[1]石建辉,李红波,朱娟,等.腰椎定点旋转复位法联合胸椎压冲复位法 治疗腰椎间盘突出症的临床研究[J].中医正骨,2016,28(02):7-10.
　SHI Jianhui,LI Hongbo,ZHU Juan,et al.Clinical study on rotating reduction at fixed points of lumbar vertebrae combined with press-dash reduction at thoracic vertebrae for treatment of lubar disk herniation[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(02):7-10.
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腰椎定点旋转复位法联合胸椎压冲复位法 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28卷
期数:
2016年02期
页码:
7-10
栏目:
临床研究
出版日期:
2016-02-20

文章信息/Info

Title:
Clinical study on rotating reduction at fixed points of lumbar vertebrae combined with press-dash reduction at thoracic vertebrae for treatment of lubar disk herniation
作者:
石建辉; 李红波; 朱娟; 何伶
中国人民解放军第303医院,广西 南宁 530021
Author(s):
SHI Jianhui; LI Hongbo; ZHU Juan; HE Ling
The 303th Hospital of PLA,Nanning 530021,Guangxi,China
关键词:
椎间盘移位;  腰椎;  推拿; 脊柱;  治疗; 临床研究性
Keywords:
intervertebral disc displacement;  lumbar vertebrae;  manipulation; spinal;  therapies; investigational
摘要:
目的:观察腰椎定点旋转复位法联合胸椎压冲复位法治疗腰椎间盘突出症的临床疗效。方法:将70例符合要求的腰椎间盘 突出症患者随机分为联合手法组和旋转复位组,每组35例。旋转复位组采用腰椎定点旋转复位法治疗,联合手法组先采用腰椎定 点旋转复位法治疗,结束后再采用胸椎压冲复位法治疗。手法治疗隔天1次,连续治疗7次。评定患者的腰痛视觉模拟量表 (visual analogue scale,VAS)评分,同时采用吕立江等制定的腰椎间盘突出症症状体征评分标准评定疗效。结果:治疗前2组患 者的腰痛VAS评分和症状体征评分比较,组间差异均无统计学意义[(5.771±1.496)分,(5.542±1.379) 分,t=0.664,P=0.509;(17.714±4.973)分,(17.257±5.489)分,t=0.365,P=0.716]; 治疗后联合手法组的腰痛VAS评分 和症状体征评分均低于旋转复位组[(1.800±1.711)分,(3.285±1.563)分,t=-3.971,P=0.000;(6.914±5.495)分 ,(12.400±6.682)分,t=-3.751,P=0.000],治疗前后腰痛VAS评分差值和症状体征评分差值均大于旋转复位组 [(3.971±1.271)分,(2.257±1.421)分,t=5.318,P=0.000;(10.800±4.234)分,(4.857±3.370) 分,t=6.496,P=0.000]。结论:腰椎定点旋转复位法联合胸椎压冲复位法能有效减轻腰椎间盘突出症患者的临床症状,改善腰部 功能,疗效优于单纯腰椎定点旋转复位法。
Abstract:
Objective:To observe the clinical curative effect of rotating reduction at fixed points of lumbar vertebrae combined with press-dash reduction at thoracic vertebrae in the treatment of lubar disk herniation (LDH).Methods:Seventy patients with LDH enrolled in the study were randomly divided into combined manipulation group and rotating reduction group,35 cases in each group.Patients in rotating reduction group were treated with rotating reduction at fixed points of lumbar vertebrae,while the others in the combined manipulation group were treated with rotating reduction at fixed points of lumbar vertebrae and press-dash reduction at thoracic vertebrae subsequently.The manipulation was performed on alternate days for consecutive 7 times.The low back pain were evaluated by using visual analogue scale(VAS)and the curative effects were evaluated according to the symptoms and signs scoring criterion of LDH made by Lyu Lijiang.Results:There was no statistical difference in the low back pain VAS scores and symptoms&signs scores between the 2 groups before treatment(5.771+/-1.496 vs 5.542+/-1.379 points,t=0.664,P=0.509; 17.714+/-4.973 vs 17.257+/-5.489 points,t=0.365,P=0.716).The low back pain VAS scores and symptoms&signs scores were lower in combined manipulation group compared to rotating reduction group after the treatment(1.800+/-1.711 vs 3.285+/-1.563 points,t=-3.971,P=0.000; 6.914+/-5.495 vs 12.400+/-6.682 points,t=-3.751,P=0.000).The difference of low back pain VAS scores and the difference of symptoms&signs scores between pre-treatment and post-treatment were larger in combined manipulation group compared to rotating reduction group(3.971+/-1.271 vs 2.257+/-1.421 points,t=5.318,P=0.000; 10.800+/-4.234 vs 4.857+/-3.370 points,t=6.496,P=0.000).Conclusion:Combination of rotating reduction at fixed points of lumbar vertebrae with press-dash reduction at thoracic vertebrae can effectively relieve the clinical symptoms of patients with LDH and improve the lumbar function,and it surpasses the monotherapy of rotating reduction at fixed points of lumbar vertebrae in the curative effect.

