Clinical Efficacy Analysis Of Duloxetine Combined With Radiofrequency Thermocoagulation Of Posterior Branch Of Spinal Nerve In The Treatment Of Chronic Non-specific Low Back Pain With Depression State

Objective: To observe the clinical efficacy of duloxetine combined with radiofrequency thermocoagulation of posterior branch of spinal nerve in the treatment of chronic nonspecific low back pain accompanied by depressive state,and to provide the reference for the clinical treatment of such diseases.Methods: According to the inclusion and exclusion criteria,54 patients who were diagnosed chronic nonspecific low back pain with depressive state were diagnosed in the pain department between September 2019 and October 2021 at Affiliated Hospital of Yanbian University.The selected cases were randomly divided into control and experimental group,27 people in each.The control group was only treated with radiofrequency thermocoagulation,while the experimental group was treated with duloxetine combined with surgical treatment.The scores of NRS,MADRS,ODI were used to evaluate the patients,pain,the degree of depression and physical dysfunction,and using the Macnab efficacy evaluation criteria to evaluate the therapeutic effect.And the scores of NRS,MADRS,ODI were evaluated at admission and 1w,1m,2m,3m after the operation.At 3m after the operation,the efficacy evaluation of Macnab was evaluated.Results:(1)Comparison between the two groups,the scores of NRS,ODI,MADRS were significantly decreased at all time note(P < 0.05).Compared between groups,NRS and ODI scores showed the same statistical tread.At admission and 1w after the operation,there was no marked change between the two groups(P > 0.05).At 1m,2m,3m postoperatively,NRS and ODI scores of the experimental group were statistically significant compared with those of the control group.Compared between groups,at 1w,1m,2m,3m after the operation,MADRS score of the experimental group was obviously lower than that group.The efficacy of Macnab was evaluated at 3m after the operation to test the efficacy of the duloxetine.The difference in the distribution of efficacy evaluation of Macnab and the excellent and good rate between the two group were statistically significant.No distinct difference in effective rate between the two groups occurred(P > 0.05).(2)Adverse event: In the course of treatment,no adverse events related to surgical procedures such as infection,and dural puncture.Dizziness and nausea occurred in 3 patients and diarrhea occurred in 1 patient among the 24 patients in the experimental group.These symptoms all appeared in about 1 week of medication.The symptoms are mild.After bed rest and more drinking water,the side effects were relieved obviously.None of the patients terminated the clinical study due to adverse drug reactions.Conclusions:Duloxetine combined with radiofrequency thermocoagulation of posterior branch of spinal nerve is superior to radiofrequency thermocoagulation of posterior branch of spinal nerve alone in the treatment of chronic non-specific low back pain with depressive state.In the meantime,the physical functions and depression of patients can be improved.