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[1]麥敏軍,黃尚君,古波,等.腰椎定位斜扳法治療腰椎失穩(wěn)[J].中醫(yī)正骨,2018,30(04):19-22,27.
　MAI Minjun,HUANG Shangjun,GU Bo,et al.Lumbar fixed-position oblique-pulling manipulation for treatment of lumbar vertebrae destabilization[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(04):19-22,27.
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腰椎定位斜扳法治療腰椎失穩(wěn)()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期數(shù):
2018年04期
頁(yè)碼:
19-22,27
欄目:
腰椎疾患
出版日期:
2018-04-20

文章信息/Info

Title:
Lumbar fixed-position oblique-pulling manipulation for treatment of lumbar vertebrae destabilization
作者:
麥敏軍1; 黃尚君1; 古波1; 黃有榮2
1.廣西壯族自治區(qū)北海市中醫(yī)醫(yī)院,廣西 北海 536000; 2.廣西中醫(yī)藥大學(xué)附屬瑞康醫(yī)院,廣西 南寧 530011
Author(s):
MAI Minjun1; HUANG Shangjun1; GU Bo1; HUANG Yourong2
1.Beihai Hospital of Traditional Chinese Medicine of Guangxi Zhuang Autonomous Region,Beihai 536000,Guangxi,China 2.Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine,Nanning 530011,Guangxi,China
關(guān)鍵詞:
腰椎;  失穩(wěn);  推拿; 脊柱;  運(yùn)動(dòng)療法
Keywords:
Keywords lumbar vertebrae;  destabilizing;  manipulation; spinal;  exercise therapy
摘要:
目的:探討腰椎定位斜扳法治療腰椎失穩(wěn)的臨床療效。方法:腰椎失穩(wěn)患者100例,隨機(jī)分為定位斜扳組和功能鍛煉組,每組50例。在禁止腰部過(guò)度負(fù)重、每日臥床休息時(shí)間≥18 h、行走時(shí)腰圍保護(hù)等基礎(chǔ)上,功能鍛煉組采用五點(diǎn)支撐法和飛燕點(diǎn)水法進(jìn)行腰背肌功能鍛煉,每日2次,每次5 min,共鍛煉14 d; 定位斜扳組行腰椎定位斜扳手法治療,隔日1次,3次為1個(gè)療程,共治療2個(gè)療程。分別于治療前、治療結(jié)束后即刻、治療結(jié)束后6個(gè)月及治療結(jié)束后1年,采用疼痛視覺(jué)模擬量表(visual analogue scale,VAS)評(píng)價(jià)患者腰痛情況,采用日本骨科學(xué)會(huì)(Japanese orthopedics association,JOA)腰背痛疾病治療成績(jī)?cè)u(píng)分標(biāo)準(zhǔn)評(píng)價(jià)患者腰椎功能恢復(fù)情況。觀察2組患者腰痛VAS評(píng)分和腰椎功能JOA評(píng)分的變化趨勢(shì),并進(jìn)行比較。結(jié)果:①腰部疼痛VAS評(píng)分。2組患者腰部疼痛VAS評(píng)分總體比較,組間差異有統(tǒng)計(jì)學(xué)意義,即存在分組效應(yīng)(F=2.967,P=0.003)。治療前后不同時(shí)間點(diǎn)之間腰部疼痛VAS評(píng)分比較,差異有統(tǒng)計(jì)學(xué)意義,即存在時(shí)間效應(yīng)(F=381.062,P=0.000)。時(shí)間因素和分組因素存在交互效應(yīng)(F=37.312,P=0.000)。2組患者腰部疼痛VAS評(píng)分隨時(shí)間均呈降低趨勢(shì),但2組的降低趨勢(shì)不完全一致; 治療前2組患者腰部疼痛VAS評(píng)分比較,組間差異無(wú)統(tǒng)計(jì)學(xué)意義[(6.08±1.08)分,(5.96±1.14)分; t=0.383,P=0.703]; 治療后各時(shí)間點(diǎn)定位斜扳組腰部疼痛VAS評(píng)分均低于功能鍛煉組[(2.16±0.85)分,(3.32±1.41)分,t=-3.530,P=0.000;(0.88±0.67)分,(1.96±0.61)分,t=-5.975,P=0.000;(0.40±0.30)分,(0.96±0.74)分,t=-3.150,P=0.003],定位斜扳組腰部疼痛VAS評(píng)分比功能鍛煉組降低更快、更明顯。②腰椎功能JOA評(píng)分。2組患者腰椎功能JOA評(píng)分總體比較,組間差異有統(tǒng)計(jì)學(xué)意義,即存在分組效應(yīng)(F=38.473,P=0.000)。治療前后不同時(shí)間點(diǎn)之間腰椎功能JOA評(píng)分比較,差異有統(tǒng)計(jì)學(xué)意義,即存在時(shí)間效應(yīng)(F=417.467,P=0.000)。時(shí)間因素和分組因素存在交互效應(yīng)(F=20.987,P=0.000)。2組患者腰椎功能JOA評(píng)分隨時(shí)間均呈增高趨勢(shì),但2組的增高趨勢(shì)不完全一致; 治療前2組患者腰椎功能JOA評(píng)分比較,組間差異無(wú)統(tǒng)計(jì)學(xué)意義[(13.76±1.72)分,(13.60±1.83)分,t=1.217,P=0.226]; 治療后各時(shí)間點(diǎn)定位斜扳組腰椎功能JOA評(píng)分均高于功能鍛煉組[(21.22±1.78)分,(17.22±2.00)分,t=10.879,P=0.000;(22.28±1.87)分,(18.58±1.65)分,t=10.448,P=0.000;(23.74±2.18)分,(19.64±1.61)分,t=10.662,P=0.000],定位斜扳組腰椎功能JOA評(píng)分比功能鍛煉組增高更快、更明顯。結(jié)論:腰椎定位斜扳法治療腰椎失穩(wěn),與腰背肌功能鍛煉相比,在緩解腰部疼痛和改善腰椎功能方面,起效更快、療效更好。
Abstract:
ABSTRACT Objective:To explore the clinical curative effect of lumbar fixed-position oblique-pulling manipulation in treatment of lumbar vertebrae destabilization.Methods:One hundred patients with lumbar vertebrae destabilization were randomly divided into fixed-position oblique-pulling manipulation group and functional exercise group,50 cases in each group.All patients were forbidden from lumbar overloading and were asked to rest in bed for≥18 hours every day and wear lumbar balteum while walking.The patients in functional exercise group were asked to do lumbodorsal muscle functional exercise by using five-point weight-support method and Feiyan Dianshui method,twice a