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中华老年骨科与康复电子杂志

中华老年骨科与康复电子杂志 ›› 2024, Vol. 10 ›› Issue (01) : 33 -38. doi: 10.3877/cma.j.issn.2096-0263.2024.01.006

康复

等离子射频治疗对颈源性头痛患者颈椎活动度和炎性因子水平的影响
刘祖耀1, 纪秀波2, 杨等1,†()   
  1. 1. 100144　北京，首都医科大学附属北京康复医院劳模健康管理中心
    2. 102600　北京，中国中医科学院广安门医院南区麻醉科
  • 收稿日期:2023-01-13 出版日期:2024-02-05
  • 通信作者: 杨等
  • 基金资助:
    2019-2021年首都医科大学附属北京康复医院科技发展专项(2019-010)

Effect of plasma radiofrequency therapy on cervical motion and inflammatory factors in patients with cervicogenic headache

Zuyao Liu1, Xiubo Ji2, Deng Yang1,†()   

  1. 1. Model Worker Health Management Center of Beijing Rehabilitation Hospital Affiliated to Capital Medical University, Beijing 100144, China
    2. South Anesthesiology Department, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 102600, China
  • Received:2023-01-13 Published:2024-02-05
  • Corresponding author: Deng Yang
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刘祖耀, 纪秀波, 杨等. 等离子射频治疗对颈源性头痛患者颈椎活动度和炎性因子水平的影响[J]. 中华老年骨科与康复电子杂志, 2024, 10(01): 33-38.

Zuyao Liu, Xiubo Ji, Deng Yang. Effect of plasma radiofrequency therapy on cervical motion and inflammatory factors in patients with cervicogenic headache[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2024, 10(01): 33-38.

目的

探讨等离子射频治疗对颈源性头痛患者颈椎活动度和炎性因子水平的影响。

方法

选择我院于2021年1月至2022年6月颈源性头痛患者83例，依据随机数字表法分为观察组42例与对照组41例。对照组口服布洛芬缓释胶囊和盐酸氟桂利嗪胶囊，观察组在对照组基础上采用等离子射频治疗。两组均于治疗4周评价。比较2组治疗疗效，治疗前后简明麦吉尔疼痛量表评分、颈椎活动度、炎性因子和基地动脉血流动力变化。

结果

观察组颈源性头痛患者总有效率（90.48%）高于对照组（73.17%）（P<0.05）。观察组治疗后颈源性头痛患者PPI（1.26±0.32）分、VAS（2.46±0.56）分和PRI（2.27±0.46）分低于对照组（2.07±0.51）分、（3.71±0.69）分和（3.18±0.57）分（P<0.05）。观察组治疗后颈源性头痛患者颈部前屈（37.86±4.61）°、后伸（39.74±4.58）°、左旋转（50.92±6.89）°和右旋转（51.27±5.58）°高于对照组（31.06±5.45）°、（30.68±5.46）°、（41.34±7.74）°和（42.08±6.47）°（P<0.05）。观察组治疗后颈源性头痛患者血清IL-1β（0.25±0.08）pg/ml、IL-6（43.24±9.87）pg/ml和TNF-α（10.83±3.46）ng/ml低于对照组（0.57±0.17）pg/ml、（67.48±14.35）pg/ml和（18.98±5.14）ng/ml（P<0.05）。观察组治疗后颈源性头痛患者Vd（29.48±3.46）cm/s、Vm（32.76±3.46）cm/s和Vp（59.84±5.78）cm/s低于对照组（33.05±2.58）cm/s、（37.48±4.05）cm/s和（64.52±5.16）cm/s（P<0.05）。

结论

等离子射频治疗对颈源性头痛患者疗效良好，可改善患者颈椎活动度，减轻患者炎性反应。

关键词: 等离子射频, 颈源性头痛, 颈椎活动度, 炎性因子
Objective

To investigate the effect of plasma radiofrequency therapy on cervical motion and inflammatory factors in patients with cervicogenic headache.

Methods

83 patients with cervicogenic headache in our hospital from January 2021 to June 2022 divided into observation group (42 cases) and control group (41 cases). The control group took ibuprofen sustained-release capsule and flunarizine hydrochloride capsule orally, and the observation group took plasma radiofrequency therapy basis control group. Two groups were evaluated after 4 weeks of treatment. The therapeutic effects of the two groups were compared, and the scores of the concise McGill pain scale, the range of cervical motion, inflammatory factors and the changes of vertebral artery hemodynamics before and after treatment were compared.

