)后第5天開始予體外沖擊波取穴治療,治療頻率每3天1次,每位患者共治療3次。所有患者術(shù)后隨訪1年,對比兩組患者術(shù)前、術(shù)后1周、17天、3個月、6個月、1年的疼痛評分、腰椎功能障礙評分,并采用改良MacNab療效評定方法比較兩組治療方式的總體治療效果。結(jié)果：60人均得到完整隨訪,隨訪時間至少1年。兩組患者的平均年齡、性別、患側(cè)、病程經(jīng)過對比具有可比性,P0.05。兩組患者術(shù)前的VAS評分比較有可比性,P0.05：術(shù)后1周、17天、3個月、6個月、1年,兩組的VAS評分比較有意義,P0.05。術(shù)前兩組患者腰椎ODI評分有可比性,P0.05：兩組術(shù)后17天、3個月、6個月、1年有統(tǒng)計學(xué)意義,P0.05。根據(jù)改良MacNab療效評定比較,對照組：優(yōu)9例,良15例,可4例,差2例,優(yōu)良率80.00%,總有效率93.33%；試驗組：優(yōu)17例,良10例,可2例,差1例,優(yōu)良率90.00%,總有效率96.67%,兩組的總有效率對比明顯不同,P0.05。結(jié)論：體外沖擊波取穴能緩解腰椎間盤突出癥射頻消融術(shù)后的殘余痛,改善腰椎功能,對射頻消融術(shù)后的殘留癥狀有預(yù)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.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R274.9

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