参考文献/References:

[1] 张启富.腰椎间盘突出症非手术治疗综述[J].颈腰痛杂志,2008,29(5):477-480.
[2] 王芃,张军,韩磊,等.中医手法治疗腰椎间盘突出症的现况调查[J].中医正骨,2010,22(3):23-25.
[3] Leemann S,Peterson CK,Schmid C,et al.Outcomes of acute and chronic patients with magnetic resonance imaging-confirmed symptomatic lumbar disc herniations receiving high-velocity,low-amplitude,spinal manipulative therapy:a prospective observational cohort study with one-year follow-up[J].J Manipulative Physiol Ther,2014,37(3):155-163.
[4] 国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:201-202.
[5] 吕立江,袁相龙,应晓明,等.杠杆定位手法治疗腰椎间盘突出症的疗效观察[J].中医正骨,2010,22(3):14-16.
[6] 徐海涛,徐达传,李云贵,等.坐位旋转手法时退变腰椎间盘内在应力和位移的有限元分析[J].中国康复医学杂志,2007,22 (9):769-771.
[7] 冯宇,杨殊杰,高燕.手法治疗腰椎间盘突出症疗效以及解除神经根受压的MRM分析[J].中国骨伤,2005,18(8):456-458.
[8] 赵继荣.腰椎间盘突出症两种方法治疗前后影像学评价[J].颈腰痛杂志,2003,24(2):82-84.
[9] Shan X,Ning X,Chen Z,et al.Low back pain development response to sustained trunk axial twisting[J].Eur Spine J,2013,22(9):1972-1978.
[10] Mellor FE,Thomas PW,Thompson P,et al.Proportional lumbar spine inter-vertebral motion patterns:a comparison of patients with chronic,non-specific low back pain and healthy controls[J].Eur Spine J,2014,23 (10):2059-2067.
[11] 郑兆俭,林樯,周倩,等.腰椎间盘突出症的复发与腰椎曲度的关系[J].中医正骨,2013,25(10):24-26.
[12] Nairn BC,Drake JD.Impact of lumbar spine posture on thoracic spine motion and muscle activation patterns [J].Hum Mov Sci,2014,37:1-11.
[13] Hodges PW,Richardson CA.Inefficient muscular stabilization of the lumbar spine associated with low back pain.A motor control evaluation of transversus abdominis[J].Spine(Phila Pa 1976),1996,21(22):2640-2650.
[14] Harriss AB,Brown SH.Effects of changes in muscle activation level and spine and hip posture on erector spinae fiber orientation[J].Muscle Nerve,2015,51(3):426-433.
[15] Hides J,Stanton W.Muscle imbalance among elite Australian rules football players:a longitudinal study of changes in trunk muscle size[J].J Athl Train,2012,47(3):314-319.
[16] 李志强,刘佳.后期康复锻炼在腰椎间盘突出症非手术治疗中的作用研究[J].中医正骨,2015,27(6):12-15.
[17] 鲍铁周,郝军.筋病理论在退行性腰背痛治疗中的应用[J].中医正骨,2013,25(9):76-77.

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通讯作者:李红波 E-mail:dreaming1980@126.com
更新日期/Last Update: 2016-04-30