Results

The observation group total effective rate of patients with cervical headache (90.48%) was higher than control group (73.17%) (P<0.05). After treatment, the observation group PPI (1.26±0.32), VAS (2.46±0.56), and PRI (2.27±0.46) scores of patients with cervical headache were lower than control group (2.07±0.51), (3.71±0.69), and (3.18±0.57) (P<0.05). After treatment, the observation group neck flexion (37.86±4.61)°, extension (39.74±4.58)°, left rotation (50.92±6.89)°, and right rotation (51.27±5.58)° were higher than control group (31.06±5.45)°, (30.68±5.46)°, (41.34±7.74)°, and (42.08±6.47)°(P<0.05). After treatment, the observation group serum IL-1β (0.25±0.08) pg/ml, IL-6 (43.24±9.87) pg/ml, and TNF-α (10.83±3.46) ng/ml of patients with cervical headache was lower than control group (0.57±0.17) pg/ml, (67.48±14.35) pg/ml, and (18.98±5.14) ng/ml (P<0.05). After treatment, the observation group Vd (29.48±3.46) cm/s, Vm (32.76±3.46) cm/s, and Vp (59.84±5.78) cm/s of patients with cervical headache were lower than control group (33.05±2.58) cm/s, (37.48±4.05) cm/s, and (64.52±5.16) cm/s (P<0.05).

Conclusions

Plasma radiofrequency therapy has a good effect on patients with cervicogenic headache. It can improve the range of motion of cervical vertebra and reduce the inflammatory reaction of patients.

Key words: Plasma radiofrequency therapy, Cervical headache, Cervical spine range of motion, Inflammatory factor
图1~3 男性，56岁、诊断颈源性头痛，颈椎间盘突出症。图1　颈前路穿刺进入颈5/6椎间盘；图2　C型臂透视颈椎正侧位确认进入颈5/6椎间隙位置无误；图3　等离子射频消融治疗
表1 两组颈源性头痛患者疗效比较[例（%）]
组别 例数 显效 有效 无效 总有效
观察组 42 27（64.29） 11（26.19） 4（9.52） 38（90.48）*
对照组 41 20（48.78） 10（24.39） 11（26.83） 30（73.17）
χ2值         4.196
P值         0.041
表2 两组颈源性头痛患者简明麦吉尔疼痛量表评分比较（±s，分）
组别 例数 PPI VAS PRI
治疗前 治疗后 治疗前 治疗后 治疗前 治疗后
观察组 42 3.17±0.54 1.26±0.32* 6.14±0.78 2.46±0.56* 5.43±0.84 2.27±0.46*
对照组 41 3.20±0.67 2.07±0.51* 6.21±0.94 3.71±0.69* 5.36±0.97 3.18±0.57*
t值   0.225 8.690 0.370 9.072 0.352 8.013
P值   0.823 <0.001 0.713 <0.001 0.726 <0.001
表3 两组颈源性头痛患者颈椎活动度比较（±s，°）
组别 例数 前屈 后伸 左旋转 右旋转
治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后
观察组 42 22.18±3.54 37.86±4.61* 22.54±3.27 39.74±4.58* 32.64±4.87 50.92±6.89* 32.18±4.52 51.27±5.58*
对照组 41 22.31±4.67 31.06±5.45* 22.47±3.98 30.68±5.46* 33.15±5.57 41.34±7.74* 31.89±5.57 42.08±6.47*
t值   0.143 6.143 0.088 8.198 0.444 5.960 0.261 6.935
P值   0.887 <0.001 0.930 <0.001 0.658 <0.001 0.795 <0.001
表4 两组颈源性头痛患者炎性因子比较（±s）
组别 例数 IL-1β（pg/ml） IL-6（pg/ml） TNF-α（ng/ml）
治疗前 治疗后 治疗前 治疗后 治疗前 治疗后
观察组 42 1.23±0.27 0.25±0.08* 92.51±13.25 43.24±9.87* 30.24±7.78 10.83±3.46*
对照组 41 1.24±0.32 0.57±0.17* 90.87±10.14 67.48±14.35* 29.46±8.85 18.98±5.14*
t值   0.154 11.015 0.632 8.985 0.427 8.493
P值   0.878 <0.001 0.529 <0.001 0.671 <0.001
表5 两组颈源性头痛患者椎动脉血流动力学比较（±s，cm/s）
组别 例数 Vd Vm Vp
治疗前 治疗后 治疗前 治疗后 治疗前 治疗后
观察组 42 38.51±2.87 29.48±3.46* 44.25±4.18 32.76±3.46* 71.86±6.62 59.84±5.78*
对照组 41 38.04±2.67 33.05±2.58* 44.51±4.76 37.48±4.05* 72.43±7.81 64.52±5.16*
t值   0.772 5.319 0.265 5.713 0.359 3.888
P值   0.442 <0.001 0.792 <0.001 0.721 <0.001
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