平乐推按法与射频靶点热凝术治疗腰椎间盘突出症的互补作用

目的:观察平乐推按法与射频靶点热凝术治疗腰椎间盘突出症的互补作用。方法:选择120例经CT、MRI明确诊断为腰椎间盘突出症的患者,随机分为采用平乐推按组(推按组)、射频靶点热凝术组(射频组)和平乐推按组与射频靶点热凝术联合组(联合组),每组40例,推按组采用平乐推按法治疗1周,射频组采用射频靶点热凝术,联合组采用平乐推按法治疗1周后再行射频靶点热凝术。比较各组治疗前、治疗后1个月、3个月疼痛强度评分和临床体征改善情况及疗效。结果:从疼痛数字评分值的变化来看,治疗后1个月推按组、射频组、联合组与治疗前相比均有降低,而联合组更为明显(P<0.01)。治疗后3个月,各组病例的疼痛症状大多数获得控制,以联合组更为明显(P<0.01)。其中推按组、联合组与射频组比较差异均有统计学意义(P<0.05)。治疗后3个月各组临床体征均较治疗前明显改善。其中直腿抬高试验阳性率,联合组与射频组、联合组与推按组相比较差异有统计学意义(P<0.05),推按组与射频组比较差异无统计学意义(P>0.05)。推按组、射频组、联合组的有效率分别是72.5%、75%、87.5%,联合组疗效明显优于推拿组、射频组。结论:平乐推按法具有解除肌肉痉挛,松解神经根粘连;射频靶点热凝术则有消除椎管内外软组织无菌性炎症、改善血供和松解肌肉的作用。两种疗法治疗腰间盘突出症具有良好的互补作用。

Complementary Effect of Pingle Massage and Radiofreqenucy Thermocoagulation in the Treatment of Lumbar Disc Herniation

Objective： To observe the complementary effect of Pingle massage and radiofreqenucy thermocoagulation in the treatment of lumbar disc herniation.Methods：120 patients diagnosed with CT and MRI as lumbar disc herniation were randomly divided into 3 groups： Group A undergoing Pingle massage for one week;group B,radiofreqenucy thermocoagulation;group C undergoing Pingle massage for one week and then radiofreqenucy thermocoagulation.40 cases in each group.The improvement of clinical symptoms was evaluated before the treatment,1month after the treatment,and 3 months after the treatment.Results：1month after the treatment,the pain scores in 3 groups were less than that before the treatment,and it is obvious in group C（P0.01）.3 months after the treatment,all the patients in 3 groups got pain relief which is more obvious in group C（P0.01）.The difference was significant among 3 groups（P0.05）.Obvious improvement of clinical physical sign was observed 3 months after the treatment.As for the positive rate of SLR,there were significant differences between group C and the other two groups（P0.05）,while there was no significant difference between group A and the B（P0.05）.The effective rate in group A,B and C was 72.5%,75% and 87.5% respectively,which was higher in group C than those in the other two groups.Conclusion：Pingle massage may release muscular spasticity and loosen the nerve root adhesion.Radiofreqenucy thermocoagulation can remove the aseptic inflammation,activate the blood circulation and relieve muscle spasm.The two therapies have complementary effect in the treatment of lumbar disc herniation.