摘要目的 观察脉冲射频松解术在肌肉缩短致病原理指导下治疗慢性腰痛的疗效和安全性.方法 慢性腰痛患者70例,随机分为脉冲射频组(A组)和物理治疗组(B组),每组35例.A组给予脉冲射频松解术治疗,共治疗3次,每次间隔7d.B组采用物理治疗.在治疗前、治疗后4周、12周和1年时观察疼痛视觉模拟评分(VAS)、局部压痛评分、指地距离、活动受限评分、总体疗效评定等指标.结果 与治疗前比较,A组患者各项指标各观察时点均有明显改善(P＜0.05),B组仅VAS评分、活动受限评分各观察时点明显改善,而局部压痛评分、指地距离无明显改善;与B组比较,A组VAS评分及活动受限评分在1年时,压痛评分及指地距离在各观察时点差异均有统计学意义(P＜0.05);总有效率在1年时A组(97.1％,34/35例)高于B组(85.7％,30/35例),差异有统计学意义(P＜0.05).两组均未见不良反应.结论 在肌肉缩短致病原理指导下脉冲射频松解术治疗慢性腰痛安全有效.

abstractsObjective To evaluate the efficacy and safety of pulsed radiofrequency decompression under the guidance of pathogenic principle of muscle shortening in the treatment of patients with chronic low back pain.Methods Seventy patients with chronic low back pain were randomly divided into pulsed radiofrequency group (group A) and physical therapy group (group B),35 cases in each group.The patients in group A were treated with pulsed radiofrequency decompression on the low back,3 times with an interval of 7 days,while in group B with physical therapy.The efficacy and safety were evaluated before and at 4,12 weeks and one year after the treatment.VAS,local pressed pain,restriction of movement,distance from the middle finger tip to the ground and total efficacy rate were observed.The side effects were also observed.Results All clinical indices in group A and VAS,the degree of restriction of movement in group B were improved significantly at 4,12 weeks and one year after the treatment (P＜0.05).Local pressed pain and the distance from the middle finger tip to the ground were not improving significantly.Compared with group B,VAS and the degree of restriction of movement at one year after the treatment,and the local pressed pain and the distance from the middle finger tip to the ground at 4,12 weeks and one year after the treatment were improved significantly in group A.The total efficacy rate was 97.1％ (34/35 cases) and 85.7％ (30/35 cases)in group A and group B respectively at one year after the treatment.Side effects were not found in the two groups.Conclusion Pulsed radiofrequency decompression under the guidance of pathogenic principle of muscle shortening is a safe and effective method in the treatment of patients with chronic low back pain.