Ejeskär A, Nachemson A, Herberts P, Lysell E, Andersson G, Irstam L, Peterson L E
Clin Orthop Relat Res. 1983 Apr(174):236-42.
The results of removal of a disc hernia at the L4/L5 level were compared with those obtained by the injection of 4000 IU (2 ml) of chymopapain (Discase) in 29 consecutive patients randomly selected for either treatment. All exhibited severe incapacitating sciatica, and all had a myelogram demonstrating a definite disc hernia. The two groups of patients did not differ significantly with regard to age, sex, or length of history. The total time of general anesthesia was significantly shorter for the injected patients by 20 minutes (p less than 0.01), as was the length of hospitalization, by three days (p less than 0.05). Within five months, eight of the patients receiving chymopapain injections had to be operated on because of unrelieved symptoms. All had definite disc herniae, and in four, a free fragment was found. All patients were seen at the time of dismissal from the hospital and at six and 12 months after operation by an independent observer. Comparisons made at these intervals, following either surgery or chymopapain injection with or without subsequent surgery, did not reveal any significant differences, but the short-term results following either treatment alone significantly (p less than 0.01) favored the surgical approach.
将L4/L5水平椎间盘突出症的手术切除结果与29例连续随机选择接受两种治疗之一的患者注射4000 IU（2 ml）木瓜凝乳蛋白酶（椎间盘酶）的结果进行了比较。所有患者均表现为严重的致残性坐骨神经痛，且所有患者的脊髓造影均显示明确的椎间盘突出。两组患者在年龄、性别或病史长度方面无显著差异。注射组患者的全身麻醉总时间显著缩短20分钟（p<0.01），住院时间也缩短三天（p<0.05）。在五个月内，8例接受木瓜凝乳蛋白酶注射的患者因症状未缓解而不得不接受手术。所有患者均有明确的椎间盘突出，其中4例发现游离碎片。所有患者在出院时以及术后6个月和12个月由一名独立观察者进行检查。在这些时间间隔进行的比较中，无论是手术还是注射木瓜凝乳蛋白酶（无论是否随后进行手术），均未发现任何显著差异，但仅采用任何一种治疗方法的短期结果均显著（p<0.01）支持手术治疗方法。
