综合康复治疗腰椎间盘突出症所致坐骨神经痛的临床效果

目的 探讨综合康复治疗对于腰椎间盘突出症（LIDP）所致坐骨神经痛的临床效果。方法 选择2011年6月～2013年6月期间在深圳市宝安区松岗人民医院康复门诊治疗的84例LIDP所致坐骨神经痛患者作为研究对象，按照数字随机表法分为两组，每组42例。治疗组应用手法推拿、电针及中药熏蒸综合康复治疗，对照组应用腰椎牵引和西药口服治疗。比较两组患者治疗前后视觉模拟评分（VAS）、日本骨科学会改良下腰痛评分（JOA）、血清神经生长因子（NGF）、P物质（SP）水平，并比较两组JOA疗效。结果 VAS评分两组治疗前差异无统计学意义（t=0．6097，P=0．5438），治疗后两组均显著下降（t=9．6612、6．3264，P=0．0000、0．0000），治疗组低于对照组（2.3±1．6）分比（3．6±1．8）分]，差异有统计学意义（t=3．4983，P=0．0008）；JOA评分两组治疗前差异无统计学意义（t=0．3984，P=0．6914），治疗后两组均显著升高（t=17．8938、9．4541，P=0．0000、0．0000），治疗组高于对照组（24．6±3．2）分比（19．6±4．8）分]，差异有统计学意义（t=5．6170，P=-0．0000）；血清NGF水平治疗前两组患者差异无统计学意义（t=0．5544，P=0．5808），治疗后两组均较治疗前显著升高（t=12．8539、7．5551，P=0．0000、0．0000），治疗组高于对照组（51.3±9．5）pg／mL比（42．4±8．9）pg／mL]，差异有统计学意义（t=4．2317，P=0．0001）；血清SP水平治疗前两组患者差异无统计学意义（t=0．2782，P=0．7815），治疗后两组均较治疗前显著下降（t=29．9548、23．8197，P=0．0000、0．0000），治疗组低于对照组（242．4±58．9）pg／mL比（326．2±67．1）pg／mL]，差异有统计学意义（t=6．0827，P=0．0000）；治疗组JOA疗效总有效率为高于对照组（95．2％比81．0％），差异有统计学意义（χ^2=4．0865，P=0．0432）。结论 综合康复治疗通过多种方式、不同途径治疗LIDP所致坐骨神经痛，具有显著临床效果。

Clinical curative effect of comprehensive rehabilitation treatment for sciatica caused by lubar intervertebral disc protrusion

Objective To investigate the clinical efficacy of comprehensive rehabilitation treatment for sciatica caused by lubar intervertebral disc protrusion （LIDP）. Methods 84 patients with sciatica caused by LIDP treated in Rehabilitation Clinic of Songgang People＇s Hospital of Bao＇an District in Shenzhen City from June 2011 to June 2013 were selected as the research objects, and divided into two groups according to the random.number table method, each group had 42 cases. The treatment group was treated by massage, acupuncture and Chinese medicine fumigation, while the control group was treated with lumbar traction and taken western medicine orally. The visual anaglogue scale （VAS）, Japanese orthopedic association low back pain score （JOA）, serum nerve growth factor （NGF） and P substance （SP） levels of the patients in the two groups before and after treatment were compared, and the effect of JOA between the two groups was also compared. Results There was no significant difference in VAS scores before treatment between the two groups （t= 0.6097, P=0.5438）; while the VAS scores significantly decreased after treatment （t=9.6612, t=6.3264, P=0.0000, P= 0.0000）; the VAS score in the treatment group was lower than that in the control group （2.3±1.6） scores vs （3.6±1.8） scores], the difference was statistically significant （t=3.4983, P=-0.0008）. The JOA score was compared between the two groups before treatment, the difference was not statistically significant （t=0.3984, P=-0.6914）; while the JOA scores significantly elevated after treatment （t=17.8938, t=9.4541, P=0.0000, P=0.0000）; the treatment group was higher than the control group （24.6±3.2） scores vs （19.6±4.8） scores], the difference was statistically significant （t=5.6170, P=0.0000）.Compared the serum NGF levels between the two groups before treatment, there was no statistical significance （t=0.5544, P=0.5808）; while after treatment the serum NGF levels in the two groups were significantly higher than those before treatment （t=12.8539, t=7.5551, P=0.0000, P=0.0000）; the treatment group was higher than the control group （51.3±9.5） pg/mL vs （42.4±8.9） pg/mL], the difference was statistically significant （t=4.2317, P=0.0001）. There was no statistical significance in serum SP level before treatment between the two groups （t=0.2782, P=0.7815）; while the serum SP levels of patients in the two groups after treatment significantly decreased than before treatment （t=29.9548, t=23.8197, P=0.0000, P=0.0000）; the treatment group was lower than the control group （242.4±58.9） pg/mL vs （326.2±67.1） pg/mL], the difference was statistically significant （t=6.0827, P=0.0000）. The total effective rate of JOA in the treatment group was higher than that in the control group （95.2% vs 81%）, the difference was statistically significant （χ^2=4.0865, P=0.0432）. Conclusion Comprehensive rehabilitation treatment for sciatica caused by LIDP through a variety of ways, it has significant clinical efficacy.