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[1]徐星星,韓璐,馬琳,等.八段錦鍛煉聯(lián)合推拿對非急性期腰椎間盤突出癥患者腰痛和生活質量的影響[J].中醫(yī)正骨,2018,30(12):18-22.
　XU Xingxing,HAN Lu,MA Lin,et al.Effect of BADUANJIN(八段錦)exercises combined with TUINA on low back pain and life quality of patients with non-acute-phase lumbar disc herniation[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(12):18-22.
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八段錦鍛煉聯(lián)合推拿對非急性期腰椎間盤突出癥患者腰痛和生活質量的影響()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期數:
2018年12期
頁碼:
18-22
欄目:
臨床研究
出版日期:
2018-12-20

文章信息/Info

Title:
Effect of BADUANJIN(八段錦)exercises combined with TUINA on low back pain and life quality of patients with non-acute-phase lumbar disc herniation
作者:
徐星星; 韓璐; 馬琳; 張晶瑩
(浙江省杭州市中醫(yī)院,浙江 杭州 310007)
Author(s):
XU Xingxing; HAN Lu; MA Lin; ZHANG Jingying
Hangzhou Hospital of Traditional Chinese Medicine,Hangzhou 310007,Zhejiang,China
關鍵詞:
椎間盤移位;  腰椎;  八段錦;  推拿;  腰痛;  生活質量;  臨床試驗
Keywords:
intervertebral disc displacement;  lumbar vertebrae;  BADUANJIN;  TUINA;  low back pain;  quality of life;  clinical trial
摘要:
目的:觀察八段錦鍛煉聯(lián)合推拿對非急性期腰椎間盤突出癥患者腰痛和生活質量的影響。方法:將符合要求的90例非急性期腰椎間盤突出癥患者隨機分為2組,每組45例。推拿組接受腰部推拿治療,每天1次,每次30 min,10 d為1個療程,休息2 d后開始下一療程,共治療2個療程。八段錦組在腰部推拿治療的基礎上,進行八段錦鍛煉。腰部推拿治療方法及療程同推拿組,八段錦鍛煉每周5次,每次練習時間不少于30 min,共練習12周。分別于治療前及治療開始后4周、8周、12周評定患者的腰部疼痛視覺模擬量表(visual analogue scale,VAS)評分和簡明健康狀況調查表(short form 36 health survey questionnaire,SF-36)評分。結果:①一般情況。至觀察結束時,八段錦組1例試驗期間失去聯(lián)系、1例不能按要求進行練習,均予以剔除; 推拿組1例因自覺療效欠佳退出試驗、1例因打籃球出現急性腰扭傷退出試驗。②腰部疼痛VAS評分。時間因素與分組因素存在交互效應(F=9.044,P=0.000)。2組疼痛VAS評分總體比較,差異有統(tǒng)計學意義,即存在分組效應(F=24.915,P=0.000)。治療前后不同時點之間疼痛VAS評分的差異有統(tǒng)計學意義,即存在時間效應(F=493.262,P=0.000)。2組疼痛VAS評分隨時間變化均呈降低趨勢,但2組的變化趨勢不完全一致[(4.47±0.94)分,(2.60±0.49)分,(1.51±0.51)分,(0.87±0.34)分,F=250.382,P=0.000;(4.87±1.10)分,(2.82±0.75)分,(2.11±0.53)分,(1.60±0.49)分,F=198.245,P=0.000]; 治療前和治療開始后4周,2組的疼痛VAS評分比較,組間差異均無統(tǒng)計學意義(t=-1.852,P=0.067; t=-1.662,P=0.100); 治療開始后8周、12周,八段錦組的疼痛VAS評分均低于推拿組(t=-5.485,P=0.000; t=-8.158,P=0.000)。③SF-36評分。時間因素與分組因素存在交互效應(F=47.838,P=0.000)。2組SF-36評分總體比較,差異有統(tǒng)計學意義,即存在分組效應(F=90.504,P=0.000)。干預后不同時點之間SF-36評分的差異有統(tǒng)計學意義,即存在時間效應(F=733.500,P=0.000)。2組SF-36評分隨時間變化均呈升高趨勢,但2組的變化趨勢不完全一致[(52.22±2.84)分,(57.11±3.14)分,(68.22±3.12)分,(73.62±2.35)分,F=256.766,P=0.000;(51.33±1.61)分,(55.96±2.53)分,(63.18±3.09)分,(64.67±3.33)分,F=335.768,P=0.000]; 治療前和治療開始后4周,2組的SF-36評分比較,組間差異均無統(tǒng)計學意義(t=1.825,P=0.071; t=1.921,P=0.058); 治療開始后8周、12周,八段錦組的SF-36評分均高于推拿組(t=7.697,P=0.000; t=14.763,P=0.000)。結論:在腰部推拿的基礎上堅持進行八段錦練習,能有效減輕非急性期腰椎間盤突出癥患者的腰部疼痛癥狀、改善患者的生活質量,其療效優(yōu)于單純腰部推拿治療。
Abstract:
