| Lumbar disc herniation is a common clinical disease,manifesting as low back pain and sciatic nerve pain.It seriously affects the patient’s daily life.In recent years,the factors of the incidence of lumbar disc herniation was significantly increased,and it has become a serious threat to public health.A variety of treatment of lumbar inter disc herniation methods such as low back muscle exercise,oral non steroidal anti-inflammatory analgesic drugs,traditional Chinese medicine massage,acupuncture and moxibustion and surgery,have been put to use,but the effect is not satisfactory,can not completely relieve the patient’s pain.ObjectiveThrough the four kinds of method such as oral NSAIDs drugs and lumbar traction,Chinese medicine rehabilitation therapy,lumbar intervertebral disc ozone injection,lumbar intervertebral disc ozone injection combined with traditional Chinese medicine rehabilitation therapy in the treatment of lumbar disc herniation associated lumbocrural pain efficacy evaluation and comparison,in order to explore actual effect of ozone injection in the treatment of lumbar disc herniation and which method had the best effect.MethodsSingle blind randomized controlled trial design was used.From October 2013 to August2015,200 patients with lumbar disc herniation affiliated to department of rehabilitation,the Jiangjin District Central Hospital of Chongqing Municipal were randomly divided into four groups: A,B,C and D,50 cases in each group.The patients in group A were treated with oral NSAIDs drugs and lumbar traction,patients of group B were cured by traditional Acupuncture and Chinese medicine orthopaedic rehabilitation therapy,group C were injectd with lumbar intervertebral disc ozone combined with traditional Acupuncture and Chinese medicine orthopaedic rehabilitation therapy,group D were used only lumbar intervertebral disc ozone injection.After treatment of 1week,2 weeks,30 days,60 days and 90 days,and at the last follow-up the functional recovery and pain relief of patients were evaluated.according to pain visual analogue scale(VAS)score and Oswestry disability index(Oswestry disability index(ODI),Japanese Orthopaedic Association and the Japanese Orthopaedic Association(JOA)score.Before and after treatment,the count data were measured byχ2 test,and the t test was used in the measurement.Results1.In group A,group B,group C and group D after a week of treatment,low back pain VAS score were 6.22 + 1.36 points,611 + 1.27 points,5.36 + 1.24 points and 5.95 + 1.60 points.The low back pain VAS score in group A and group C,group B and group C,group C and D group compared with had statistically significant difference(P < 0.05),score of group C were evidently lower than those in other groups.In group A,group B,group C and group D after two weeks of treatment,low back pain VAS score were 5.19±1.50 points,5.02±1.43 points,4.26±1.34 points and 4.75±1.38 points.The low back pain VAS score in group A and group C,group B and group C compared with had statistically significant difference(P < 0.05),score of group C were evidently lower than those in other groups.In group A,group B,group C and D group treatment after 30 days of low back pain VAS score were 4.55 + 1.16 points,4.30 +1.04 points,3.64 +0.85% and 3.99 + 0.97,the low back pain VAS score in group A and group C,group A and group D,group B and group C compared with had statistically significant difference(P < 0.05).The scores of group C were significantly lower than those in other groups.In group A,group B,group C and group D after 60 days of treatment,the low back pain VAS score were 2.94±1.41 points,2.73±1.27 points,1.96±1.15 points and 2.35±1.19 points.The low back pain VAS score in group A and group C,group B and group C compared with had statistically significant difference(P < 0.05),score of group C were evidently lower than those in other groups.In group A,group B,group C and D group treatment after 90 days of low back pain VAS score were 1.96 + 0.84 points,2.05 + 0.86 points,138 + 0.77 points and 1.69 + 0.81 points,the low back pain VAS score ingroup A and group C,group B and group C compared with statistically had significant difference(P < 0.05).The score of group C were obviously lower than those in other groups.2.In group A,group B,group C and D group treatment after 1 week of low back pain VAS score were 6.35±2.32,6.23±2.17 points,4.62±1.70 points and 5.78±1.89 points,the Skelalgia VAS score in group A and group C,group B and group C,group C and group D compared with statistically had significant difference(P < 0.05).The score of group C were obviously lower than those in other groups.In group A,group B,group C and D group treatment after 2 weeks of leg pain VAS score were 3.57±1.05,3.75±1.02 points,3.01±0.88 points and 3.46±1.01 points,the Skelalgia VAS score in group A and group C,group B and group C,group C and group D compared with statistically had significant difference(P < 0.05).The score of group C were obviously lower than those in other groups.In group A,group B,group C and D group treatment after 30 days of leg pain VAS score were 3.41 + 1.03 points,3.23±0.91 points,2.62±0.80 points and 2.93±0.88 points,the Skelalgia VAS score in group A and group C,group B and group C,group A and group D compared with statistically had significant difference(P < 0.05).The score of group C were obviously lower than those in other groups.In group A,group B,group C and D group treatment after 60 days of leg pain VAS score were 2.80 ±0.93 points,2.67±0.85 points,2.11±0.75 points and 2.44±0.89 points,the leg pain VAS score in group A and group