神经根脉冲射频对腰椎间盘突出症术后残余神经痛的影响

Effect of nerve root pulsed radiofrequency on residual neuralgia after operation for lumbar disc herniation

  • 摘要:
    目的 探讨神经根脉冲射频对腰椎间盘突出症(LDH)术后残余神经痛及患者血清白细胞介素-1(IL-1)、白细胞介素-8(IL-8)、肿瘤坏死因子α(TNF-α)水平的影响。
    方法 选取LDH术后残余神经痛患者80例, 采用随机数字表法分为传统组和研究组, 每组40例。传统组给予传统治疗方式, 研究组给予神经根脉冲射频治疗。比较2组患者血清IL-1、IL-8、TNF-α水平, 疼痛情况视觉模拟评分法(VAS)、腰椎功能日本矫形外科腰痛评分(JOA)及临床疗效。
    结果 治疗前及治疗后1、3、6个月, 2组血清IL-1、IL-8、TNF-α水平逐渐降低, 且研究组治疗后6个月血清IL-1、TNF-α水平低于传统组, 差异有统计学意义(P < 0.05); 与治疗前比较, 2组治疗后1、3、6个月VAS评分均降低, 且研究组治疗后6个月VAS评分低于传统组, 差异有统计学意义(P < 0.05)。治疗前, 研究组和传统组JOA评分分别为(13.15±1.58)、(13.73±1.75)分; 治疗后3、6个月, 研究组JOA评分分别为(17.13±2.14)、(20.12±2.67)分, 传统组分别为(15.28±1.89)、(18.78±2.15)分, 研究组JOA评分均高于传统组, 差异有统计学意义(P < 0.05)。研究组总有效率为92.50%, 传统组为70.00%, 差异有统计学意义(P < 0.05)。
    结论 神经根脉冲射频用于LDH术后残余神经痛患者可有效减轻疼痛, 提高腰椎功能, 降低血清IL-1、IL-8、TNF-α水平, 减轻炎症反应。

     

    Abstract:
    Objective To explore the effect of nerve root pulse radiofrequency on postoperative residual neuralgia and levels of serum interleukin-1 (IL-1), interleukin-8 (IL-8) and tumor necrosis factor-α (TNF-α) in patients with lumbar disc herniation (LDH).
    Methods A total of 80 LDH patients with postoperative residual neuralgia were selected and randomly divided into traditional group and study group, with 40 cases in each group. The traditional group was given traditional therapy, while the study group was treated with nerve root pulse radiofrequency. The levels of serum IL-1, IL-8 and TNF-α, the condition of painevaluated by the Visual Analogue Scale (VAS), lumbar functionevaluated by the Japanese Orthopedic Association (JOA) Scores and clinical efficacy were compared between the two groups.
    Results At the time points of before treatment and 1 month, 3 and 6 months after treatment, the levels of serum IL-1, IL-8 and TNF-α in both groups decreased gradually, and the levels of serum IL-1 and TNF-α at 6 months after treatment in the study group were significantly lower than those in the traditional group (P < 0.05); compared with the VAS score before treatment, the VAS scores at 1 month, 3 and 6 months after treatment in both groups decreased, and the VAS score at 6 months after treatment in the study group was significantly lower than that in the traditional group (P < 0.05). Before treatment, the JOA scores in the study group and the traditional group were (13.15±1.58) and (13.73±1.75) respectively; at 3 and 6 months after treatment, the JOA scores were (17.13±2.14) and (20.12±2.67) respectively in the study group and (15.28±1.89) and (18.78±2.15) respectively in the traditional group, and the JOA scores in the study group were significantly higher than those in the traditional group (P < 0.05). The total effective rate of the study group was 92.50%, which was significantly higher than 70.00% of the traditional group (P < 0.05).
    Conclusion For the LDH patients with postoperative residual neuralgia, nerve root pulse radiofrequency can effectively reduce degree of pain, improve lumbar function, reduce levels of serum IL-1, IL-8 and TNF-α, and alleviate inflammatory reaction.

     

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