胶原酶髓核化学溶解术配合针刀松解术治疗急性腰椎间盘突出症的疗效观察

目的探讨胶原酶髓核化学溶解术配合针刀松解术治疗急性腰椎间盘突出症的临床疗效。方法将83例急性腰椎间盘突出症患者随机分为2组，其中观察组41例，采用胶原酶髓核化学溶解术配合针刀松解术治疗；对照组42例，采用胶原酶髓核化学溶解术治疗。2组均平均治疗2周，术后2周及术后3个月分别进行近期和随访期疗效观察。结果2组术后近期和随访期疼痛视觉模拟评分（VAS）、口本骨科学会（JOA）症状体征积分及椎间盘突出指数（IDH）均较治疗前改善（P〈0．01）；术后近期2组组间VAS、JOA评分差异有统计学意义（P〈0．01）。观察组近期疗效优良率为85．37％，对照组为58．54％，差异有统计学意义（P〈0．05）；随访期疗效2组组间差异无统计学意义（P〉0．05）。结论采州针川松解术配合胶原酶髓核化学溶解术治疗急性腰椎间盘突出症比单纯胶原酶髓核化学溶解术疗效更好，可迅速缓解疼痛，具有内外兼顾、标本兼治的作用。

Efficacy observation of collagenasechemonucleolysis combined with acupotomy for treatment of acute lumbar intervertbrai disc herniation

Objective To explore the clinical efficacy of collagenase chemonucleolysis comhined with acupotomy for treatment of acute lumbar intervertbral disc herniation （LIDH）. Methods Eighty-three cases of acute LIDtt were randomly divided into two groups. The observation group （41 cases） was treated with collagenase chemonucleolysis combined with acupotomy, while the control group （42 cases） was treated with collagenase chemonucleolysis. Both groups were averagely treated for two weeks, and the efficacy observation of short term and follow-up visit was performed two weeks and three months after the surgery, respectively. Results Compared before the treatment, the VAS, symptom and sign score of JOA and index of disc herniation of short term and follow-up visit were all improved after surgery in both groups （P 〈0. 01 ）. After the surgery, differences of short-term VAS and JOA scores between two groups were statistically significant （P 〈0. 01 ）. The short-term effective rate was 85.37% in the observation group and 58.54% in the control group, which was significantly different （P 〈 0, 05 ）. The clinical efficacy of follow-up visit had no statistical difference between two groups. Conclusion The acupotomy combined with collagenase chemonuclcolysis has better effect for treatment of acute lumbar intervertbrral disc herniation than collagenase chemonucleolysis alone, which could rapidly relieve the pain aml have an effect of resolving symptoms and eliminating root causes.