[1]薛彬,奚小冰,张昊,等.魏氏伤科非手术疗法治疗后腰椎间盘突出重吸收情况调查[J].中医正骨,2020,32(11):44-48.
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魏氏伤科非手术疗法治疗后腰椎间盘突出重吸收情况调查()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期数:
2020年11期
页码:
44-48
栏目:
临床报道
出版日期:
2020-11-20

文章信息/Info

作者:
薛彬1; 奚小冰2; 张昊1; 万世元1; 李飞跃1
(1.上海交通大学医学院附属瑞金医院,上海 200025; 2.上海市伤骨科研究所,上海 200025)
关键词:
椎间盘移位;  腰椎;  椎间盘突出后重吸收;  非手术疗法
摘要:
目的:调查采用魏氏伤科非手术疗法治疗后腰椎间盘突出重吸收的情况。方法:选取2012年1月至2018年12月在上海交通大学医学院附属瑞金医院采用魏氏伤科非手术疗法治疗的椎间盘突出症患者的病例资料进行研究。治疗方法包括魏氏伤科手法治疗、伸筋活血汤口服、魏氏伤科蒸敷方外敷、魏氏伤科撑弓导引锻炼、西药口服。所有患者均于治疗前和随访时采用同型号机器行MRI检查,前后2次MRI检查时间间隔≥6个月。基于MRI检查结果,采用密歇根州立大学(Michigan State University,MSU)腰椎间盘突出区域定位分型法进行椎间盘突出区域定位,采用日本学者福田庄司提出的方法评价腰椎间盘突出后重吸收情况。结果:①一般情况。共纳入398例患者,男102例、女296例; 年龄18～60岁,中位数42岁; 单节段突出261例,其中L3～4突出3例、L4～5突出107例、L5S1突出151例,多节段椎间盘突出137例。治疗时间10～62 d,中位数29 d; 末次腰椎MRI检查距治疗前腰椎MRI检查6～62个月,中位数25个月。②腰椎间盘突出区域定位分型结果。根据MSU分型,治疗前A型79例(1-A型0例、2-A型12例、3-A型67例),B型131例(1-B型0例、2-B型117例、3-B型14例),AB型173例(2-AB型90例、3-AB型83例),C型15例(1-C型0例、2-C型15例); 治疗后A型79例(1-A型5例、2-A型14例、3-A型60例),B型131例(1-B型14例、2-B型111例、3-B型6例),AB型173例(2-AB型103例、3-AB型70例),C型15例(1-C型1例、2-C型14例)。③腰椎间盘突出后重吸收评价结果。治疗后6例(1.51%)完全吸收、12例(3.02%)明显吸收、29例(7.28%)部分吸收、335例(84.17%)几乎不变、16例(4.02%)增大; 完全吸收患者的MSU分型以AB型为主(3-A型1例,3-B型1例,2-AB型2例,3-AB型2例),明显吸收患者的MSU分型也以AB型为主(3-A型2例,2-B型3例,3-B型1例,2-AB型4例,3-AB型2例),且均多为单一节段椎间盘突出。结论:采用魏氏伤科非手术疗法治疗后,腰椎间盘突出后重吸收的发生率较低; 发生重吸收现象的主要为单一节段偏一侧型椎间盘突出,且突出节段椎间盘大部分突破后纵韧带。

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备注/Memo

备注/Memo:
基金项目:全国名老中医药专家李飞跃传承工作室建设项目(MLZJGZS-2017001); 上海市名老中医李飞跃学术经验研究工作室建设项目(SHGZS-2017010); 上海市临床重点专科(中西医结合骨关节病)建设项目; 上海市科技计划项目(20YF1427500)
通讯作者:李飞跃 E-mail:sklifeiyue@163.com
更新日期/Last Update: 2020-11-20