陆氏整骨三步五法治疗腰椎间盘突出症临床规范化研究

Clinical study of Herniation of Lumbar intervertebral disc treated by Luwen＇s Traditional Chinese Manipulation Reduction

目的：规范陆文整骨手法，评价其治疗腰椎间盘突出症效果。方法：采用三中心、随机、对照的研究方法，对233例腰椎间盘突出症患者进行规范化研究，按照简单随机数字法分为手法组和热敷牵引组。其中陆氏整骨手法组122例，男38例，女84例，平均年龄（48．3±9．95）岁，平均病程（2．7353±3．7468）个月，病情程度轻度7例、中度47例、重度68例。中药热敷牵引组111例，男41例，女70例，平均年龄（47．38±9．59）岁，平均病程（2．5822±2．7658）个月，病情程度轻度14例、中度38例、重度59例。结果：经改良日本骨科学会下腰痛评分表评价，研究组患者优36例（占29．5％），良53例（占43．4％），可19例（占15．6％），差14例（11．5％），有效108例（占88．5％）；对照组患者优22例（占19．8％），良34例（占30．6％），可27例（占24.3％），差28例（25．2％），有效83例（占74．8％）。经统计学检验χ^2=13．097，P=0．004〈0．05，两者有效率在统计学上有显著性差异。结论：陆文整骨三步五法治疗腰椎间盘突出症具有较好的临床疗效，临床易于操作，值得推广应用。

Objective： To standardize the Luwen＇s manipulation, and valuate the effect of the lumbar disc herniation treated by it. Methods： A random and controlled test was carried on, to assess the cure effect and the relation between clinical symptom and cure effect. 233 cases were divided to two groups, in study group, 38 males and 84 females, average age （48.3±9.95） years, average course of disease （2.7353±3.7468） months, level of illness, light 7 cases, medium 47 cases, serious 68 cases; In control group, 41 males and 70 females, average age （47.38±9.59） years, average course of disease （2.5822± 2.7658） months, level of illness, light 14 cases, medium 38 cases, serious 59 cases. Results： 233 cases were statistically analyzed, 122 cases of study group, 111 cases of control group. Assessed by the cure effect valuation standard （modify JOA score）： In the study group, excellent of 36, good of 53, fair of 19, bad of 14, the effective rate was 88.5%; In the control group, excellent of 22, good of 34, fair of 27, bad of 28, the effective rate was 88.5%. It was significant difference, χ^2=13.097, P=0.004〈0.05. Conclusion： The Luwen＇s manipulation is an effective, major treatment of lumbar disc herniation. It is easy to operate, and should be popularized.