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[1]林松青,羅勇杰,陳肖,等.神經(jīng)阻滯聯(lián)合整脊手法治療腰椎間盤突出癥的臨床研究[J].中醫(yī)正骨,2014,26(06):31-34.
　Lin Songqing*,Luo Yongjie,Chen Xiao,et al.Clinical study on nerve block combined with chiropractic manipulation in the treatment of lubar disk herniation[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2014,26(06):31-34.
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神經(jīng)阻滯聯(lián)合整脊手法治療腰椎間盤突出癥的臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第26卷
期數(shù):
2014年06期
頁碼:
31-34
欄目:
臨床研究
出版日期:
2014-06-30

文章信息/Info

Title:
Clinical study on nerve block combined with chiropractic manipulation in the treatment of lubar disk herniation
作者:
林松青1; 羅勇杰2; 陳肖1; 王彬2; 楊曾靜2; 張磊2
1.廣東省深圳市福田區(qū)中醫(yī)院,廣東 深圳 518034; 2.湖南中醫(yī)藥大學(xué),湖南 長沙 410007
Author(s):
Lin Songqing*; Luo Yongjie; Chen Xiao; Wang bin; Yang Zengjing; Zhang Lei.*
Futian Hospital of Traditional Chinese Medicine,Shenzhen 518034,Guangdong,China
關(guān)鍵詞:
椎間盤移位 腰椎 神經(jīng)傳導(dǎo)阻滯 手法; 捏脊 治療; 臨床研究性
Keywords:
Intervertebral disk displacement;  Lumbar vertebrae;  Nerve block;  Manipulation; chiropractic;  Therapies; investigational
摘要:
目的:觀察神經(jīng)阻滯聯(lián)合整脊手法治療腰椎間盤突出癥的臨床療效。方法:將符合要求的125例患者隨機(jī)分為3組,Ⅰ組45例,采用神經(jīng)根孔或側(cè)隱窩神經(jīng)阻滯聯(lián)合整脊手法治療; Ⅱ組40例,采用神經(jīng)根孔或側(cè)隱窩神經(jīng)阻滯治療; Ⅲ組40例,采用整脊手法治療。觀察比較3組患者的疼痛評分、腰痛分級和總體療效。結(jié)果:①疼痛評分。治療前3組患者的疼痛評分比較,差異無統(tǒng)計(jì)學(xué)意義[(69.16±8.35)分,(68.98±7.28)分,(70.32±6.78)分; F=0.562,P=0.682]; 治療后3組患者的疼痛評分均較治療前下降[(69.16±8.35)分,(20.31±9.05)分,t=3.593,P=0.000;(68.98±7.28)分,(24.11±8.28)分,t=4.124,P=0.004;(70.32±6.78)分,(50.89±10.32)分,t=1.043,P=0.029],Ⅰ組下降程度大于Ⅱ組和Ⅲ組,Ⅱ組下降程度大于Ⅲ組[(48.72±8.56)分,(46.31±6.53)分,(18.43±9.01)分,P=0.021,P=0.000,P=0.004]。②腰痛分級。3組患者治療后的Denis腰痛分級結(jié)果比較,Ⅰ組優(yōu)于Ⅱ組和Ⅲ組,Ⅱ組與Ⅲ組差異無統(tǒng)計(jì)學(xué)意義[Ⅰ組95%CI為(0.214,0.365),R^-=0.216; Ⅱ組95%CI為(0.417,0.761),R^-=0.346; Ⅲ組95%CI為(0.511,0.812),R^-=0.392]。③總體療效。Ⅰ組優(yōu)31例、良13例、差1例,Ⅱ組優(yōu)16例、良13例、可10例、差1例,Ⅲ組優(yōu)10例、良15例、可8例、差7例。Ⅰ組總體療效優(yōu)于Ⅱ組和Ⅲ組,Ⅱ組優(yōu)于Ⅲ組[Ⅰ組95%CI為(0.326,0.475),R^-=0.316; Ⅱ組95%CI為(0.518,0.691),R^-=0.487; Ⅲ組95%CI為(0.702,0.877),R^-=0.492]。結(jié)論:神經(jīng)阻滯聯(lián)合整脊手法治療腰椎間盤突出癥,可以有效緩解腰痛或下肢放射性疼痛癥狀,促進(jìn)腰椎功能恢復(fù),值得臨床推廣應(yīng)用。
Abstract:
Objective:To observe the clinical curative effects of nerve block combined with chiropractic manipulation in the treatment of lubar disk herniation(LDH).Methods:One hundred and twenty-five patients enrolled in the study were randomly divided into 3 groups,45 cases in groupⅠ,40 cases in groupⅡand 40 cases in groupⅢ.The patients in groupⅠwere treated with nerve block at the nerve root foramen or lateral recess combined with chiropractic manipulation,the patients in groupⅡwere treated with nerve block at the nerve root foramen or lateral recess,while the others in groupⅢwere treated with chiropractic manipulation.The visual analogue scores(VAS),Denis lower back pain classification and total curative effect were observed and compared between the 3 groups.Results:There was no statistical difference in VAS between the 3 groups before the treatment(69.16+/-8.35,68.98+/-7.28,70.32+/-6.78 points,F=0.562,P=0.682),while the VAS decreased in the 3 groups after the treatment(69.16+/-8.35 vs 20.31+/-9.05 points,t=3.593,P=0.000; 68.98+/-7.28 vs 24.11+/-8.28 points,t=4.124,P=0.004; 70.32+/-6.78 vs 50.89+/-10.32 points,t=1.043,P=0.029),and there was a bigger decline in groupⅠcompared to groupⅡand groupⅢ,and there was a bigger decline in groupⅡcompared to groupⅢ(48.72+/-8.56,46.31+/-6.53,18.43+/-9.01 points,P=0.021,P=0.000,P=0.004).There was no statistical difference in Denis lower back pain classification between groupⅡand groupⅢafter the treatment,while groupⅠsurpassed groupⅡand groupⅢ(groupⅠ:95%CI 0.214-0.365,R^-=0.216; groupⅡ:95%CI0.417-0.761,R^-=0.346; groupⅢ:95%CI0.511-0.812,R^-=0.392).Thirty-one patients obtained an excellent result,13 good and 1 poor in groupⅠ; and 16 patients obtained an excellent result,13 good,10 fair and 1 poor in groupⅡ; while 10 patients obtained an excellent result,15 good,8 fair and 7 poor in groupⅢ.The groupⅠsurpassed the groupⅡand groupⅢin the total curative effect,and the groupⅡsurpassed groupⅢ(groupⅠ:95%CI 0.326-0.475,R^-=0.316); groupⅡ:95%CI 0.518-0.691,R^-=0.487); groupⅢ:95%CI 0.702-0.877,R^-=0.492).Conclusion:In the treatment of LDN,the therapy of nerve block combined with chiropractic manipulation can effectively relieve the lower back pain or lower limbs radiated pain and promote the functional rehabilitation of lumbar vertebrae,so it is worthy of popularizing in clinic.

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更新日期/Last Update: 1900-01-01