[1]叶晓宇,徐卫星,王润民.非手术与微创手术治疗椎间盘源性腰痛的研究进展[J].中医正骨,2018,30(05):40-42.
点击复制

非手术与微创手术治疗椎间盘源性腰痛的研究进展()
分享到:

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期数:
2018年05期
页码:
40-42
栏目:
综述
出版日期:
2018-05-20

文章信息/Info

作者:
叶晓宇1徐卫星2王润民3
1.浙江中医药大学,浙江 杭州 310053; 2.浙江省立同德医院,浙江 杭州 310012; 3.浙江省乐清市中医院,浙江 乐清 325600
关键词:
腰痛 椎间盘退行性变 外科手术微创性 非手术疗法 综述
文献标志码:
A
摘要:
由椎间盘病变引起的腰痛称为椎间盘源性腰痛,在临床较为常见。减轻或消除疼痛、提高生活质量是椎间盘源性腰痛治疗的最终目的。开放手术由于存在复发率高、并发症较多等问题,在椎间盘源性腰痛治疗中的应用受到限制。临床用于治疗椎间盘源性腰痛的非手术方法包括卧床休息、牵引、针灸、推拿、药物治疗、功能锻炼等,牵引、推拿可以调节脊柱生理曲度、纠正脊柱畸形和关节突关节紊乱,功能锻炼可以增强腰背肌肌力,但病变的髓核并没有被清除,对于病程长、疼痛剧烈的患者,非手术治疗往往难以取得满意的疗效。椎间盘源性腰痛的微创手术方法包括椎间盘减压法、椎间盘内注射法及椎间盘摘除术,这些手术虽然能清除髓核或灭活神经以止痛,但均没有恢复脊柱正常的生理曲度、纠正脊柱畸形和关节突关节紊乱,其远期疗效还有待进一步观察。将非手术疗法和微创手术结合,取长补短,可能会取得更好的疗效。

参考文献/References:

[1] 陈小珍,唐萌芽,倪慧英,等.综合疗法治疗盘源性腰痛的临床疗效观察[J].中医正骨,2014,26(5):46-48.
[2] MOLINOS M,ALMEIDA CR,CALDEIRA J,et al.Inflammation in intervertebral disc degeneration and regeneration[J].J R Soc Interface,2015,12(14):20141191.
[3] KUMAR NS,SHAH SM,TAN BW,et al.Discogenic axial back pain:is there a role for nucleoplasty?[J].Asian Spine J,2013,7(4):314-321.
[4] 林友禧,沈建雄.椎间盘源性腰痛诊治的研究进展[J].中华骨与关节外科杂志,2015,8(6):534-537.
[5] MANCHIKANTI L,HIRSCH JA.An update on the management of chronic lumbar discogenic pain[J].Pain Manag,2015,5(5):373-386.
[6] 文传兵,刘慧.椎间盘内电热疗法新进展[J].实用医院临床杂志,2008,5(1):20-22.
[7] 温鸿源,黄荷,龙洁珍,等.针灸结合悬吊治疗盘源性腰痛的临床疗效观察[J].内蒙古中医药,2016,35(2):119.
[8] 张永锋,张斌,董琪.腹四穴手法为主配合腰腹肌功能锻炼治疗椎间盘源性腰痛的临床观察[J].中国中医急症,2017,26(10):1828-1831.
[9] 范玉江,陈霞.骶管阻滞结合蜡疗治疗椎间盘源性腰痛疗效观察[J].新疆中医药,2017,35(4):35-37.
[10] HART L.Exercise therapy for nonspecific low-back pain:a meta-analysis[J].Clin J Sport Med,2006,16(2):189-190.
[11] 胡居正,徐友高,杨智贤.经皮半导体激光椎间盘减压术治疗椎间盘源性下腰痛50例的疗效观察[J].广西医学,2008,30(5):718-719.
[12] 胡居正.经皮半导体激光椎间盘减压术治疗盘源性下腰痛对腰椎稳定性的影响[J].内蒙古中医药,2012,31(7):10-11.
[13] MUTO M,ANDREULA C,LEONARDI M.Treatment of herniated lumbar disc by intradiscal and intraforaminal oxygen-ozone(O2-O3)injection[J].J Neuroradiol,2004,31(3):183-189.
[14] 李中锋,邓强,张彦军,等.经皮激光汽化术加臭氧配合牵引治疗腰椎间盘突出症[J].中国中医骨伤科杂志,2015,23(2):11-14.
[15] 王发凤,黄海,赵焰.臭氧溶盘术治疗盘源性下腰痛的疗效观察[J].中国中医骨伤科杂志,2016,24(7):63-64.
[16] 陈爱民,李荣春.腰椎间盘内注射O3治疗盘源性下腰痛58例报告[J].中医正骨,2008,20(2):40.
[17] 胡湘玉,倪家骧.低温等离子以纤维环为靶点射频消融治疗盘源性腰痛手术的研究[J].医药论坛杂志,2016,37(1):81-82.
[18] 徐天同,夏英鹏,田融.低温等离子体髓核成型术治疗间盘源性下腰痛的研究现状[J].医学综述,2009,15(11):1666-1668.
[19] 何杰勇.等离子射频消融术治疗椎间盘源性腰痛患者的临床效果[J].医学信息,2015,28(8):322.
[20] 吴叶,侯树勋,吴闻文,等.射频消融髓核成型术治疗盘源性腰痛疗效观察[J].中国疼痛医学杂志,2006,12(3):135-137.
[21] 柳晨,袁慧书.椎间盘内电热疗法治疗下腰痛的研究进展[J].中国医刊,2010,45(6):21-22.
[22] SAAL JS,SAAL JA.Management of chronic discogenic low back pain with a thermal intradiscal catheter.A preliminary report[J].Spine(Phila Pa 1976),2000,25(3):382-388.
[23] 陈志瑾,张丽云,陆炯,等.椎间盘内电热疗法治疗盘源性腰痛的疗效[J].中国介入影像与治疗学,2014,11(11):717-720.
[24] SALAH M,SAMY N,FADEL M.Methylene blue mediated photodynamic therapy for resistant plaque psoriasis[J].J Drugs Dermatol,2009,8(1):42-49.
[25] 唐国柯,黄庆华,张朝跃.椎间盘内亚甲蓝与臭氧注射治疗盘源性腰痛的对照研究[J].湖南中医药大学学报,2012,32(12):39-40.
[26] 刘丰平,赵红卫,陈海丹.微创手术治疗椎间盘源性腰痛临床应用进展[J].实用医学杂志,2014,30(8):1179-1181.
[27] 庄澄宇,曹鹏,郑涛,等.盘内注射治疗伴终板Modic改变的退行性慢性盘源性腰痛[J].中华医学杂志,2009,89(35):2490-2494.
[28] 王星宇,谢水华,骆云鹏.经皮椎间孔镜技术在腰椎病变中的应用和进展[J].医学诊断,2016,6(2):47-53.
[29] 陈远明,王建,周跃,等.经皮椎间孔镜下腰椎间盘切除术治疗下腰痛[J].中国内镜杂志,2012,18(2):184-187.
[30] 牛玉珍,杨吉风,李功伟,等.盘源性腰痛的诊断及治疗方法的选择[J].实用骨科杂志,2016,22(12):1112-1115.

