标题：不同手术方式治疗腰椎间盘突出症的疗效及其与β-内啡肽和P物质的相关性

      作者：潘富文 1，刘 强 1，李春根 2，张国如 1，林诗富 1，韩耀光 1，吴林清 1
    (1.海南省农垦三亚医院，海南 三亚 572000；
2.北京中医药大学东直门医院，北京 100700)

      卷次： 2015年26卷12期

      【摘要】 目的 探讨不同手术方式治疗腰椎间盘突出症的疗效及其与β-内啡肽和 P物质的相关性。
方法 分别统计70例患者在接受开窗术(A组)、半椎板切除术(B组)、全椎板切除术(C组)、低温等离子消融术(D
组)后的优良率，测定其术前、术后 1 d、术后 7 d、术后 14 d的疼痛评分、β-内啡肽和 P物质含量，并分析疼痛评
分与β-内啡肽和 P物质的相关性。结果 70例患者均顺利手术，优良率分别为 A组 77.78% (14/18)、B组
72.22% (13/18)、C组 66.67% (12/18)、D组 93.75% (15/16)。不同手术组患者疼痛VAS评分和P物质含量从术前
到术后呈降低趋势，β-内啡肽含量从术前到术后逐渐升高。与术前比较，不同手术组VAS评分、β-内啡肽和P
物质在术后 7 d和 14 d差异有统计学意义(P<0.05)，且D组VAS评分、β-内啡肽和P物质术后 1 d与术前比较差
异有统计学意义(P<0.05)；关联性分析，疼痛VAS评分与β-内啡肽含量呈负相关，与 P物质含量呈正相关(P<
0.05)。结论 严格根据腰椎间盘突出症的手术指征选择适宜的手术方式，腰椎间盘突出症患者疼痛程度与β-内
啡肽含量呈负相关，与P物质含量呈正相关。

      【关键词】 腰椎间盘突出症；手术治疗；β-内啡肽；P物质

      【中图分类号】 R681.5+3 【文献标识码】 A 【文章编号】 1003—6350（2015）12—1738—04


Effect of different surgical procedures for lumbar disc herniation and the correlations with β-endorphen and
substance P.
PANG Fu-wen 1, LIU Qiang 1, LI Chun-gen 2, ZHANG Guo-ru 1, LIN Shi-fu 1, HAN Yao-guang 1, WU
Lin-qing 1. 1. Department of Orthopedics, Hainan Province Nongken Sanya Hospital, Sanya 572000, Hainan, CHINA;
2. Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, CHINA

【Abstract】 Objective To explore different surgical procedures for lumbar disc herniation, and to observe the
correlations with β-endorphen (β-EP) and substance P (SP). Methods Seventy patients with lumbar disc herniation
were given laminectomy windows (group A, 18 cases), semi-laminectomy (group B, 18 cases), total-laminectomy
(group C, 18 cases), and radiofrequency ablation (group D, 16 cases), respectively. Then the excellent and good rate
was detected and compared. Visual analogue scale (VAS), levels of β-EP and SP before operation, 1 day, 7 days, 14
days of post-operation were tested, and the correlations between VAS and β-EP, SP were analzyed. Results The 70
patients were operated successfully, with the excellent and good rate of 77.78% in group A (14/18), 72.22% in group B
(13/18), 66.67% in group C (12/18), and 93.75% in group D (15/16). The VAS and SP in different groups decreased
·论 著·doi:10.3969/j.issn.1003-6350.2015.12.0623