Objective:To observe the effects of BADUANJIN(八段錦,BDJ)exercises combined with TUINA on low back pain and life quality of patients with non-acute-phase lumbar disc herniation(LDH).Methods:Ninety patients with non-acute-phase LDH enrolled in the study were randomly divided into BDJ group and TUINA group,45 cases in each group.All patients in both of the 2 groups were treated with TUINA at the low back,once a day,30 minutes at a time for two courses of treatment,10 days for each course with a 2-day rest-insertion between courses.Moreover,the patients in BDJ group were treated with BDJ exercises,five times a week,at least 30 minutes at a time for consecutive 12 weeks.The low back pain visual analogue scale(VAS)scores and the short form 36 health survey questionnaire(SF-36)scores were recorded and evaluated before treatment and at 4,8 and 12 weeks after the beginning of the treatment respectively.Results:One patient lost to follow-up and one patient failed to do the exercises in BDJ group and they were excluded.Two patients in TUINA group dropped out of the trial for poor clinical effect and acute lumbar sprain due to playing basketball respectively.There was interaction between time factor and group factor in low back pain VAS scores(F=9.044,P=0.000).There was statistical difference in the low back pain VAS scores between the 2 groups in general,in other words,there was group effect(F=24.915,P=0.000).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=493.262,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(4.47+/-0.94,2.60+/-0.49,1.51+/-0.51,0.87+/-0.34 points,F=250.382,P=0.000; 4.87+/-1.10,2.82+/-0.75,2.11+/-0.53,1.60+/-0.49 points,F=198.245,P=0.000).There was no statistical difference in low back pain VAS scores between the 2 groups before the treatment and at 4 weeks after the beginning of the treatment(t=-1.852,P=0.067; t=-1.662,P=0.100).The low bcak pain VAS scores were lower in BDJ group compared to TUINA group at 8 and 12 weeks after the beginning of the treatment(t=-5.485,P=0.000; t=-8.158,P=0.000).There was interaction between time factor and group factor in SF-36 scores(F=47.838,P=0.000).There was statistical difference in SF-36 scores between the 2 groups in general,in other words,there was group effect(F=90.504,P=0.000).There was statistical difference in SF-36 scores between different timepoints after intervention,in other words,there was time effect(F=733.500,P=0.000).The SF-36 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 SF-36 scores(52.22+/-2.84,57.11+/-3.14,68.22+/-3.12,73.62+/-2.35 points,F=256.766,P=0.000; 51.33+/-1.61,55.96+/-2.53,63.18+/-3.09,64.67+/-3.33 points,F=335.768,P=0.000).There was no statistical difference in SF-36 scores between the 2 groups before the treatment and at 4 weeks after the beginning of the treatment(t=1.825,P=0.071; t=1.921,P=0.058).The SF-36 scores were higher in BDJ group compared to TUINA group at 8 and 12 weeks after the beginning of the treatment(t=7.697,P=0.000; t=14.763,P=0.000).Conclusion:BDJ exercises combined with TUINA at the low back can effectively relieve the low back pain and improve the life quality of patients with non-acute-phase LDH,and it surpasses the monotherapy of TUINA at the low back in the clinical curative effect.

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通訊作者:徐星星 E-mail:[email protected] (收稿日期:2018-08-01 本文編輯:李曉樂)
更新日期/Last Update: 2019-05-30