C,group B and group C compared with statistically had significant difference(P < 0.05),the score of group C were evidently lower than those in other groups.In group A,group B,group C and D group treatment after 90 days of leg pain VAS score were 1.59±0.74 points,1.64±0.78 points,1.25±0.63 points and 1.51±0.67 points,the leg pain VAS score in group A and group C,group B and group C compared with statistically had significant difference(P < 0.05),the score of group C were evidently lower than those in other groups.3.In group A,group B,group C and group d after treatment of nerve root edema score were respectively 2.71±1.54 points,2.55±1.42 points,1.88±0.76 points and 1.51±0.67 points,thenerve root edema scores in group A and group C,group B and group C compared with had statistically significant difference(P < 0.05),the score of group C was obviously lower than that of the other groups.In group A,group B,group C and group d after treatment of FAM joint activities score were respectively 4.53±1.75 points,5.28±1.86 points,6.20±2.18 points and 5.79±1.95 points,the FAM joint activities scores in group A and group C,group B and group C compared with had statistically significant difference(P < 0.05),the score of group C was obviously lower than that of the other groups.4.Accounted to MacNab backleg pain efficacy evaluation after 30 days of treatment,16 cases were excellent,20 cases were benign,6 cases were fair and 8 cases poor in group A,17 cases were excellent,19 cases were good,5 cases were fair and 9 cases poor in group B,26 cases were excellent,20 cases were benign,3 cases can and 1 case poor in group C,21 cases were excellent,19 cases were benign,7 cases were fair,3 cases were difference in group D.The MacNab lumbocrural pain curative effect evaluation of group C was better than the other 3 groups(P<0.05),the curative effect of D group was better than that of A group and B group.Accounted to MacNab backleg pain efficacy evaluation after 60 days of treatment,15 cases were excellent,18 cases were benign,8 cases were fair and 9 cases poor in group A,14 cases were excellent,19 cases were good,10 cases were fair and 7 cases poor in group B,26 cases were excellent,17 cases were benign,4 cases can and 3 case poor in group C,18 cases were excellent,21 cases were benign,7cases were fair,4 cases were difference in group D.The MacNab lumbocrural pain curative effect evaluation of group C was better than the other 3 groups(P<0.05),the curative effect of D group was better than that of A group and B group.Accounted to MacNab backleg pain efficacy evaluation after 90 days of treatment,11 cases were excellent,12 cases were benign,18 cases were fair and 19 cases poor in group A,12 cases were excellent,10 cases were good,15 cases were fair and 13 cases poor in group B,21 cases were excellent,14 cases were benign,9 cases can and 6 case poor in group C,15 cases were excellent,16 cases were benign,10 cases were fair,9cases were difference in group D.The MacNab lumbocrural pain curative effect evaluation of group C was better than the other 3 groups(P<0.05).Accounted to MacNab backleg pain efficacy evaluation at the last follow-up,10 cases were excellent,13 cases were benign,15 cases were fair and 12 cases poor in group A,11 cases were excellent,9 cases were good,16 cases were fair and14 cases poor in group B,18 cases were excellent,16 cases were benign,10 cases can and 6 case poor in group C,14 cases were excellent,17 cases were benign,10 cases were fair,9 cases were poor in group D.The MacNab lumbocrural pain curative effect evaluation of group C was better than the other 3 groups(P<0.05).5.In group A,group B,group C and D group after 30 days treatment,the Oswestry disability index(ODI)score were respectively 52.38±10.36 points,55.27±10.48 points,47.34±10.32 points and 48.56±10.35 points,the ODI score in group A and group C,group B and group D,group B and group C compared with statistically had significant difference(P < 0.05).In group A,group B,group C and D group after 60 days treatment,the Oswestry disability index(ODI)score were respectively 49.37±9.88 points,47.39±9.67 points,40.11±7.64 points and 48.56±10.35 points,the ODI score in group A and group C,group C and group D,group C and group B compared with statistically had significant difference(P < 0.05).The score of group C were obviously lower than those in other groups.In group A,group B,group C and D group after 90 days treatment,the Oswestry disability index(ODI)score were respectively 36.40±5.71 points,35.79±4.43 points,29.16±5.25 points and 34.29±4.20 points,the ODI score in group A and group C,group C and group D,group C and group B compared with statistically had significant difference(P < 0.05).The score of group C were obviously lower than those in other groups.In group A,group B,group C and D group at the last follow-up,the Oswestry disability index(ODI)score were respectively 35.43±14.91 points,33.56±12.51 points,26.28±12.20 points and 29.45±12.33 points,the ODI score in group A and group C,group B and group C compared with statistically had significant difference(P < 0.05).The score of group C were obviously lower thanthose in other groups.Conclusions1.The near and long-term effect is better for protrusion of lumbar intervertebral disc to be remedied by Ozone injection combined with traditional Chinese medicine.2.The safe concentration of ozone injection in the treatment of lumbar disc herniation has no obvious toxic and side effects,the treatment effect is good,and the operation is strong. |
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