针刀筋膜松解术联合局部封闭治疗腰3横突综合征临床研究

目的]观察针刀筋膜松解术联合局部封闭治疗腰3横突综合征的临床疗效。方法]选取2018年3月至2019年7月于中国中医科学院望京医院骨科门诊就诊的腰3横突综合征患者50例,随机分为治疗组(针刀筋膜松解术联合局部封闭治疗)和对照组(单用局部封闭治疗),每组各25例。两组分别于术前、术后3d及术后2周观察比较患者疼痛视觉模拟评分(visual analogue scale,VAS)以及Oswestry功能障碍指数(Oswestry disability index,ODI),并评定其ODI有效率。结果]术前、术后3d及术后2周两组患者VAS评分逐渐降低且组内比较差异均有统计学意义(P<0.01);治疗组术前、术后3d及术后2周ODI逐渐降低且组内比较差异有统计学意义(P<0.01),而对照组不同时点间比较差异无统计学意义(P>0.05);治疗组患者术后2周VAS评分和ODI均低于对照组,差异具有统计学意义(P<0.05),其余时间点组间比较差异均无统计学意义(P>0.05)。治疗组ODI有效率为92.00%,高于对照组ODI有效率68.00%,差异具有统计学意义(P<0.05)。结论]在改善腰3横突综合征患者疼痛程度及腰椎活动功能方面,针刀筋膜松解术联合局部封闭比单用局部封闭的疗效优势更加明显。

Needle-knife Fascial Release Combined with Local Block in Treatment of Third Lumbar Transverse Process Syndrome

Objective]To observe the clinical effect of needle-knife fascial release combined with local block in treatment of third lumbar transverse process syndrome.Methods]Fifty patients with third lumbar transverse process syndrome from March 2018 to July 2019 treated in Outpatient Department of Orthopaedics,Wangjing Hospital of China Academy of Chinese Medical Science,were randomly divided into treatment group(needle-knife fascial release combined with local block)and control group(local block alone),with 25 cases in each group.The visual analogue scale(VAS)score and Oswestry disability index(ODI)were observed before operation,3 days and 2 weeks after operation respectively,and the ODI effective rate was compared.Results]The VAS score of the two groups decreased gradually from before operation,to 3 days and 2 weeks after operation,and there was statistical difference within the two groups(P<0.01).The ODI of treatment group decreased gradually from before operation,to 3 days and 2 weeks after operation,and there was statistical difference within the two groups(P<0.01),but there was no statistical difference in control group(P>0.05).The VAS score and ODI of treatment group were lower than those of control group at 2 weeks after operation,the difference was statistically significant(P<0.05).There was no significant difference among the other time points(P>0.05).The ODI effective rate of treatment group was 92.00%,higher than 68.00%of control group,the difference was statistically significant(P<0.05).Conclusion]Needle-knife fascial release combined with local block is more effective than local block alone in alleviating pain and improving lumbar function of third lumbar transverse process syndrome.