相似文献/References:

[1]宁兴明,伍亮,王廷,等.五禽戏配合核心肌力训练治疗非特异性腰痛的临床研究[J].中医正骨,2015,27(11):25.
 NING Xingming,WU Liang,WANG Ting,et al.Clinical study on five mimic-animal boxing combined with core muscular strength exercise for the treatment of nonspecific low back pain[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(05):25.
[2]王仁灿,黄炎洪,潘伟江,等.45°肩踝悬吊牵引下撞击腰椎疗法治疗L5S1椎间盘突出症[J].中医正骨,2015,27(08):51.
[3]金立昆,齐越峰,唐可,等.中药离子导入联合腰背部功能锻炼治疗 非特异性腰痛的临床研究[J].中医正骨,2016,28(01):20.
 JIN Likun,QI Yuefeng,TANG Ke,et al.Clinical study on iontophoresis of traditional Chinese medicine combined with lower back functional exercise for treatment of non-specific low back pain[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(05):20.
[4]杨勇,王雷生,张娟.经椎关节突关节温针治疗腰椎关节突关节源性腰痛[J].中医正骨,2016,28(02):67.
[5]袁启令,刘亮,马江涛,等.针刺治疗慢性非特异性腰痛的临床研究[J].中医正骨,2016,28(06):12.
 YUAN Qiling,LIU Liang,MA Jiangtao,et al.A clinical study of acupuncture therapy for treatment of chronic nonspecific low back pain[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(05):12.
[6]王栋,潘浩,朱杭,等.强筋壮骨祛风合剂对髓核致炎大鼠背根神经节中3型酸敏感离子通道的影响[J].中医正骨,2017,29(01):18.
 WANG Dong,PAN Hao,ZHU Hang,et al.Effect of Qiangjin Zhuanggu Qufeng Heji on acid-sensing ion channel 3 of dorsal root ganglia in rats with inflammation caused by nucleus pulposus[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(05):18.
[7]刘艳,谢新立,杜彪,等.SPECT全身骨显像在儿童和青少年腰痛诊断中的价值[J].中医正骨,2017,29(04):42.
[8]吴婷婷,杨京辉,汪亚群,等.针刺联合太极拳训练治疗慢性非特异性腰痛的临床研究[J].中医正骨,2017,29(06):32.
 WU Tingting,YANG Jinghui,WANG Yaqun,et al.Clinical study on acupuncture therapy combined with Taijiquan(太极拳)exercise for treatment of chronic nonspecific low back pain[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(05):32.
[9]熊国星,王鑫,程元辉,等.动推疗法与单纯推拿疗法治疗慢性非特异性腰痛的近期疗效对比研究[J].中医正骨,2017,29(11):33.
 XIONG Guoxing,WANG Xin,CHENG Yuanhui,et al.A comparative study of short-term clinical curative effect of massage during exercise versus monotherapy of TUINA for treatment of chronic nonspecific low back pain[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(05):33.
[10]李展新,刘建航,李锦威,等.韦氏脊柱整治手法结合核心肌群训练治疗非职业高尔夫运动者非特异性腰痛[J].中医正骨,2018,30(04):13.
 LI Zhanxin,LIU Jianhang,LI Jinwei,et al.Wei's spinal remediation manipulation combined with core muscle training for treatment of nonspecific low back pain in non-professional golfers[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(05):13.
[11]李记天,马言,罗漫丽.淫羊藿苷干预大鼠椎间盘源性腰痛的实验研究[J].中医正骨,2020,32(03):7.
 LI Jitian,MA Yan,LUO Manli.An experimental study of icariin for intervention of discogenic low back pain in rats[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2020,32(05):7.

更新日期/Last Update: 1900-01-01