拨针松解联合臭氧对腰椎间盘突出症的临床疗效研究

Clinical Study on the Treatment of Lumbar Intervertebral Disc Herniation by Acupuncture and Ozone

摘要: 目的：观察应用拔针椎间孔松解术联合臭氧对腰椎间盘突出症的临床疗效。方法：选取黑龙江中医药大学附属第一医院门诊的50名腰椎间盘突出症病人，选择时间从2021年2月至2022年2月，分成观察组25名和对照组25名，本研究用Excel随机表格法进行分组。观察组使用拔针松解术，对照组给予小针刀松解术，两组均辅以臭氧注射治疗每周两次，共治疗三周。对比观察两组治疗前后两周的视觉模拟法疼痛评分(VAS评分)以及治疗前后两周的血清白细胞介素-1 (IL-1)、白细胞介素-10 (IL-10)、肿瘤坏死因子-α (TNF-α)的水平。检测p-P38MAPK通路蛋白表达[基质金属蛋白酶(MMP)-3、MMP-9、血管内皮生长因子(VEGF)、p-P38MAPK]水平。结果：通过1~3周的疗程和两个月后的随访发现，观察组25例患者中，12例治愈，8例疗效显著，3例有效，2例无效，有效率92.0%；对照组25例患者中，9例患者治愈，6例疗效显著，2例有效，8例无效，有效率68.0%；两组病人在治疗前、后腰功能评分、VAS评分、血清IL-1、IL-10、TNF-α水平的比较上，差异有显著性(P < 0.05)。两组病人术后腰椎间盘症状与VAS评分、腰椎间盘症状的追踪分析结果有显著性差异(P < 0.05)。与对照组相比，观察组在疼痛程度、症状、功能评分和疗效方面均有明显提高(P < 0.05)。结论：采用拔针式椎间孔松解疗法，可以明显减轻腰椎间盘突出症的临床症状，使腰椎功能得到恢复，加强疗效。

Abstract: Objective: To observe the clinical effect of needle extraction intervertebral pore release combined with ozone on lumbar disc herniation. Methods: Fifty patients with lumbar disc herniation in the outpatient department of the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from February 2021 to February 2022 were selected and divided into observation group (25) and control group (25) by Excel random table method. The observation group was treated with needle extraction lysis, while the control group was treated with small needle knife lysis. Both groups were treated with ozone injection twice a week for a total of 3 weeks. Visual analogue pain score (VAS score) and serum levels of interleukin-1 (IL-1), interleukin-10 (IL-10) and tumor necrosis factor-α (TNF-α) were compared between the two groups before and after treatment. The protein expression of p-P38MAPK pathway [matrix metalloproteinase (MMP)-3, MMP-9, vascular endothelial growth factor (VEGF), p-P38MAPK] was detected. Results: In the observation group, 12 cases were cured, 8 cases had significant curative effect, 3 cases were effective, 2 cases were ineffective, and the effective rate was 92.0%. In the control group of 25 patients, 9 cases were cured, 6 cases were effective, 2 cases were effective, 8 cases were ineffective, the effective rate was 68.0%; There were significant differences in the preoperative and posterior lumbar function scores, VAS scores, serum levels of IL-1, IL-10 and TNF-α between the two groups (P < 0.05). There were significant differences in postoperative lumbar disc symptoms, VAS score and follow-up analysis results of lumbar disc symptoms between the two groups (P < 0.05). Compared with the control group, the pain degree, symptoms, functional scores and efficacy in the observation group were significantly improved (P < 0.05). Conclusion: The clinical symptoms of lumbar disc herniation can be alleviated and the function of lumbar spine can be restored.