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射频热凝联合脉冲射频治疗腰椎间盘突出症的疗效及对血清抗炎因子水平的影响 预览

Effect of radiofrequency thermocoagulation combined with pulsed radiofrequency on lumbar disc herniation and its effect on serum anti-inflammatory cytokines
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摘要 目的观察射频热凝联合脉冲射频治疗腰椎间盘突出症的临床效果及对血清白细胞介素4(interleukin-4,IL-4)、IL-10水平的影响。方法选取2014年7月至2017年12月武汉科技大学附属汉阳医院收治的腰椎间盘突出症患者60例,采用随机数字表法随机分为对照组和观察组,每组30例。对照组单纯给予椎间盘射频热凝靶点消融术治疗,观察组给予椎间盘射频热凝靶点消融联合椎间孔脊神经脉冲射频术治疗。分别于治疗前及治疗后7d、3个月、12个月对两组患者进行疼痛视觉模拟量表(visual analoguescale,VAS)评分、日本骨科学会(JapaneseOrthopaedicAssociation,JOA)评分,同时测定患者血清IL-4、IL-10水平,并于治疗后7d、3个月、12个月对两组患者进行Macnab疗效评价。结果两组患者治疗前VAS评分、JOA评分比较差异均无显著性(P>0.05)。两组治疗后VAS评分均明显低于治疗前,且术后3个月、12个月时观察组明显低于对照组,差异有显著性(P<0.05);两组治疗后JOA评分均明显高于治疗前,且术后3个月、12个月时观察组明显高于对照组,差异有显著性(P<0.05)。Macnab疗效评价显示两组治疗后3个月、12个月疗效明显优于治疗后7d,且观察组明显优于对照组,差异均有显著性(P<0.05)。两组治疗前血清IL-4、IL-10水平比较差异无显著性(P>0.05),治疗后两组血清IL-4、IL-10水平均明显高于治疗前,且治疗后3个月、12个月时观察组明显高于对照组,差异均有显著性(P<0.05)。结论射频热凝联合脉冲射频治疗腰椎间盘突出症临床疗效肯定,并可减轻炎症反应,值得临床应用。 Objective To observe the effect of radiofrequency thermocoagulation combined with pulsed radiofrequency therapy on lumbar disc herniation(LDH) and the impacts on serum concentrations of interleukin-4(IL-4) and interleukin-10(IL-10). Method From July 2014 to December 2017, Sixty patients of LDH were recruited in Hanyang Hospital Affiliated to Wuhan University of Science and Technology, and were randomized into two groups, thirty patients in each group. The patients in control group only received the therapy of radiofrequency thermocoagulation and target ablation of intervertebral disc, and the patients in observation group received the combination of the treatment in control group and foraminal nerve pulsed radiofrequency therapy. Before treatment and 7 days after treatment(7 th day), 3 months after treatment(3 rd month), 12 months after treatment(12 th month), two groups of VAS score and JOA score were performed respectively, while patients with serum IL-4, IL-10 level was determined, and Macnab efficacy was evaluated in both groups at 7 th day, 3 rd month and 12 th month. Result Before treatment, there was no significant difference in VAS score and JOA score between the two groups(P>0.05). After treatment, VAS scores of the two groups were significantly lower than those before treatment, and VAS scores of the observation group were significantly lower than those of the control group at 3 rd month and 12 th month, with significant differences(P<0.05);JOA scores of the two groups were significantly higher than those before treatment, and JOA scores of the observation group were significantly higher than those of the control group at 3 rd month and 12 th month, with significant differences(P<0.05).The efficacy evaluation of Macnab showed that the efficacy of the two groups at 3 th month and 12 th month was significantly better than that at 7 th day, and the observation group was significantly better than the control group, with significant differences(P<0.05). There was no significant difference in serum IL-4 and I
作者 李凌霄 李熳 方勇 LI Ling-xiao;LI Man;FANG Yong(Department of Traditional Chinese Medicine,Hanyang Hospital Affiliated to Wuhan University of Science and Technology,Hubei Wuhan 430050,China;School of Basic Medicine,Tongji Medical College of Huazhong University of Science and Technology,Hubei Wuhan 430030,China)
出处 《中国医刊》 CAS 2020年第1期52-56,共5页 Chinese Journal of Medicine
基金 国家自然科学基金面上项目(81674057) 武汉市卫生计生委科研项目(WX15C05)。
关键词 腰椎间盘突出症 白细胞介素 射频热凝 脉冲射频 Lumbar disc herniation Interleukins Radiofrequency thermocoagulation Pulsed radiofrequency
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