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臭氧联合类固醇治疗椎间盘源性下腰痛的临床疗效:一项随机双盲临床研究。

The clinical efficacy of ozone combined with steroid in the treatment of discogenic low back pain: a randomized, double-blinded clinical study.

作者信息

Yang Xiao-Hui, Liu Xiao-Hui, Ma Yun-Gai, Fan Jia-Xing, Ma Xiao-Long, Zhuang Guan-Ying, Yang Zhan-Min

机构信息

Pain Clinic of Anesthesiology Department, Aerospace Center Hospital, Beijing, China.

出版信息

Front Neurol. 2023 Aug 10;14:1078111. doi: 10.3389/fneur.2023.1078111. eCollection 2023.

Abstract

OBJECTIVE

This randomized double-blinded clinical study is to investigate the clinical efficacy of per-paravertebral disk ozone injection combined with steroids in the treatment of patients with chronic discogenic low back pain (CDLBP).

METHODS

Group A ( = 60) received a per-paravertebral injection of a steroid mixture of 10 mL with pure oxygen 20 mL, while group B ( = 60) received a per-paravertebral injection of a steroid mixture of 10 mL combined with ozone 20 mL (30 μg/mL). Injections were administered once a week for 3 weeks, with a follow-up of 6 months. Clinical outcomes were assessed at week 1, month 3, and month 6 with the help of Visual Analog Scale (VAS) scores and Macnab efficacy evaluation.

RESULTS

The VAS score of both group A (1.65 vs. 6.87,  = 0.000) and group B (1.25 vs. 6.85,  = 0.000) at week 1 was significantly reduced compared to baseline. The effect was sustained at the 3- and 6-month follow-up periods ( < 0.05). Group B had significantly lower VAS scores at month 3 (1.53 vs. 3.82,  = 0.000) and month 6 (2.80 vs. 5.05,  = 0.000) compared to group A, respectively. Based on Macnab criteria, 95 and 96.7% of patients in groups A and B had good rates "excellent plus good" at week 1, respectively. Good rates were significantly higher in group B at month 3 (91.7 vs. 78.3%,  = 0.041) and month 6 (85.0 vs. 68.3%,  = 0.031) compared to group A, respectively. No serious adverse events were noted in both groups.

CONCLUSION

Per-paravertebral injection of steroid and ozone combination resulted in better relief of CDLBP compared to pure oxygen plus steroid.

CLINICAL TRIAL REGISTRATION

ChiCTR2100044434 https://www.chictr.org.cn/showproj.html?proj=121571.

摘要

目的

本随机双盲临床研究旨在探讨经皮椎旁椎间盘臭氧注射联合类固醇治疗慢性盘源性下腰痛(CDLBP)患者的临床疗效。

方法

A组(n = 60)接受经皮椎旁注射10 mL类固醇混合物加20 mL纯氧,而B组(n = 60)接受经皮椎旁注射10 mL类固醇混合物加20 mL臭氧(30μg/mL)。每周注射1次,共3周,随访6个月。在第1周、第3个月和第6个月借助视觉模拟量表(VAS)评分和Macnab疗效评估对临床结果进行评估。

结果

与基线相比,A组(1.65对6.87,P = 0.000)和B组(1.25对6.85,P = 0.000)在第1周时VAS评分均显著降低。在3个月和6个月的随访期效果持续存在(P < 0.05)。与A组相比,B组在第3个月(1.53对3.82,P = 0.000)和第6个月(2.80对5.05,P = 0.000)时VAS评分显著更低。根据Macnab标准,A组和B组在第1周时分别有95%和96.7%的患者“优加良”率良好。与A组相比,B组在第3个月(91.7%对78.3%,P = 0.041)和第6个月(85.0%对68.3%,P = 0.031)时良好率显著更高。两组均未观察到严重不良事件。

结论

与纯氧加类固醇相比,经皮椎旁注射类固醇和臭氧联合能更好地缓解CDLBP。

临床试验注册

ChiCTR2100044434 https://www.chictr.org.cn/showproj.html?proj=121571

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