【作者】 李泽恩；

【导师】 刘通；

【作者基本信息】 福建中医学院 ， 中西医结合临床， 2006， 硕士

【摘要】 [目的]（1）观察骶管注射灯盏细辛对腰椎间盘突出症（Protrusion of lumbar intervertebral disc，LIDP）患者腰腿痛评分的变化，比较其与地塞米松的治疗差异，为灯盏细辛替代地塞米松治疗LIDP提供临床资料。（2）探讨灯盏细辛治疗LIDP的效果与血清中IgG、IgM含量的相关性。 [方法]选择ASA Ⅰ-Ⅱ级LIDP患者60例，年龄20-60岁，随机分为以下三组：对照组（Control Group，CG），激素组（Steroid Group，SG），灯盏细辛组（Dengzhanxixin Group，DG），每组20例。CG配方为：2％利多卡因5ml、VitB₁100mg、VitB₁₂500ug，加生理盐水稀释至30ml；SG配方为：2％利多卡因5ml、VitB₁100mg、VitB₁₂500ug、地塞米松5mg，加生理盐水稀释至30ml；DG配方为：2％利多卡因5ml、VitB₁100mg、VitB₁₂500ug、灯盏细辛注射液5ml，加生理盐水稀释至30ml。三组均采用骶管阻滞注射治疗。每周一次，连续三周。依据所设计的腰腿痛评分量表分别在第一次治疗前、第七天治疗前、第十四天治疗前和第二十一天对患者进行评分。并且在治疗前后分别检测血清中IgG、IgM含量。 [结果]（1）疗效观察：二十一天时，DG组总有效率为90％，SG组总有效率为85％，CG组总有效率为60％。DG组、SG组治疗LIDP均能取得较为理想的疗效，明显优于CG组（p＜0.05）。（2）CG、SG、DG三组腰腿痛评分：DG组、SG组腰腿痛评分的改善好于CG组。DG组、SG组治疗后均能显著改善腰腿痛评分（p＜0.05），但两者治疗后比较无显著性差异（p＞0.05）。CG组治疗后腰腿痛评分改善不显著（p＞0.05）。（3）治疗前后IgG、IgM变化：DG组、SG组患者血清中IgG、IgM含量下降幅度大于CG组。DG组、SG组患者血清中IgG、IgM治疗后下降显著（p＜0.05），而CG组治疗后下降不显著（p＞0.05）。（4）不同疗效与IgG、IgM含量变化的关系：LIDP的临床疗效与IgG、IgM含量明显相关，更多还原

【Abstract】 [Objective] （1）To determine Dengzhanxixin what effects exterted to the score of lumbodynia and skelalgia of LIDP patients .Compare the efficacy of Dengzhanxixin with dexamethasone. To provide the clinical evidence and investigated whether dexamethasone could be replaced by Dengzhanxixin （2） Discuss the relationship between the curative effect and the concentrations of IgG and IgM in serum.[Methods] Sixty ASA I - II LIDP patients ,20-60 years old, were selected and divided into three groups randomly: Control Group（CG）,, Steroid Group （SG）, Dengzhanxixin Group （DG）, each group contained 20 cases.CG: 2% Lidocaine 5ml, VitB₁ 100mg, VitB₁₂500ug, added 0.9%Natri Chloride up to30ml; SG:2% Lidocaine 5ml, VitB₁ 100mg, VitB₁₂500ug, dexamethasone 5mg,added 0.9%Natri Chloride up to 30ml; Dengzhanxixin Group : 2% Lidocaine 5ml, VitB₁ 100mg, VitB₁₂ 500ug, Dengzhanxixin injection 5ml,added 0.9%Natri Chloride up to 30ml. Caudal injection were utilized in three groups every once a week.The treatment lasted three weeks. According to the score table of lumbodynia and skelalgia ,first, the seventh day before treatment, the 14th day before treatment, the 21st day,the patients were scored.At pre-treatment and at post-treatment,assay the concentrations of IgG and IgM in serum.[Results] （1） Observation of the curative effect: At day 21,the total effective rate in DG was 90% and SG was 85%;the total effective rate in CG was 60%. DG, JG were superior to CG （p<0.05）. （2） The grades of lumbodynia and skelalgia in DG 、 SG、 CG: the improvement of the score of lumbodynia and skelalgia in DG and SG were better than that of CG . DG,SG both could significantly improve the grades（p<0.05）.While at post-treatment, there was no significant difference between DG and SG .（P>0.05）, The CG had no significant difference between pre-treatment and post-reatment （p>0.05）. （3） The change of the concentrations of IgG and IgM between pre-treatment and post-treatment:the falling tendency更多还原