山东医药2012，Vol.52Issue(16)：21-24,4.
脉络宁硬膜外自控式注射配合手法治疗腰椎间盘突出症
Treatment of lumbar intervertebral disc herniation by patient-controlled epidural analgesia with Mailuoning injection combined with manipulation
摘要
Abstract
Objective To explore the advantages and the effectiveness of patient-controlled epidural analgesia (PCEA) with Mailuoning injection combined with manipulation in treatment of lumbar intervertebral disc hemiation (L1DH). Methods One hundred and fifty-six patients (93 male and 63 female) with LIDH diagnosed and treated in the department of Pain or Orthopedics and Traumatology were selected between July 2008 and March 2010 aged 20-65 years, the course of disease was from 6 to 12 months. All the patients were informed and agreed the treating plans. They were randomly divided into four groups: group TMM (re = 38 ) was treated with traction manipulation massage, group MET (n = 40) with epidural analgesia (EA) with Mailuoning injection combined with traction manipulation massage, group MPT (n = 36) with PCEA with Mailuoning injection combined with traction manipulation massage, group WPT (n =42) with PCEA with western medicine injection combined with traction manipulation massage. One week was used as a treatment course and all the patients accepted for 4 weeks. Vision analog score (VAS) was estimated at the beginning, 1 day after each course and 1 month after 4 courses. The levels of Oswestry disability index (ODI) were also recorded and evaluated at the beginning, the end of the 1st and 3rd month in the study. The excellent rate and total effective rate of all groups were calculated. Measure and count datums were compared by t test and Chi-square test. Results The patients among group MET, MPT and WPT had an obvious decrease of VAS at 1 day after each course and 1 month after 4 courses, there were significantly lower than group TMM (P < 0.01 or P < 0.05). The excellent rate and total effective rate of group MET, MPT and WPT were significantly higher than group TMM (P <0.01 or P < 0.05 ) , but the result of group MPT and WPT were better and more stable (P < 0. 01). No apparent side effect was observed in all patients accepted treatment. Conclusions PCEA with Mailunning injection combined with traction manipulation massage in treatment of LIDH is safe and effective, it can manifestly shorten the course of the disease and decrease the dosage of glucocorticoid. This method is a good alternative to the patients with LIDH who are not benefited from other conservative treatments or afraid of operations.关键词
注射,硬膜外/腰椎间盘突出症/脉络宁/推拿牵引/非手术治疗Key words
injections, epidural/ lumbar intervertebral disc hemiation/ Mailuoning injection/ traction manipulation massage/ non-operative treatment分类
医药卫生引用本文复制引用
李跃兵,涂国卿,肖建英,李晴宇,邹来勇..脉络宁硬膜外自控式注射配合手法治疗腰椎间盘突出症[J].山东医药,2012,52(16):21-24,4.基金项目
江西省重点科技成果推广指导性计划项目(2010ZDS3700). （2010ZDS3700）
