[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.
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非手术与微创手术治疗椎间盘源性腰痛的研究进展()
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《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.

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更新日期/Last Update: 1900-01-01