[1]林松青,罗勇杰,陈肖,等.神经阻滞联合整脊手法治疗腰椎间盘突出症的临床研究[J].中医正骨,2014,26(06):31-34.
　Lin Songqing*,Luo Yongjie,Chen Xiao,et al.Clinical study on nerve block combined with chiropractic manipulation in the treatment of lubar disk herniation[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2014,26(06):31-34.
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神经阻滞联合整脊手法治疗腰椎间盘突出症的临床研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第26卷
期数:
2014年06期
页码:
31-34
栏目:
临床研究
出版日期:
2014-06-30

文章信息/Info

Title:
Clinical study on nerve block combined with chiropractic manipulation in the treatment of lubar disk herniation
作者:
林松青1; 罗勇杰2; 陈肖1; 王彬2; 杨曾静2; 张磊2
1.广东省深圳市福田区中医院,广东 深圳 518034; 2.湖南中医药大学,湖南 长沙 410007
Author(s):
Lin Songqing*; Luo Yongjie; Chen Xiao; Wang bin; Yang Zengjing; Zhang Lei.*
Futian Hospital of Traditional Chinese Medicine,Shenzhen 518034,Guangdong,China
关键词:
椎间盘移位 腰椎 神经传导阻滞 手法; 捏脊 治疗; 临床研究性
Keywords:
Intervertebral disk displacement;  Lumbar vertebrae;  Nerve block;  Manipulation; chiropractic;  Therapies; investigational
摘要:
目的:观察神经阻滞联合整脊手法治疗腰椎间盘突出症的临床疗效。方法:将符合要求的125例患者随机分为3组,Ⅰ组45例,采用神经根孔或侧隐窝神经阻滞联合整脊手法治疗; Ⅱ组40例,采用神经根孔或侧隐窝神经阻滞治疗; Ⅲ组40例,采用整脊手法治疗。观察比较3组患者的疼痛评分、腰痛分级和总体疗效。结果:①疼痛评分。治疗前3组患者的疼痛评分比较,差异无统计学意义[(69.16±8.35)分,(68.98±7.28)分,(70.32±6.78)分; F=0.562,P=0.682]; 治疗后3组患者的疼痛评分均较治疗前下降[(69.16±8.35)分,(20.31±9.05)分,t=3.593,P=0.000;(68.98±7.28)分,(24.11±8.28)分,t=4.124,P=0.004;(70.32±6.78)分,(50.89±10.32)分,t=1.043,P=0.029],Ⅰ组下降程度大于Ⅱ组和Ⅲ组,Ⅱ组下降程度大于Ⅲ组[(48.72±8.56)分,(46.31±6.53)分,(18.43±9.01)分,P=0.021,P=0.000,P=0.004]。②腰痛分级。3组患者治疗后的Denis腰痛分级结果比较,Ⅰ组优于Ⅱ组和Ⅲ组,Ⅱ组与Ⅲ组差异无统计学意义[Ⅰ组95%CI为(0.214,0.365),R^-=0.216; Ⅱ组95%CI为(0.417,0.761),R^-=0.346; Ⅲ组95%CI为(0.511,0.812),R^-=0.392]。③总体疗效。Ⅰ组优31例、良13例、差1例,Ⅱ组优16例、良13例、可10例、差1例,Ⅲ组优10例、良15例、可8例、差7例。Ⅰ组总体疗效优于Ⅱ组和Ⅲ组,Ⅱ组优于Ⅲ组[Ⅰ组95%CI为(0.326,0.475),R^-=0.316; Ⅱ组95%CI为(0.518,0.691),R^-=0.487; Ⅲ组95%CI为(0.702,0.877),R^-=0.492]。结论:神经阻滞联合整脊手法治疗腰椎间盘突出症,可以有效缓解腰痛或下肢放射性疼痛症状,促进腰椎功能恢复,值得临床推广应用。
Abstract:
Objective:To observe the clinical curative effects of nerve block combined with chiropractic manipulation in the treatment of lubar disk herniation(LDH).Methods:One hundred and twenty-five patients enrolled in the study were randomly divided into 3 groups,45 cases in groupⅠ,40 cases in groupⅡand 40 cases in groupⅢ.The patients in groupⅠwere treated with nerve block at the nerve root foramen or lateral recess combined with chiropractic manipulation,the patients in groupⅡwere treated with nerve block at the nerve root foramen or lateral recess,while the others in groupⅢwere treated with chiropractic manipulation.The visual analogue scores(VAS),Denis lower back pain classification and total curative effect were observed and compared between the 3 groups.Results:There was no statistical difference in VAS between the 3 groups before the treatment(69.16+/-8.35,68.98+/-7.28,70.32+/-6.78 points,F=0.562,P=0.682),while the VAS decreased in the 3 groups after the treatment(69.16+/-8.35 vs 20.31+/-9.05 points,t=3.593,P=0.000; 68.98+/-7.28 vs 24.11+/-8.28 points,t=4.124,P=0.004; 70.32+/-6.78 vs 50.89+/-10.32 points,t=1.043,P=0.029),and there was a bigger decline in groupⅠcompared to groupⅡand groupⅢ,and there was a bigger decline in groupⅡcompared to groupⅢ(48.72+/-8.56,46.31+/-6.53,18.43+/-9.01 points,P=0.021,P=0.000,P=0.004).There was no statistical difference in Denis lower back pain classification between groupⅡand groupⅢafter the treatment,while groupⅠsurpassed groupⅡand groupⅢ(groupⅠ:95%CI 0.214-0.365,R^-=0.216; groupⅡ:95%CI0.417-0.761,R^-=0.346; groupⅢ:95%CI0.511-0.812,R^-=0.392).Thirty-one patients obtained an excellent result,13 good and 1 poor in groupⅠ; and 16 patients obtained an excellent result,13 good,10 fair and 1 poor in groupⅡ; while 10 patients obtained an excellent result,15 good,8 fair and 7 poor in groupⅢ.The groupⅠsurpassed the groupⅡand groupⅢin the total curative effect,and the groupⅡsurpassed groupⅢ(groupⅠ:95%CI 0.326-0.475,R^-=0.316); groupⅡ:95%CI 0.518-0.691,R^-=0.487); groupⅢ:95%CI 0.702-0.877,R^-=0.492).Conclusion:In the treatment of LDN,the therapy of nerve block combined with chiropractic manipulation can effectively relieve the lower back pain or lower limbs radiated pain and promote the functional rehabilitation of lumbar vertebrae,so it is worthy of popularizing in clinic.

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更新日期/Last Update: 1900-01-01