目的 觀察穴位注射腺苷鈷胺治療腰椎間盤突出癥的臨床療效。方法 選取2015年12月-2016年11月到天津市南開醫(yī)院康復(fù)科就診的腰椎間盤突出癥患者58例，隨機(jī)分為對照組和治療組，每組各29例。對照組患者給予電針治療，5次/周，10次為1個(gè)療程。治療組在對照組治療基礎(chǔ)上給予穴位注射注射用腺苷鈷胺，5次/周，10次為1個(gè)療程。兩組患者均連續(xù)治療2個(gè)療程。觀察兩組的臨床療效，比較兩組治療前后JOA評分、VAS評分、Oswestry功能障礙指數(shù)（ODI）的變化情況。結(jié)果 治療后，對照組和治療組的總有效率分別為82.76%、93.10%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療1、2個(gè)療程后，兩組患者JOA主觀癥狀評分、JOA臨床體征評分均較治療前顯著升高，VAS評分、ODI指數(shù)均顯著降低，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療1個(gè)療程后，治療組JOA主觀癥狀評分高于對照組，VAS評分、ODI指數(shù)低于對照組；治療2個(gè)療程后，治療組JOA主觀癥狀評分、JOA臨床體征評分高于對照組，VAS評分低于對照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 穴位注射腺苷鈷胺治療腰椎間盤突出癥具有較好的臨床療效，可顯著改善患者臨床癥狀，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To study the clinical effect of acupoint injection of cobamamide in treatment of lumbar disc herniation. Methods Patients (58 cases) with lumbar disc herniation in Tianjin Nankai Hospital from December 2015 to November 2016 were randomly divided into control and treatment groups, and each group had 29 cases. Patients in the control group were iv administered with electroacupuncture treatment, five times one week, and 10 times were as one course of treatment. Patients in the treatment group were given acupuncture injection with Cobamamide for injection on the base of the control group, five times one week, and 10 times were as one course of treatment. Patients in two groups were treated for 2 courses of treatment. After treatment, the clinical efficacy was evaluated, and the changes of JOA scores, VAS scores, and ODI in two groups were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 82.76% and 93.10%, respectively, and there were differences between two groups (P<0.05). After treatment for 1 and 2 courses, JOA subjective symptoms score and JOA clinical signs score in two groups were significantly increased, but VAS scores, and ODI were significantly decreased, and the difference was statistically significant in the same group (P<0.05). After treatment for 1 course, JOA subjective symptoms score in the treatment group was higher than that in the control group, but VAS scores and ODI were lower than those in the control group. After treatment for 1 course, JOA subjective symptoms score and JOA clinical signs score in the treatment group were higher than those in the control group, but VAS scores was lower than that in the control group, and there was difference between two groups (P<0.05). Conclusion Acupoint injection of cobamamide has a significant effect in treatment of lumbar disc herniation, and can significantly improve the clinical symptoms, which has a certain clinical application value.