【摘要】 目的:探讨骶管注射疗法对腰椎间盘突出症的临床作用。方法:将90例腰椎间盘突出症的患者,随机分为生理盐水组、地塞米松低剂量组、地塞米松高剂量组、曲安奈德低剂量组、曲安奈德高剂量组和丹参注射液组,每组15例。每组患者均按照各自的组方配制成20mL的溶液给予骶管注射。治疗前及治疗后即刻、1周和2周均使用改良的日本矫形外科学会(M-JOA)腰痛评分标准和疼痛视觉模拟评分(VAS)进行临床疗效评价。结果:治疗前各组患者M-JOA腰痛评分和VAS评分比较差异无统计学意义(P>0.05);治疗后即刻各组患者的VAS评分与治疗前比较均有降低(P<0.05),但M-JOA评分与治疗前比较差异无统计学意义(P>0.05);骶管注射治疗后,糖皮质激素各组的M-JOA评分与VAS评分比生理盐水组和丹参注射液组降低明显(P<0.01),但生理盐水组和丹参注射液组、糖皮质激素各剂量组之间的M-JOA评分与VAS评分相比较差异无统计学意义(P>0.05)。治疗后1周,曲安奈德组的M-JOA评分与VAS评分降低比地塞米松组明显(P<0.05),但治疗后2周,曲安奈德组与地塞米松组的M-JOA评分与VAS评分比较差异无统计学意义(P>0.05)。结论:腰椎间盘突出症的骶管注射疗法中,中药制剂的作用与生理盐水无异;起关键作用的是糖皮质激素,且临床运用中最好遵循低剂量给药和水剂优先的原则。更多还原

【Abstract】 Objective: To discuss the clinical effectiveness of sacral injection therapy to treat lumbar disc protrusion.Methods: All of 90 patients with lumbar disc protrusion were divided into 6 groups randomly: the control group,low dose hexadecadrol injection group,high dose hexadecadrol injection group,low dose triamcinolone acetonide injection group,high dose triamcinolone acetonide injection group and DanShen injection group.Each group has the patients of same number,and the injection volumes were all 20 ml in each case.All the patients were accessed by M-JOA and VAS before injection、after injection immediately、1 week and 2 week after injection.Results: There were no significant difference between M-JOA and VAS scores in all of the group before injection(P >0.05);The VAS scores immediately after injection were significantly lower than that in all of group before injection(P <0.05),but there were no significant difference in the M-JOA scores in all of groups before and immediately after injection(P >0.05);The M-JOA and VAS scores of hexadecadrol and triamcinolone acetonide injection groups were significantly higher than the scores in normal saline and DanShen groups at 1 week after injection(P <0.01);furthermore the M-JOA and VAS scores of triamcinolone acetonide group are significantly higher than that in hexadecadrol group(P <0.05);The M-JOA scores and VAS scores of hexadecadrol and triamcinolone acetonide injection groups are significantly higher than normal saline and DanShen groups at 2 weeks after injection(P <0.01),but the M-JOA score and VAS score of triamcinolone acetonide group and hexadecadrol group have no significantly difference(P >0.05);The M-JOA score and VAS score in each group of different dose glucocorticoid injections and normal saline and DanShen groups had no significant difference(P >0.05). Conclusion: Traditional Chinese medicine preparation got the same effect as normal saline injection in sacral injection therapy to treat lumbar disc protrusion,however,the glucocorticoid injection play a key role in the treatment to lumbar disc protrusion and it must be given from low dose and be followed the principle of agent priority.更多还原