目的 探讨骶管神经阻滞联合腰部核心肌群肌力训练治疗对腰椎间盘突出症(LDH)患者腰椎功能及炎症因子水平的影响.方法 将LDH患者采用随机数字表法分为观察组(n=50)和对照组(n=50),对照组给予骶管神经阻滞治疗,观察组在对照组治疗的基础上联合腰部核心肌群肌力训练治疗.治疗后4、12周比较两组患者的JOA、ODI、VAS评分及炎症因子白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平.结果 治疗后4、12周,两组JOA评分均较治疗前升高(P＜0.05),ODI评分与VAS评分均较治疗前降低(P＜0.05),但观察组JOA评分均高于对照组(P＜0.05),ODI评分与VAS评分均低于对照组(P＜0.05).治疗后12周与治疗后4周比较,观察组3项评分比较差异均无统计学意义(P＞0.05),对照组JOA评分有所下降,ODI评分与VAS评分有所升高,但差异无统计学意义(P＞0.05).治疗后12周,两组血清IL-6、TNF-α水平均较治疗前降低(P＜0.05),且观察组降低幅度优于对照组(P＜0.05).结论 骶管神经阻滞联合腰部核心肌群肌力训练治疗有利于缓解LDH患者疼痛,降低患者体内炎症因子水平,增强患者脊柱稳定性及腰椎功能.%Objective To investigate the clinical effect of sacral block combined with core muscle group training in the treatment of lumbar disc herniation (LDH). Methods The 100 patients with LDH were divided into the obser-vation group (n=50) and the control group (n=50) by using the random digital table method. The control group was treated with sacral block, and the observation group underwent combined with the muscle strength training of the lumbar core muscle group on the basis of the control group. At 4 weeks and 12 weeks after treatment, the JOA score, ODI score, VAS and the levels of IL-6 and TNF-α were compared between the two groups. Results At 4 weeks and 12 weeks after treatment, the scores of JOA in the two groups were higher than before the treatment (P＜0.05), and the scores of ODI and VAS were lower than those before the treatment (P＜0.05). But JOA score in the observation group was higher than that of the control group (P＜0.05), and the scores of ODI and VAS were lower than those of the control group (P＜0. 05). At 12 weeks after treatment, compared with the 4 weeks after treatment, there was no significant difference between the 3 scores of the observation group (P＞0. 05), the JOA score in the control group was decreased, and the scores of ODI and VAS increased, but the difference was not statistically significant (P＞0.05). At 12 weeks of treatment, the levels of serum IL-6 and TNF-α in the two groups were lower than those before the treatment (P＜0.05), and the decrease in the observation group was significantly better than that of the control group (P＜0.05). Conclusions Compared with the treatment of sacral block,combined with core muscle training helps to relieve pain in LDH patients and depression and anxiety,reduce the level of inflammatory factors in patients with lumbar spinal stability and enhance the function of patients.
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