[1]谢峰,王立刚,边俊,等.脑力劳动者与体力劳动者慢性非特异性腰痛的临床和影像特点比较[J].中医正骨,2019,31(04):22-25.
　XIE Feng,WANG Ligang,BIAN Jun,et al.A comparison of clinical and imaging characteristics of chronic nonspecific low back pain between manual workers and mental workers[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2019,31(04):22-25.
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脑力劳动者与体力劳动者慢性非特异性腰痛的临床和影像特点比较()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第31卷
期数:
2019年04期
页码:
22-25
栏目:
临床研究
出版日期:
2019-04-30

文章信息/Info

Title:
A comparison of clinical and imaging characteristics of chronic nonspecific low back pain between manual workers and mental workers
作者:
谢峰1; 王立刚1; 边俊1; 景成伟1; 陈维善2
(1.绍兴市中医院,浙江 绍兴 312000; 2.浙江大学医学院附属第二医院,浙江 杭州 310009)
Author(s):
XIE Feng1; WANG Ligang1; BIAN Jun1; JING Chengwei1; CHEN Weishan2
1.Shaoxing Hospital of Traditional Chinese Medicine,Shaoxing 312000,Zhejiang,China 2.The Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou 310009,Zhejiang,China
关键词:
腰痛;  体力劳动者;  脑力劳动者
Keywords:
low back pain;  manual worker;  mental worker
摘要:
目的:比较脑力劳动者与体力劳动者慢性非特异性腰痛的临床和影像特点。方法:回顾性分析39例慢性非特异性腰痛患者的病例资料,其中脑力劳动者18例(脑力劳动组)、体力劳动者21例(体力劳动组)。男11例,女28例。年龄31～60岁,中位数48岁。比较2组患者治疗前的腰痛视觉模拟量表(visual analogue scale,VAS)评分、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评分以及口服美洛昔康片2周后的临床疗效,观察腰椎骨赘情况,测量并比较2组患者的脊柱全长X线片上骨盆入射角(pelvic incidence,PI)、骨盆倾斜角(pelvic tilt,PT)、骶骨倾斜角(sacral slope,SS)、胸腰联合角(thoracolumbar junction,TLJ)、T1脊柱骨盆倾斜角(T1-spinopelvic inclination,T1-SPi)、T9脊柱骨盆倾斜角(T9-spinopelvic inclination,T9-SPi)、腰椎前凸角(lumbar lordosis,LL)、胸椎后凸角(thoracic kyphosis,TK)、矢状面轴向垂直距离(sagittal vertical axis,SVA)。结果:治疗前,2组患者的腰痛VAS评分比较,差异无统计学意义[(4.8±0.9)分,(4.4±0.9)分,t=1.579,P=0.123]; 脑力劳动组的HAMA评分高于体力劳动组[(13.0±5.1)分,(9.8±3.4)分,t=2.289,P=0.030]。口服美洛昔康片2周后,脑力劳动组有效13例、无效5例,体力劳动组有效18例、无效3例,2组患者的临床疗效比较差异无统计学意义(χ2=1.082,P=0.298)。脑力劳动组5例有腰椎骨赘、体力劳动组18例有腰椎骨赘,脑力劳动组的腰椎骨赘发生率低于体力劳动组(χ2=13.447,P=0.000)。2组患者PI、PT、SS、TLJ、T1-SPi、LL、SVA比较,组间差异均无统计学意义[47.6°±11.3°,51.7°±8.5°,t=-1.303,P=0.201; 15.3°±10.7°,17.7°±7.9°,t=-0.778,P=0.441; 32.2°±6.8°,34.0°±8.5°,t=-0.722,P=0.475; 6.8°±5.4°,10.3°±9.2°,t=-1.439,P=0.159; -2.0°±3.0°,-3.5°±3.7°,t=1.387,P=0.174; -34.1°±22.4°,-28.3°±42.5°,t=-0.538,P=0.595;(33.0±28.1)mm,(19.7±36.6)mm,t=1.265,P=0.214]; 脑力劳动组的T9-SPi大于体力劳动组(-6.3°±4.0°,-10.2°±4.5°,t=2.819,P=0.008),TK小于体力劳动组(23.5°±10.5°,31.5°±6.8°,t=-2.854,P=0.007)。结论:慢性非特异性腰痛患者中,脑力劳动者的焦虑程度相对严重、T9-SPi相对较大,体力劳动者容易出现腰椎骨赘、TK相对较大。
Abstract:
Objective:To compare the clinical and imaging characteristics of chronic nonspecific low back pain(CNLBP)between mental workers and manual workers.Methods:The medical records of 39 patients with CNLBP(11 males and 28 females)between the ages of 31 and 60(Median=48 yrs)were analyzed retrospectively.The patients consisted of 18 mental workers(mental-work group)and 21 manual workers(manual-work group).The low back pain visual analogue scale(VAS)scores and Hamilton anxiety scale(HAMA)scores measured before the treatment and the clinical curative effects evaluated after 2-week oral application of meloxicam tablets were compared between the 2 groups.The lumbar vertebrae osteophytes were observed and pelvic incidence(PI),pelvic tilt(PT),sacral slope(SS),thoracolumbar junction(TLJ),T1-spinopelvic inclination(T1-SPi),T9-spinopelvic inclination(T9-SPi),lumbar lordosis(LL),thoracic kyphosis(TK)and sagittal vertical axis(SVA)on whole spine X-ray films were measured and compared between the 2 groups.Results:There was no statistical difference in low back pain VAS scores between the 2 groups before the treatment(4.8+/-0.9 vs 4.4+/-0.9 points,t=1.579,P=0.123).The HAMA scores were higher in mental-work group compared to manual-work group(13.0+/-5.1 vs 9.8+/-3.4 points,t=2.289,P=0.030).After 2-week oral application of meloxicam tablets,13 patients got a good therapeutic result and 5 patients got a poor therapeutic result in mental-work group,while 18 patients got a good therapeutic result and 3 patients got a poor therapeutic result in manual-work group.There was no statistical difference in clinical curative effects between the 2 groups(χ2=1.082,P=0.298).The lumbar vertebrae osteophytes were found in mental-work group(5)and manual-work group(18).The incidence rates of lumbar vertebrae osteophytes were lower in mental-work group compared to manual-work group(χ2=13.447,P=0.000).There was no statistical difference in PI,PT,SS,TLJ,T1-SPi,LL and SVA between the 2 groups(47.6+/-11.3 vs 51.7+/-8.5 degrees,t=-1.303,P=0.201; 15.3+/-10.7 vs 17.7+/-7.9 degrees,t=-0.778,P=0.441; 32.2+/-6.8 vs 34.0+/-8.5 degrees,t=-0.722,P=0.475; 6.8+/-5.4 vs 10.3+/-9.2 degrees,t=-1.439,P=0.159; -2.0+/-3.0 vs -3.5+/-3.7 degrees,t=1.387,P=0.174; -34.1+/-22.4 vs -28.3+/-42.5 degrees,t=-0.538,P=0.595; 33.0+/-28.1 vs 19.7+/-36.6 mm,t=1.265,P=0.214).The T9-SPis were larger and the TKs were smaller in mental-work group compared to manual-work group(-6.3+/-4.0 vs -10.2+/-4.5 degrees,t=2.819,P=0.008; 23.5+/-10.5 vs 31.5+/-6.8 degrees,t=-2.854,P=0.007).Conclusion:For patients with CNLBP,more severe anxiety and larger T9-SPi can be found in mental workers,while more lumbar vertebrae osteophytes and larger TK can be found in manual workers.

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备注/Memo

备注/Memo:
通讯作者:谢峰 E-mail:xiefenghema@163.com(收稿日期:2019-01-23 本文编辑:郭毅曼)
更新日期/Last Update: 2019-10-08