目的: 观察PLDD联合银质针治疗腰椎间盘突出症(LDH)放射性腰腿痛疗效。方法: 符合标准LDH患者50例,将所有患者随机分为治疗组和对照组各25例。对照组采用单纯PLDD治疗,治疗组采用PLDD联合银质针治疗。采用VAS评分、ODI腰椎功能评分分别评估两组患者术前、术后1周、1月、2月、6月的疼痛缓解情况及腰椎功能改善情况,采用改良的MacNab疗效评价标准评价患者术后2月、6月的临床疗效。结果: 两组患者基线资料及术前VAS评分、ODI评分比较,差异无统计学意义(P＞0.05); VAS评分比较,两组患者术后各时间点与术前比较,差异均有统计学意义(P＜0.05); 治疗组术后1周、1月的VAS评分优于对照组,差异显著(P＜0.05)。两组患者术后各时间点ODI腰椎功能评分与术前比较,差异均有统计学意义(P＜0.05); 治疗组术后1周、1月、2月的ODI评分明显优于对照组,差异有统计学意义(P＜0.05)。两组患者分别于治疗后2月、6月运用改良MacNab疗效评价标准疗效评价结果比较。治疗组术后2月、术后6月优良率均为96%,优于对照组术后2月优良率80%,同样也优于对照组术后6月优良率92%(P＜0.05); 治疗组术后2月、术后6月有效率均为100%,优于对照组术后2月有效率96%,同样也优于对照组术后6月有效率96%(P＜0.05)。对照组术后2月优良率80%,低于术后6月优良率92%(P＜0.05)。治疗组与对照组术后2月、术后6月有效率无明显差异(P＞0.05)。结论: PLDD联合银质针治疗LDH放射性腰腿痛短期内能够有效缓解疼痛、麻木等临床症状,并且能够为突出髓核的逐渐回缩提供有利环境,值得临床推广应用。

Objective: To observe the clinical efficacy of percutaneous laser disc decompression(PLDD) combined with silver needle for the treatment of radioactive lumbocrural pain of lumbar disc herniation (LDH). Method: 50 patients with standard LDH were enrolled. All patients were randomly divided into treatment group and control group, 25 cases each. The control group was treated with PLDD alone, and the treatment group was treated with PLDD combined with silver needle. VAS score and ODI lumbar function score were used to evaluate the pain relief and lumbar function improvement of the two groups preoperative and postoperative at 1 week, 1 month, 2 months and 6 months. The modified MacNab efficacy evaluation criteria were used to evaluate the clinical efficacy of the patients at 2 months and 6 months after operation. Results: Two groups of patients in baseline data and preoperative VAS scores and ODI scores, the difference was not statistically significant (P＞0.05). The compare of VAS scores between the two groups at the time points preoperative and postoperative, the difference was statistically significant (P＜0.05). The treatment group postoperative 1 week, 1 month VAS scores were better than the control group, the difference was statistically significant (P＜0.05). The compare of ODI lumbar function scores between the two groups at the time points preoperative and postoperative, the difference was statistically significant (P＜0.05). The treatment group postoperative 1 week, 1 month and 2 months ODI scores were significantly better than the control group, the difference was statistically significant (P＜0.05). Two groups of patients after the treatment respectively in 2 months, 6 months by using the modified MacNab evaluation standard of curative effect evaluation curative effect comparison, treatment group postoperative 2 months, 6 months, the excellent rate was 96%, which was better than the control group postoperative 2 months excellent rate 80%, also better than the control group postoperative 6 months excellent rate 92% (P＜0.05). The treatment group postoperative 2 months, 6 months, the effective rate was 100%, which was better the control group postoperative 2 months effective rate 96%, also better than the control group postoperative 6 months effective rate 96% (P＜0.05). The control group postoperative 2 months excellent rate 80% was lower than postoperative 6 months excellent rate 92% (P＜0.05). There was no significant difference in the efficiency between the treatment group and the control group postoperative 2 months, 6 months (P＞0.05). Conclusion: PLDD combined with silver needle treatment of radioactive lumbocrural pain of lumbar dise herniation can effectively relieve the pain, numbness and other clinical symptoms in short term, and can provide a favorable environment for the gradual retraction of prominent nucleus, which is worthy of clinical promotion and application.