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[1]楊晗丹,范德輝,劉建,等.牽抖沖壓法和常規(guī)牽引法治療腰椎間盤(pán)突出癥的對(duì)比研究[J].中醫(yī)正骨,2016,28(12):26-30.
　YANG Handan,FAN Dehui,LIU Jian,et al.A comparative study of draw-shake-ram manipulation versus conventional lumbar traction for treatment of lumbar disc herniation[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(12):26-30.
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牽抖沖壓法和常規(guī)牽引法治療腰椎間盤(pán)突出癥的對(duì)比研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期數(shù):
2016年12期
頁(yè)碼:
26-30
欄目:
臨床研究
出版日期:
2016-12-30

文章信息/Info

Title:
A comparative study of draw-shake-ram manipulation versus conventional lumbar traction for treatment of lumbar disc herniation
作者:
楊晗丹1; 范德輝2; 劉建2; 林錦坤3; 蘇美意2; 張振宇2; 吳晶晶2; 康健2; 鄧玲琳2
1.廣州中醫(yī)藥大學(xué),廣東 廣州 510006;
2.廣東省第二中醫(yī)院,廣東 廣州 510095;
3.重慶市銅梁區(qū)中醫(yī)院,重慶 402560
Author(s):
YANG Handan1; FAN Dehui2; LIU Jian2; LIN Jinkun3; SU Meiyi2; ZHANG Zhenyu2; WU Jingjing2; KANG Jian2; DENG Linglin2
1.Guangzhou University of Chinese Medicine,Guangzhou 510006,Guangdong,China 2.The Second Hospital of Traditional Chinese Medicine of Guangdong,Guangzhou 510095,Guangdong,China 3.Tongliang Hospital of Traditional Chinese Medicine,Chongqing 402560,China
關(guān)鍵詞:
椎間盤(pán)移位;  腰椎;  牽引術(shù);  牽抖沖壓法;  臨床試驗(yàn)
Keywords:
intervertebral disc displacement;  lumbar vertebrae;  traction;  draw-shake-ram manipulation;  clinical trial
摘要:
目的:比較牽抖沖壓法和常規(guī)牽引法治療腰椎間盤(pán)突出癥的臨床療效。方法:將90例腰椎間盤(pán)突出癥患者隨機(jī)分為2組,每組45例,分別采用牽抖沖壓法和常規(guī)牽引法治療。每天均治療1次,7次為1個(gè)療程,療程間休息2 d,共治療2個(gè)療程。分別于治療前和治療2個(gè)療程后比較2組患者腰痛視覺(jué)模擬量表(visual analog scale,VAS)評(píng)分、改良日本骨科學(xué)會(huì)(Japanese orthopaedic association,JOA)腰痛疾患評(píng)分和腰部軟組織張力,并于治療2個(gè)療程后參照《中藥新藥臨床研究指導(dǎo)原則》中腰椎間盤(pán)突出癥的療效評(píng)價(jià)標(biāo)準(zhǔn)比較2組患者的總體療效。結(jié)果:①腰痛VAS評(píng)分。治療前2組患者腰痛VAS評(píng)分比較,差異無(wú)統(tǒng)計(jì)學(xué)意義[(7.74±0.72)分,(7.52±0.67)分,t=1.501,P=0.137]; 治療2個(gè)療程后,牽抖沖壓組腰痛VAS評(píng)分低于常規(guī)牽引組[(2.17 ±1.42)分,(3.57±1.58)分,t=4.421,P=0.000],牽抖沖壓組和常規(guī)牽引組腰痛VAS評(píng)分均低于治療前(t=21.362,P=0.000; t=23.128,P=0.000)。②改良JOA腰痛疾患評(píng)分。治療前2組患者改良JOA腰痛疾患評(píng)分比較,差異無(wú)統(tǒng)計(jì)學(xué)意義[(10.24 ±2.15)分,(10.62±1.73)分,t=0.924,P=0.358]; 治療2個(gè)療程后,牽抖沖壓組改良JOA腰痛疾患評(píng)分高于常規(guī)牽引組[(23.56 ±3.21)分,(19.02 ±4.13)分,t=5.822,P=0.000],牽抖沖壓組和常規(guī)牽引組改良JOA腰痛疾患評(píng)分均高于治療前(t=15.440,P=0.000; t=12.584,P=0.000)。③腰部軟組織張力。治療前2組患者患側(cè)、健側(cè)腰部軟組織位移比較,組間差異均無(wú)統(tǒng)計(jì)學(xué)意義[(5.72±0.17)mm,(5.67±0.15)mm,t=1.480,P=0.143;(6.10 ±0.16)mm,(6.07±0.18)mm,t=0.836,P=0.406]。治療2個(gè)療程后,牽抖沖壓組患側(cè)和健側(cè)腰部軟組織位移均大于常規(guī)牽引組[(6.71 ±0.18)mm,(5.91±0.19)mm,t=20.505,P=0.000;(7.28 ±0.21)mm,(6.11±0.16)mm,t=29.729,P=0.000]; 牽抖沖壓組患側(cè)和健側(cè)腰部軟組織位移均大于治療前(t=26.823,P=0.000; t=29.983,P=0.000); 常規(guī)牽引組患側(cè)腰部軟組織位移大于治療前(t=6.651,P=0.000),健側(cè)腰部軟組織位移與治療前比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(t=1.114,P=0.286)。④總體療效。治療2個(gè)療程后,牽抖沖壓組臨床治愈21例、顯效16例、有效4例、無(wú)效4例,常規(guī)牽引組臨床治愈12例、顯效11例、有效12例、無(wú)效10例; 牽抖沖壓組的總體療效優(yōu)于常規(guī)牽引組(Z=-2.789,P=0.005)。結(jié)論:對(duì)于腰椎間盤(pán)突出癥患者而言,采用牽抖沖壓法和常規(guī)牽引法治療,均能緩解腰部疼痛,降低腰部軟組織張力,促進(jìn)腰椎功能的恢復(fù); 但牽抖沖壓法的總體療效優(yōu)于常規(guī)牽引法,值得臨床推廣應(yīng)用。
Abstract:
Objective:To compare the clinical curative effects of draw-shake-ram manipulation versus conventional lumbar traction for treatment of lumbar disc herniation(LDH).Methods:Ninty patients with LDH enrolled in the study were randomly divided into 2 groups,45 cases in each group.The patients were treated with draw-shake-ram manipulation(group A)and conventional lumbar traction(group B)respectively,once a day for 2 course of treatment,7 times for each course with a 2-day rest-insertion between courses.The visual analog scale(VAS)scores and modified Japanese orthopaedic association(JOA)scores for low back pain and lumbar soft tissue tension were compared between the 2 groups before the treatment and after 2-course treatment,and the total clinical curative effects were also compared between the 2 groups according to the therapeutic effect criterion of LDH which was extracted from Guiding principles of clinical research on new Chinese medicine after 2-course treatment.Results:There was no statistical difference in low back pain VAS scores between the 2 groups before treatment(7.74+/-0.72 vs 7.52+/-0.67 points,t=1.501,P=0.137).The low back pain VAS scores were lower in group A compared to group B after 2-course treatment(2.17+/-1.42 vs 3.57+/-1.58 points,t=4.421,P=0.000)and the low back pain VAS scores decreased in both of the 2 groups(t=21.362,P=0.000; t=23.128,P=0.000).There was no statistical difference in modified JOA low back pain scores between the 2 groups before treatment(10.24+/-2.15 vs 10.62+/-1.73 points,t=0.924,P=0.358).The modified JOA low back pain scores were higher in group A compared to group B after 2-course treatment(23.56+/-3.21 vs 19.02+/-4.13 points,t=5.822,P=0.000)and the modified JOA low back pain scores increased in both of the 2 groups(t=15.440,P=0.000; t=12.584,P=0.000).There was no statistical difference in the lumbar soft tissue displacement of affected and unaffected sides between the 2 groups before treatment(5.72+/-0.17 vs 5.67+/-0.15 mm,t=1.480,P=0.143; 6.10+/-0.16 vs 6.07+/-0.18 mm,t=0.836,P=0.406).The lumbar soft tissue displacement of affected and unaffected sides increased in group A after 2-course treatment(t=26.823,P=0.000; t=29.983,P=0.000),and they were greater in group A compared to group B(6.71 +/-0.18 vs 5.91+/-0.19 mm,t=20.505,P=0.000; 7.28+/-0.21 vs 6.11+/-0.16 mm,t=29.729,P=0.000).The post-treatment lumbar soft tissue displacement of affected sides were greater than those of pre-treatment(t=6.651,P=0.000)and there was no statistical difference in the lumbar soft tissue displacement of unaffected sides between pre-treatment and post-treatment(t=1.114,P=0.286).After 2-course treatment,21 patients were cured,16 good,4 fair and 4 poor in group A; while 12 patients were cured,11 good,12 fair and 10 poor in group B.The group A surpassed the group B in the clinical curative effect(Z=-2.789,P=0.005).Conclusion:Both draw-shake-ram manipulation and conventional lumbar traction can relieve low back pain and reduce lumbar soft tissue tension and improve lumbar function recovery in patients with LDH,while the former surpasses the latter in the total clinical curative effects,so it is worthy of popularizing in clinic.

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備注/Memo

備注/Memo:
基金項(xiàng)目:廣州市科技和信息化局重大民生科研課題(2014Y2-00045)
通訊作者:范德輝 E-mail:[email protected]
更新日期/Last Update: 2016-12-30