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[1]謝云興,呂立江,杜紅根,等.杠桿定位手法治療腰椎間盤突出癥的臨床研究[J].中醫(yī)正骨,2021,33(03):1-5.
　XIE Yunxing,LYU Lijiang,DU Honggen,et al.A clinical study of lever positioning manipulation for treatment of lumbar disc herniation[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(03):1-5.
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杠桿定位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33卷
期數(shù):
2021年03期
頁(yè)碼:
1-5
欄目:
臨床研究
出版日期:
2021-03-20

文章信息/Info

Title:
A clinical study of lever positioning manipulation for treatment of lumbar disc herniation
作者:
謝云興; 呂立江; 杜紅根; 姚俊丞
(1.浙江省中醫(yī)院,浙江 杭州 310006; 2.浙江中醫(yī)藥大學(xué)第三臨床醫(yī)學(xué)院,浙江 杭州 310053)
Author(s):
XIE Yunxing; LYU Lijiang; DU Honggen; YAO Juncheng
1.Zhejiang Provincial Hospital of Traditional Chinese Medicine,Hangzhou 310006,Zhejiang,China；2.The Third Clinical Medical College of Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang,China
關(guān)鍵詞:
椎間盤移位;  腰椎;  腰部斜扳法;  杠桿定位法
Keywords:
intervertebral disc displacement;  lumbar vertebrae;  lumbar oblique thrust;  lever positioning manipulation
摘要:
目的:探討杠桿定位手法治療腰椎間盤突出癥(lumbar disc herniation,LDH)的臨床療效。方法:LDH患者93例,隨機(jī)分為杠桿定位組和腰椎斜扳組。2組患者均先采用柔筋手法松解肌肉痙攣,然后杠桿定位組采用杠桿定位手法治療、腰椎斜扳組采用腰椎斜扳手法治療。隔天治療1次,6次為1個(gè)療程,共治療2個(gè)療程。分別于治療前和治療結(jié)束后,采用日本骨科協(xié)會(huì)(Japanese Orthopedic Association,JOA)腰痛評(píng)分評(píng)價(jià)患者腰痛程度,采用Oswestry功能障礙指數(shù)(Oswestry disability index,ODI)評(píng)分評(píng)價(jià)患者腰椎功能,采用Seze氏法測(cè)量腰椎曲度值,采用Ferguson’s法測(cè)量腰骶角; 并在治療結(jié)束后,參照《中醫(yī)病證診斷療效標(biāo)準(zhǔn)》中LDH療效評(píng)價(jià)標(biāo)準(zhǔn)評(píng)價(jià)綜合療效。對(duì)2組患者的評(píng)價(jià)和測(cè)量結(jié)果進(jìn)行比較。結(jié)果:治療前,2組患者JOA腰痛評(píng)分比較,差異無統(tǒng)計(jì)學(xué)意義[(11.23±1.49)分,(11.13±1.34)分,t=-0.354,P=0.724]; 治療結(jié)束后,2組患者JOA腰痛評(píng)分均較治療前增加,且杠桿定位組高于腰椎斜扳組[(21.29±3.98)分,(18.74±4.20)分,t=3.590,P=0.001]。治療前,2組患者腰部ODI評(píng)分比較,差異無統(tǒng)計(jì)學(xué)意義[(46.17±2.00)分,(46.22±1.89)分,t=-0.117,P=0.907]; 治療結(jié)束后,2組患者腰部ODI評(píng)分均較治療前降低,且杠桿定位組低于腰椎斜扳組[(20.55±8.34)分,(26.80±10.36)分,t=-3.209,P=0.002]。治療前,2組患者腰椎曲度值和腰骶角比較,組間差異均無統(tǒng)計(jì)學(xué)意義[(0.62±0.11)cm,(0.65±0.10)cm,t=-1.298,P=0.198; 24.72°±1.14°,25.00°±0.99°,t=-1.251,P=0.214]; 治療結(jié)束后,2組患者腰椎曲度值和腰骶角均增加,且杠桿定位組均大于腰椎斜扳組[(1.62±0.39)cm,(1.31±0.44)cm,t=3.571,P=0.001; 33.17°±3.14°,30.91°±3.59°,t=3.571,P=0.002]。治療結(jié)束后評(píng)價(jià)綜合療效,杠桿定位組治愈27例、好轉(zhuǎn)17例、無效3例,腰椎斜扳組治愈10例、好轉(zhuǎn)26例、無效10例,杠桿定位組綜合療效優(yōu)于腰椎斜扳組(Z=-3.632,P=0.000)。結(jié)論:采用杠桿定位手法治療LDH,可緩解腰部疼痛,恢復(fù)腰椎功能,改善腰椎曲度和穩(wěn)定性,療效優(yōu)于腰椎斜扳手法。
Abstract:
Objective:To explore the clinical curative effects of lever positioning manipulation for treatment of lumbar disc herniation(LDH).Methods:Ninety-three LDH patients were enrolled in the study and were randomly divided into 2 groups.All patients in the 2 groups were treated with sinew softening manipulation for releasing muscle spasms; moreover,the patients were treated with lever positioning manipulation(lever positioning group)and lumbar oblique-pulling manipulation(lumbar oblique-pulling group)respectively.The manipulations were performed in patients of the 2 groups on alternate days for consecutive 2 courses of treatment,6 times for each course.The low back pain and lumbar function were evaluated by using Japanese Orthopedic Associations(JOA)low back pain scores and Oswestry disability index(ODI)scores respectively,and the lumbar curvature value and lumbosacral angle(LSA)were measured by using Seze’s method and Ferguson’s method respectively before the treatment and after the end of the treatment.The clinical curative effects were evaluated according to the therapeutic effect evaluation standard of LDH which was extracted from Standard for diagnosis and therapeutic effectiveness evaluation of traditional Chinese medicine syndromes after the end of the treatment.The evaluation results and measurement results were compared between the 2 groups.Results:There was no statistical difference in JOA low back pain scores between the 2 groups before the treatment(11.23±1.49 vs 11.13±1.34 points,t=-0.354,P=0.724).The JOA low back pain scores increased after the end of the treatment compared to pretreatment in the 2 groups,and were higher in lever positioning group compared to lumbar oblique-pulling group(21.29±3.98 vs 18.74±4.20 points,t=3.590,P=0.001).There was no statistical difference in lumbar ODI scores between the 2 groups before the treatment(46.17±2.00 vs 46.22±1.89 points,t=-0.117,P=0.907).The lumbar ODI scores decreased after the end of the treatment compared to pretreatment in the 2 groups,and were lower in lever positioning group compared to lumbar oblique-pulling group(20.55±8.34 vs 26.80±10.36 points,t=-3.209,P=0.002).There was no statistical difference in lumbar curvature value and LSA between the 2 groups before the treatment(0.62±0.11 vs 0.65±0.10 cm,t=-1.298,P=0.198; 24.72±1.14 vs 25.00±0.99 degrees,t=-1.251,P=0.214).The lumbar curvature value and LSA increased after the end of the treatment compared to pretreatment in the 2 groups,and were greater in lever positioning group compared to lumbar oblique-pulling group(1.62±0.39 vs 1.31±0.44 cm,t=3.571,P=0.001; 33.17±3.14 vs 30.91±3.59 degrees,t=3.571,P=0.002).After the end of the treatment,27 patients were cured,17 good and 3 poor in lever positioning group; while 10 patients were cured,26 good and 10 poor in lumbar oblique-pulling group.The lever positioning group surpassed the lumbar oblique-pulling group in the clinical curative effects(Z=-3.632,P=0.000).Conclusion:The lever positioning manipulation can relieve low back pain,restore lumbar function and improve lumbar curvature and stability in treatment of LDH,and its curative effect is better than that of lumbar oblique-pulling manipulation.

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備注/Memo

備注/Memo:
基金項(xiàng)目:國(guó)家自然科學(xué)基金項(xiàng)目(81774447)
通訊作者:杜紅根 E-mail:[email protected]
更新日期/Last Update: 1900-01-01