血沉与颈肩腰腿痛患者疼痛缓解程度的相关性分析

Correlation Analysis of Erythrocyte Sedimentation Rate and the Degree of Pain Relief in Patients with Neck, Shoulder, Waist and Leg Pain

摘要: 目的：探讨颈肩腰腿痛患者治疗前后红细胞沉降率(血沉，ESR)的变化与其疼痛缓解程度的相关性，评估血沉作为炎症监控指标在临床疗效评价中的价值。方法：采用回顾性研究方法，收集2022年1月至2025年4月某院收治的90例颈肩腰腿痛患者的病历资料。记录患者治疗前及治疗4周后的血沉(ESR)、视觉模拟评分(VAS)及C反应蛋白(CRP)水平。根据ΔVAS (治疗前后VAS评分差值)将患者分为显著缓解组(ΔVAS ≥ 3分或疼痛缓解率 ≥ 50%，n = 58)和未显著缓解组(n = 32)。采用配对t检验、独立样本t检验及Pearson相关性分析进行统计学处理。结果：治疗后，全体患者的ESR、VAS评分及CRP均较治疗前显著下降(P < 0.01)。显著缓解组的ΔESR显著大于未显著缓解组[(−19.09 ± 9.37) mm/h vs (−4.46 ± 3.58) mm/h，P < 0.01]。相关性分析显示，全体患者的ΔESR与ΔVAS呈显著正相关(r = 0.72, P < 0.01)，决定系数R² = 0.52。分层分析表明，在显著缓解组中，ΔESR与ΔVAS仍保持较强相关性(r = 0.65, P < 0.01)，而在未显著缓解组中无显著相关性(r = 0.28, P = 0.12)。结论：血沉动态变化与颈肩腰腿痛患者的疼痛缓解程度呈正相关，尤其在炎症活动明显的患者中相关性更强。监测血沉变化有助于评估临床疗效，但其作为非特异性指标，临床解读时需结合患者具体情况并排除混杂因素。

Abstract: Objective: To explore the correlation between the changes in erythrocyte sedimentation rate (ESR) before and after treatment in patients with neck, shoulder, waist and leg pain and the degree of pain relief, and to evaluate the value of ESR as an inflammatory monitoring indicator in the clinical efficacy evaluation. Method: A retrospective study was conducted to collect the medical records of 90 patients with neck, shoulder, waist and leg pain admitted to a certain hospital from January 2022 to April 2025. Record the levels of erythrocyte sedimentation rate (ESR), Visual Analogue Scale (VAS), and C-reactive protein (CRP) of the patients before treatment and 4 weeks after treatment. Patients were divided into the significant remission group (ΔVAS ≥ 3 points or pain relief rate ≥ 50%, n = 58) and the non-significant remission group (n = 32) based on ΔVAS (the difference in VAS scores before and after treatment). Statistical processing was performed using paired t-tests, independent sample t-tests and Pearson correlation analysis. Result: After treatment, the ESR, VAS score and CRP of all patients decreased significantly compared with those before treatment (P < 0.01). The ΔESR in the significant remission group was significantly greater than that in the non-significant remission group [(−19.09 ± 9.37) mm/h vs (−4.46 ± 3.58) mm/h, P < 0.01]. Correlation analysis showed that the ΔESR and ΔVAS of all patients were significantly positively correlated (r = 0.72, P < 0.01), with a coefficient of determination R² = 0.52. Stratified analysis indicated that in the significant remission group, ΔESR and ΔVAS still maintained a strong correlation (r = 0.65, P < 0.01), while in the non-significant remission group, there was no significant correlation (r = 0.28, P = 0.12). Conclusion: The dynamic changes of erythrocyte sedimentation rate (ESR) are positively correlated with the degree of pain relief in patients with neck, shoulder, waist and leg pain, especially in patients with obvious inflammatory activity, the correlation is even stronger. Monitoring changes in erythrocyte sedimentation rate (ESR) is helpful for evaluating clinical efficacy. However, as a non-specific indicator, when interpreting it clinically, the specific conditions of the patient should be taken into account and confounding factors should be excluded.