经皮激光椎间盘减压术对腰椎间盘突出症患者血浆中β-内啡呔和P物质的影响

目的:观察经皮激光椎间盘减压术(PLDD)对腰椎间盘突出(LDH)症患者血浆中β-内啡呔(β-EP)和P物质(SP)的影响。方法:78例确诊的LDH患者分成2组,PLDD组40例给以PLDD治疗;对照组38例行物理因子治疗。治疗前后检测2组患者外周血浆中β-EP和SP的浓度;评定疼痛指数的变化。结果:治疗后第1天,2组血浆中SP较治疗前明显下降,β-EP上升,VAS疼痛评分下降;治疗后第1和4周时2组各项指标变化更显著,PLDD组治疗后各时点均较对照组表现显著(均P0.01)。结论:PLDD治疗能够降低腰椎间盘突出症患者血浆中SP和提高β-EP而发挥良好的镇痛效果。SP与β-EP检测可作为临床治疗疼痛疗效的客观评价指标。

Effect of Percutaneous Laser Disc Decompression on β-Endorphine and P-Substance in Patients with Protrusion of Lambar Disc Herniation

Objective：To observe the effect of percutaneous laser disc decompression （PLDD） for the patients with protrusion of lumbar intervertebral disc on β-endorphine and P-substance. Method：Seventy-eight patients with lumbar intervertebral disc herniation were randomly divided into two groups. The patients in control group （40 patients） were treated with lumbar spine traction and physical therapy,and those in experimental group （38 patients） were treated with PLDD. β-endorphine and P-substance in the peripheral blood plasma were determined respectively before the procedure and on the first day,the first week,the fourth week after the procedure. Meanwhile the VAS was applied to assess the pain of the patients. Results：On the first day and the first week after the treatment,P-substance in the peripheral blood plasma was reduced,β-endorphine was increased and pain was relived in all the patients. There was significant difference between two groups （P0.001）. On the fourth week,the effect obtained in the experimental group was more satisfactory than in the control group （P0.01）. Conclusion：PLDD can reduce P-substance and increase β-endorphine in the patients with lumbar intervertebral disc herniation,thus relieving pain. P-substance and β-endorphine can be the objective indexes to evaluate clinical curative effectiveness of relieving pain.