發(fā)布時間：2018-10-05 15:57

【摘要】：目的觀察小針刀治療PVP術(shù)后殘余腰痛的臨床療效。方法收集行椎體成形術(shù)并在術(shù)后出現(xiàn)殘余痛的患者43例,按隨機數(shù)字法分為3組,針刀+藥物組運用小針刀治療配合口服阿法骨化醇片和鈣爾奇;針刀組單純應(yīng)用小針刀治療;藥物組僅口服阿法骨化醇片和鈣爾奇。在針刀治療前、針刀處理后、術(shù)后1、6、12個月行VAS評分及ODI評分以評價患者生活質(zhì)量。紀錄每次針刀治療前的壓痛點個數(shù)。結(jié)果壓痛點方面,第一次針刀治療前,3組間差異無統(tǒng)計學(xué)意義(P0.05);第二次針刀治療前,針刀+藥物組與針刀組間差異無統(tǒng)計學(xué)意義(P0.05),藥物組與針刀+藥物組、針刀組間差異有統(tǒng)計學(xué)意義(P0.05);第三次針刀治療前,針刀組與針刀+藥物組、藥物組間差異無統(tǒng)計學(xué)意義(P0.05),針刀+藥物組與藥物組間差異有統(tǒng)計學(xué)意義(P0.05);3組各組組內(nèi)比較,治療前后差異均有統(tǒng)計學(xué)意義(P0.05)。對于VAS評分,3組在針刀處理前,VAS評分差異無統(tǒng)計學(xué)意義(P0.05);在針刀處理后,3組兩兩比較,差異有統(tǒng)計學(xué)意義(P0.05);術(shù)后1、6個月,針刀+藥物組與針刀組差異無統(tǒng)計學(xué)意義(P0.05),藥物組與針刀+藥物組、針刀組差異有統(tǒng)計學(xué)意義(P0.05);術(shù)后12個月,針刀+藥物組與藥物組差異有統(tǒng)計學(xué)意義(P0.05),而針刀+藥物與針刀組,針刀組與藥物組間差異無統(tǒng)計學(xué)意義(P0.05);藥物組、針刀組VAS評分組內(nèi)比較,各時間點間差異均有統(tǒng)計學(xué)意義(P0.05),且評分呈下降趨勢;在針刀+藥物組組內(nèi),針刀處理后、術(shù)后1、6、12個月與針刀處理前對比,差異有統(tǒng)計學(xué)意義(P0.05),而在術(shù)后6個月與術(shù)后12個月間,差異無統(tǒng)計學(xué)意義(P0.05)。對于ODI評分,在針刀處理前,各組ODI評分差異無統(tǒng)計學(xué)意義,針刀處理后、術(shù)后1個月3組兩兩間差異均有統(tǒng)計學(xué)意義(P0.05);術(shù)后6、12個月的ODI評分,針刀+藥物組與針刀組、藥物組間差異有統(tǒng)計學(xué)意義(P0.05),而針刀組與藥物組間差異無統(tǒng)計學(xué)意義(P0.05);各組組內(nèi)比較,各時間點前后比較差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論小針刀療法處理PVP術(shù)后殘余痛,可明顯緩解疼痛,提高生活質(zhì)量,療效肯定,在臨床當(dāng)中值得推廣。
[Abstract]:Objective to observe the clinical effect of small needle knife on residual low back pain after PVP. Methods Forty-three patients with residual pain after vertebroplasty were divided into 3 groups according to the random number method. The small needle knife group was treated with small needle knife combined with oral Alfacalciol tablets and calcium, and the needle knife group was treated with small needle knife only. The drug group only took Alfacalciol tablets and calcium. The quality of life was evaluated by VAS and ODI scores 1 and 12 months before and after needle knife treatment. The number of tenderness points before treatment was recorded. Results in terms of tenderness point, there was no significant difference among the three groups before the first needle knife treatment (P0.05), but there was no significant difference between the needle knife drug group and the needle knife group before the second needle knife therapy (P0.05), the drug group and the needle knife drug group had no significant difference (P0.05), and there was no significant difference between the drug group and the acupuncture knife group before the second acupuncture knife treatment (P0.05). Before the third acupuncture knife treatment, there was no significant difference between the needle knife group and the needle knife drug group (P0.05), the difference between the needle knife drug group and the drug group was statistically significant (P0.05), the difference between the acupuncture knife group and the drug group was statistically significant (P0.05), and there was no significant difference between the three groups before the third acupuncture knife treatment (P0.05). The differences before and after treatment were statistically significant (P0.05). There was no significant difference in VAS score between the three groups before the needle knife treatment (P0.05); after the needle knife treatment, the differences were statistically significant (P0.05); 1, 6 months after operation, the difference was significant (P0.05). There was no significant difference between the drug group and the needle knife group (P0.05), but there was a significant difference between the drug group and the needle knife group (P0.05); 12 months after operation, there was no significant difference between the drug group and the needle knife group (P0.05). The difference between the drug group and the drug group was statistically significant (P0.05), but there was no significant difference between the needle knife drug group and the needle knife group, the needle knife group and the drug group (P0.05); the drug group, needle knife group VAS score group comparison, There were significant differences between each time point (P0.05), and the score showed a downward trend; in the needle scalpel drug group, after needle knife treatment, 1 and 12 months after the needle treatment compared with before the needle knife treatment, The difference was statistically significant (P0.05), but there was no significant difference between 6 months and 12 months after operation (P0.05). For the ODI score, there was no significant difference in ODI score between the three groups before the needle knife treatment, but there were significant differences between the three groups one month after the needle knife treatment (P0.05); the ODI score of the 6, 12 months after operation, the needle knife drug group and the needle knife group, There was significant difference between the drug group (P0.05), but there was no significant difference between the needle knife group and the drug group (P0.05); within the group comparison, the differences before and after each time point were statistically significant (P0.05). Conclusion the treatment of residual pain after PVP with small needle knife therapy can obviously relieve the pain and improve the quality of life. It is worth popularizing in clinical practice.
【作者單位】： 柳州市中醫(yī)醫(yī)院脊柱外科;
【基金】：柳州市科學(xué)研究與技術(shù)開發(fā)計劃課題(編號:2014J030 415)
【分類號】：R687.3

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