| Low back pain is one of the most common clinical symptoms in clinical work,and it is also one of the more prominent social and public health issues.It also affects the physical structure and function of people in pain rehabilitation,Activities and issues of social participation cannot be ignored.Although advances in assessment and treatment have led clinicians to more and more ways to treat pain,the treatment of low back pain remains a challenge for researchers and clinicians.For the treatment of pain,the challenge is not only in the differences in possible etiology,predisposing factors,duration,prognosis,disturbance of activity and quality of life,but also in the increase in disability associated with low back pain.Therefore,lower back pain has become one of the clinical symptoms with high incidence and lifetime prevalence.Low back pain mainly includes three different sources of pain:axial lumbosacral pain,root pain,and metastatic pain.These three types of pain are relatively common,and they are true all over the world.Among the three types of pain,axial lumbosacral pain is the most common,and lumbar disc herniation can reach more than 39%.The cause of lumbar disc herniation is due to degenerative spinal joint and disc disease.Disc herniation or nucleus pulposus is the most important disc disease.For the current first-line treatment of lumbar disc herniation,non-invasive treatment,including rest,correction of bad living habits,medication and physical therapy,can not relieve pain,then consider invasive treatment,such as local intramuscular injection of nerve block drugs,disc reduction Pressure surgery or even surgical treatment Considering the unsatisfactory effect of surgical treatment and the obvious complications and potential complications of surgery,many alternative minimally invasive disc decompression techniques have been developed in the past few decades to reduce the need for surgery.Currently,surgery is limited to patients with progressive neurological dysfunction,cauda equina syndrome,and severe intolerable pain.Ozone therapy(oxygen-ozone therapy,O2-O3 therapy)is a method of treating lumbar disc herniation using the biochemical properties of a mixture of oxygen and ozone gas.The local injection technique or decompression technique is a minimally invasive,safe,and low-cost operation.It has the effects of reducing disc compression,reducing nerve root inflammation,and improving the local microenvironment.At present,the commonly used ozone therapy in clinical practice mainly includes direct intramuscular or epidural injection and intravertebral disc injection.Injecting ozone can not only significantly reduce the inflammatory response in the intervertebral disc and promote the release of anti-inflammatory factors,thereby inhibiting the inflammatory process.At the same time,it can also directly reduce the mechanical compression by ablating the intervertebral disc,improve the microcirculation and oxygen saturation around the diseased intervertebral disc,reduce vascular stasis,and thereby reduce Hypoxia-related pain to relieve pain.Studies have shown that patients with lumbar disc herniation have significantly reduced pain scores and disability after two weeks of ozone injection into the disc,and that the pain relief effect can last up to 6 months and more.At the same time,ozone therapy has the advantages of high safety and fewer adverse reactions.In addition,ozone still has a significant and positive effect on patients with lumbar disc herniation who have not responded to other non-invasive treatments and invasive treatments,and has shown good clinical effects in treating lumbar disc herniation.Recent research results show that ozone treatment can be an effective method for treating lumbar disc herniation,and patients who can't respond to conservative treatment before surgery can benefit.Moreover,many published data show that the success rate of ozone therapy for lumbar disc herniation in different combinations is about 68%to 76%,and the efficacy is safe and the complications are few.In summary,ozone therapy has theoretically become an alternative or additional treatment option for the treatment of lumbar disc herniation.However,it cannot be ignored that in many clinical practices,ozone therapy is not just used in the form of O2-O3 mixtures,often combined with steroids and or anesthetic drugs to treat lumbar disc herniation.Whether tissues,pharmaceutical preparations,and doses affect the evaluation of their clinical efficacy,and whether disc changes after ozone therapy are present are still controversial.Therefore,the efficacy of ozone therapy for lumbar disc herniation is still under discussion.Objective:To systematically evaluate the clinical efficacy of ozone therapy for lumbar disc herniation.Study Design:A randomized controlled trial of English-derived sources was obtained for systematic review and meta-analysis.Method:The literatures ending in 2016 were searched in three electronic databases of English,PubMed,Coclirane Library and Clinical trials.The article type chosen for the study was a randomized trial with active control.Outcome parameters:The outcome measures were patients with short-term pain relief after ozone therapy for at least 6 months or long-term pain relief for more than 6 months.Results:A randomized trial of 4 eligible ozone therapy for lumbar disc herniation was selected in the selected randomized controlled trials in English.The level of evidence for the analysis of ozone therapy is 1B,which also means that ozone therapy can be used for the treatment of lumbar disc herniation with paraspinal muscle injection of discogenic,and the treatment can provide long-term pain relief.Restriction:Selection criteria are limited to English language literature.Not all of the literature designs obtained had placebo-controlled trials.Conclusion:A systematic review shows that ozone treatment is effective for lumbar disc herniation due to intervertebral discs,and this review shows that for long-term pain relief of lumbar disc herniation,the level of evidence for ozone treatment is 1B. |
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