| Objective: The purpose of this study is to compare and analyze the short-term efficacy of radiofrequency ablation plus ozone injection with acupuncture and comprehensive conservative treatment of patients with CDH.in order to explore the differences in the therapeutic effects of radiofrequency ablation plus ozone injection,acupuncture and comprehensive conservative treatment,so as to provide more effective ideas and methods for clinical treatment of CDH.Methods:This subject retrospectively analyzed the clinical data of patients who were hospitalized in the Department of Orthopaedics or the Department of Acupuncture and moxibustion of the first affiliated Hospital from October 2020 to April 2022 and referred to the diagnostic criteria of "CDH" in Spinal surgery.Imaging combined with clinical examination confirmed the diagnosis of "CDH".Ninety-six patients with cervical disc herniation who were included in the standard vertebrae were selected as the object of study.All patients were randomly divided into three groups.Observation group(radiofrequency ablation plus ozone injection),control group A(acupuncture)and control group B(neck traction,traditional Chinese medicine smearing,ironing,acupoint application,oral celecoxib treatment).There were 35 patients in the observation group(12 males and 23 females),31 patients in the control group A(9 males and 22females)and 30 patients in the control group B(8 males and 22females).All patients in the three groups met the inclusion criteria of cervical disc herniation,and were diagnosed by MR,DR and other imaging and physical examination,excluding specific diseases such as cervical spinal stenosis,lumbar fracture,digestive system and other serious medical diseases,pregnant and lactating women,mental disorders and other patients.All patients had good compliance and there was no case shedding phenomenon.In the observation group,there were 12 males and 23 females,with an average age of 54.66±4.03,an average pain time of 13.11 ±2.89 months,10 patients with protrusion of C4-5 segment,13 patients with protrusion of C5-6segment and 12 patients with protrusion of C6-7 segment.The average VAS score and NDI score were 6.74 ±1.57 and 33.14 ±3.52 respectively.In control group A,there were 9 males and 22 females,with an average age of 54.35 ±5.26 years,an average pain time of13.16 ±3.19 months,13 patients with protrusion of C4-5 segment,8patients with protrusion of C5-6 segment and 10 patients with protrusion of C6-7 segment.The average VAS score and NDI score were 7.00 ±1.44 and 32.84 ±2.70,respectively.Control group B: 8males and 22 females.The average age was 56.33 ±4.47 years,the average pain time was 11.93 ±2.85 months,there were 8 patients with protrusion of C4-5 segment,9 patients with protrusion of C5-6segment and 13 patients with protrusion of C6-7 segment.The average VAS score was 6.70 ±1.1.21,and the average NDI score was33.20 ±2.83.There was no significant difference in sex,age and the number of protruding segments of cervical vertebrae among the three groups(P > 0.05).The patients in the three groups were treated with radiofrequency ablation plus ozone treatment,acupuncture treatment and comprehensive conservative treatment.The VAS score and NDI score of the three groups before treatment,1 day after treatment,1month,3 months and 6 months after treatment were compared and analyzed.At the end of follow-up,the improved Mac Nad standard efficacy evaluation method was used to determine the curative effect.All the data were statistically analyzed by SPSS26.0 statistical software.Results: A total of 96 patients were included in this study,all of them had complete information,all patients completed their treatment plans according to groups,and there were no adverse events and deaths in all cases.1.General data: through the comparison of sex,age and average course of disease among the observation group,control group An and control group B,it was found that there was no significant difference in VAS score.2.VAS score: compared with that before treatment,the VAS score of the three groups decreased 1 day,1 month,3 months and 6 months after treatment.Compared with 1 day after treatment,the VAS scores of the three groups decreased at 1 month,3 months and 6 months after treatment,and the VAS scores of the three groups increased 3 months and 66 months after treatment.Compared with 3 months after treatment,the VAS scores of the three groups increased 6 months after treatment.Comparison between groups: there was no significant difference in VAS scores among the three groups before treatment.The VAS scores in the observation group at 1 day,1 month,3 months and 6 months after treatment were lower than those in the control group An and B(P < 0.05).On the 1st day after treatment,the VAS score in the control group A was lower than that in the control group B.At 1 month,3 months and 6 months after treatment,the VAS score of control group B was lower than that of control group A3.NDI score: compared with that before treatment,the NDI score of the three groups decreased at 1 day,1 month,3 months and 6 months after treatment.Compared with 1 day after treatment,the NDI score of the three groups decreased 1 month,3 months and 6 months after treatment,and the NDI score of the three groups increased 3 months and 6 months after treatment.Compared with 3 months after treatment,the NDI score of the three groups increased 6 months after treatment.Comparison between groups: there was no significant difference in NDI scores among the three groups before treatment.The NDI scores of observation group after treatment,1 month,3months and 6 months after treatment were lower than those of control group An and control group B.NDI score of control group A was lower than that of control group B at 1 day after treatment,and NDI score of control group B was lower than that of control group An at 1month,3 months and 6 months after treatment.4.Modified Mac Nad criteria: through the final follow-up of the therapeutic effects of the subjects,three groups of patients were evaluated: the observation group(excellent in 20 cases,good in 12 cases,fair in 3 cases,poor in 0 cases),control group A(excellent in13 cases,good in 12 cases,fair in 6 cases,poor in 0 cases),and control group B(excellent in 15 cases,good in 10 cases,fair in 5cases,poor in 0 cases).Conclusion(s):(1)radiofrequency ablation combined with ozone injection,acupuncture and comprehensive conservative treatment are effective in the treatment of CDH.The three treatments are effective in improving the function of cervical vertebra and relieving local pain.(2)the total excellent and good rate of radiofrequency ablation combined with ozone injection is better than that of acupuncture and comprehensive conservative treatment. |