day,5 minutes at a time for consecutive 14 days.The patients in fixed-position oblique-pulling manipulation group were treated with lumbar fixed-position oblique-pulling manipulation,one time every other day for consecutive 2 courses of treatment,three times for each course.The low back pain was evaluated by using visual analogue scale(VAS)and the lumbar function recovery was evaluated by using Japanese orthopaedic association(JOA)low back pain scoring system before treatment and at once,6 months and 1 year after the end of the treatment respectively.The variation tendencies of low back pain VAS scores and lumbar function JOA scores were observed and compared between the 2 groups.Results:There was statistical difference in low back pain VAS scores between the 2 groups in general,in other words,there was group effect(F=2.967,P=0.003).There was statistical difference in low back pain VAS scores between different timepoints before and after the treatment,in other words,there was time effect(F=381.062,P=0.000).There was interaction between time factor and group factor(F=37.312,P=0.000).The low back pain VAS scores presented a time-dependent decreasing trend in both of the 2 groups,while the 2 groups were inconsistent with each other in the decreasing trend of low back pain VAS scores.There was no statistical difference in low back pain VAS scores between the 2 groups before treatment(6.08+/-1.08 vs 5.96+/-1.14 points,t=0.383,P=0.703).The low back pain VAS scores were lower in fixed-position oblique-pulling manipulation group compared to functional exercise group at each posttreatment time point(2.16+/-0.85 vs 3.32+/-1.41 points,t=-3.530,P=0.000; 0.88+/-0.67 vs 1.96+/-0.61 points,t=-5.975,P=0.000; 0.40+/-0.30 vs 0.96+/-0.74 points,t=-3.150,P=0.003),and the low back pain VAS scores decreased more rapidly and more obviously in fixed-position oblique-pulling manipulation group compared to functional exercise group.There was statistical difference in lumbar function JOA scores between the 2 groups in general,in other words,there was group effect(F=38.473,P=0.000).There was statistical difference in lumbar function JOA scores between different timepoints before and after the treatment,in other words,there was time effect(F=417.467,P=0.000).There was interaction between time factor and group factor(F=20.987,P=0.000).The lumbar function JOA scores presented a time-dependent increasing trend in both of the 2 groups,while the 2 groups were inconsistent with each other in the increasing trend of lumbar function JOA scores.There was no statistical difference in lumbar function JOA scores between the 2 groups before the treatment(13.76+/-1.72 vs 13.60+/-1.83 points,t=1.217,P=0.226).The lumbar function JOA scores were higher in fixed-position oblique-pulling manipulation group compared to functional exercise group at each posttreatment time point(21.22+/-1.78 vs 17.22+/-2.00 points,t=10.879,P=0.000; 22.28+/-1.87 vs 18.58+/-1.65 points,t=10.448,P=0.000; 23.74+/-2.18 vs 19.64+/-1.61 points,t=10.662,P=0.000),and the lumbar function JOA scores increased more rapidly and more obviously in fixed-position oblique-pulling manipulation group compared to functional exercise group.Conclusion:Compared with lumbodorsal muscle functional exercises,lumbar fixed-position oblique-pulling manipulation provides superior curative effect and faster onset of action in alleviating low back pain and improving lumbar function in treatment of lumbar vertebrae destabilization.

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備注/Memo

備注/Memo:
基金項(xiàng)目:廣西壯族自治區(qū)北海市科學(xué)研究與技術(shù)開(kāi)發(fā)計(jì)劃項(xiàng)目(201005008) 通訊作者:黃有榮 E-mial:[email protected]
更新日期/Last Update: 2018-08-24