Abstract:

Objective　To explore the effect of targeted radiofrequency thermocoagulation combined with core muscle training in the treatment of patients with lumbar disc herniation. Methods　A total of 92 patients with lumbar disc herniation admitted to Department of Orthopedics and Traumatology of Traditional Chinese Medicine, Xuzhou First People's Hospital from January 2021 to January 2023 were selected for the randomized controlled trial, and were divided into an observation group and a control group, with 46 cases in each group. There were 25 males and 21 females in the observation group; they were (42.23±10.57) years old; their disease course was (36.24±11.71) months. There were 28 males and 18 females in the control group; they were (43.37±9.82) years old; their disease course was (38.58±12.39) months. The control group took targeted radiofrequency thermocoagulation, and the observation group took targeted radiofrequency thermocoagulation and did core muscle training. The pain degrees [Visual Analog Scale (VAS)], lumbar function, therapeutic effects, and incidences of complications were compared between the two groups. The enumeration data were analyzed by the χ² test; the measurement data conforming to normal distribution were analyzed by repeated measurement ANOVA and SNK-q test. Results　There were statistical differences in the scores of VAS and lumbar function between the two groups (F_{between groups}=5.236, F_time=6.025, F_interaction=5.842; F_{between groups}=12.364, F_time=11.482, F_interaction=14.217; all P<0.05). Seven days and 1, 3, and 6 months after the treatment, the scores of VAS and lumbar function in the observation group were lower than those in the control group [(4.02±1.46) vs. (4.76±1.78), (3.22±1.34) vs. (3.85±1.55), (2.21±1.11) vs. (2.74±1.37), and (1.03±0.42) vs. (1.65±0.69);(25.21±7.31) vs. (28.34±7.65), (15.37±6.85) vs. (18.35±7.42), (10.05±5.32) vs. (12.65±6.51), and (5.53±3.64) vs. (7.45±3.87)], with statistical differences (all P<0.05). The scores of VAS and lumber function were lower 7 d and 1, 3, and 6 months after than before the treatment in both groups (all P<0.05). The excellent and good rates 1, 3 and 6 months after the treatment in the observation group were higher than those in the control group [69.57% (32/46) vs. 45.65% (21/46), 82.61% (38/46) vs. 63.04% (29/46), and 93.48% (43/46) vs. 73.91% (34/46)], with statistical differences (χ²=5.386, 4.449, and 6.452; all P<0.05). After the treatment, the incidence of complications in the observation group was lower than that in the control group [6.52% (3/46) vs. 21.74% (10/46)], with a statistical difference (χ²=4.389; P=0.036). Conclusion　Targeted radiofrequency thermocoagulation combined with core muscle training for patients with lumbar disc herniation can relieve their pain, improve their lumbar function, and reduce the occurrence of complications, with significant therapeutic effect.

Key words:

Target radiofrequency thermocoagulation, Core muscle training, Lumbar disc herniation, Effect

摘要：

目的　探究靶点射频热凝术联合核心肌群训练治疗腰椎间盘突出患者的效果。方法　本研究为随机对照试验，选取2021年1月至2023年1月徐州市第一人民医院中医骨伤科收治的92例腰椎间盘突出患者作为研究对象，按照随机数字表法分为观察组（46例）和对照组（46例）。观察组男25例、女21例，年龄（42.23±10.57）岁，病程（36.24±11.71）个月；对照组男28例、女18例，年龄（43.37±9.82）岁，病程（38.58±12.39）个月。对照组采用靶点射频热凝术治疗，观察组采用靶点射频热凝术联合核心肌群训练治疗。对比两组患者疼痛程度［视觉模拟评分法（VAS）］、腰椎功能情况、治疗效果以及并发症发生情况。计数资料行χ²检验，符合正态分布计量资料采用重复测量方差分析，行SNK-q检验。结果　两组患者的VAS评分及腰椎功能情况组间、时间、交互比较，差异均有统计学意义（F_组间=5.236，F_时间=6.025，F_交互=5.842；F_组间=12.364，F_时间=11.482，F_交互=14.217，均P<0.05）；组间比较，治疗后7 d、1个月、3个月、6个月，观察组患者的VAS评分［（4.02±1.46）分、（3.22±1.34）分、（2.21±1.11）分、（1.03±0.42）分］及腰椎功能评分［（25.21±7.31）分、（15.37±6.85）分、（10.05±5.32）分、（5.53±3.64）分］均低于对照组［（4.76±1.78）分、（3.85±1.55）分、（2.74±1.37）分、（1.65±0.69）分及（28.34±7.65）分、（18.35±7.42）分、（12.65±6.51）分、（7.45±3.87）分］，差异均有统计学意义（均P<0.05）；组内比较，治疗后7 d、1个月、3个月、6个月，两组患者的VAS评分及腰椎功能评分均逐渐降低（均P<0.05）。治疗后1个月、3个月、6个月，观察组优良率为69.57%（32/46）、82.61%（38/46）、93.48%（43/46），均高于对照组［45.65%（21/46）、63.04%（29/46）、73.91%（34/46）］，差异均有统计学意义（χ²=5.386、4.449、6.452，均P<0.05）。观察组治疗后并发症发生率为6.52%（3/46），低于对照组的21.74%（10/46），差异有统计学意义（χ²=4.389，P=0.036）。结论　靶点射频热凝术联合核心肌群训练可以减轻腰椎间盘突出患者疼痛，改善腰椎功能，减少并发症的发生，治疗效果显著。

关键词:

靶点射频热凝术, 核心肌群训练, 腰椎间盘突出, 效果