富血小板血浆(PRP)治疗非手术类腰椎退行性疾病的疗效观察
Observation of the Therapeutic Efficacy of Platelet-Rich Plasma (PRP) in Nonsurgical Lumbar Degenerative Disorders
摘要: 目的：分析富血小板血浆(PRP)治疗非手术类腰椎退行性疾病的临床疗效。方法：选取2023年10月~2025年1月遵义市中医院骨伤科收治的腰椎退行性疾病(LDD)的患者60例为研究对象，采用随机数字表法分为对照组与试验组，各30例。对照组行骶管注射神经阻滞混合液体(组成：地塞米松磷酸钠注射液、盐酸利多卡因注射液、维生素B12注射液)治疗。试验组行骶管注射富血小板血浆(PRP)治疗。比较两组治疗前后日本骨科协会(Japanese Orthopaedic Association, JOA)评分、Oswestry功能障碍指数Oswestry disability index, ODI)评分、视觉模拟评定(visual analogue scale, VAS)评分、末次随访时行Mac Nab疗效评定。结果：治疗前，两组JOA、ODI、VAS评分比较，差异无统计学意义(P > 0.05)；治疗后，两组试验组视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)评分均低于对照组(P < 0.05)，试验组日本骨科学会(JOA)腰痛评分高于对照组(P < 0.05)。试验组与对照组有效率分别为90%、73.33%，观察组高于对照组。结论：骶管注射富血小板血浆可有效改善腰椎退行性疾病的临床症状，恢复腰椎功能，促进神经修复，操作安全性较高。
Abstract: Objective: To evaluate the clinical efficacy of platelet-rich plasma (PRP) in the treatment of nonsurgical lumbar degenerative disease (LDD). Methods: A total of 60 patients with LDD admitted to the Department of Orthopedics and Traumatology, Zunyi City Traditional Chinese Medicine Hospital, from October 2023 to January 2025 were enrolled and randomly assigned to either a control group or an experimental group (30 cases each). The control group received caudal epidural injections of a mixed nerve block solution (dexamethasone sodium phosphate, lidocaine hydrochloride, and vitamin B12), whereas the experimental group received caudal epidural injections of PRP. Clinical efficacy was evaluated using the Japanese Orthopedic Association (JOA) score, Oswestry Disability Index (ODI), Visual Analogue Scale (VAS) score, and Mac Nab criteria before treatment and at the last follow-up. Results: Before treatment, no statistically significant differences in JOA, ODI, or VAS scores were observed between the two groups (P > 0.05). After treatment, the experimental group showed significantly lower VAS and ODI scores and higher JOA scores compared with the control group (P < 0.05). The effective rates were 90% in the experimental group and 73.33% in the control group, indicating superior outcomes with PRP treatment. Conclusion: Caudal epidural injection of PRP can effectively alleviate clinical symptoms, improve lumbar function, and promote nerve repair in patients with LDD, with a high degree of safety.
文章引用：吴文旭, 孔维军, 李国栋. 富血小板血浆(PRP)治疗非手术类腰椎退行性疾病的疗效观察[J]. 医学诊断, 2025, 15(5): 496-501. https://doi.org/10.12677/md.2025.155067

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