腰椎间盘突出症悬浮式牵引下三维按压手法对照研究

Comparative study of three-dimensional pressing technique under suspension traction for lumbar disc herniation

目的腰椎间盘突出症(lumbar disk herniation,LDH)为临床常见病,多发病,目前以非手术治疗为主,包括手法、牵引、物理治疗、中药内服外敷和针灸针刀等。本研究探讨悬浮式牵引下三维按压手法治疗LDH的临床效果。方法选取2018-03-01-2019-09-30北京市大兴区中西医结合医院骨伤科住院的125例符合LDH诊断患者为研究对象,按照组间匹配的原则分为观察组(63例)与对照组(62例)。观察组采用悬浮式牵引下三维按压手法治疗,对照组采用悬浮式牵引配合按压手法治疗,综合评价临床治疗效果。结果治疗后,两组日本骨科协会评估治疗(Japanese Orthopaedic Association,JOA)评分均有所升高,且观察组为(25.06±5.38)分,高于对照组的(21.47±3.96)分,差异有统计学意义,t=7.014,P=0.013。两组Oswestry功能障碍指数(Oswestry disability index,ODI)评分均下降,且观察组为(19.33±3.12)分,低于对照组的(26.29±4.27)分,差异有统计学意义,t=5.962,P=0.009。两组腰背肌及腰腹肌疲劳试验与治疗前相比均有提升,且观察组腰背肌疲劳试验为(50.25±4.77)s,高于对照组的(43.12±3.79)s,t=8.496,P=0.037;观察组腰腹肌耐力试验为(37.18±4.77)s,高于对照组的(31.53±5.06)s,t=5.962,P=0.016。结论悬浮式牵引下三维按压手法治疗LDH可改善JOA和ODI评分,提升腰背肌及腰腹肌疲劳试验和腰腹肌耐力,优于悬浮式牵引配合按压手法治疗。

OBJECTIVE Lumbar disc herniation(LDH)is a common clinical disease.At present,it is mainly treated by non-surgical treatment,including manipulation,traction,physical therapy,internal and external application of traditional Chinese medicine,acupuncture and acupotomy.The purpose of this study is to investigate the clinical effect of three-dimensional pressing manipulation under suspension traction on LDH.METHODS From March 1,2018 to September 30,2019,125 patients with LDH in integrated Chinese and Western Medicine Hospital of Daxing District in Beijing were selected as the study objects.According to the principle of matching between groups,the patients were divided into observation group(63 cases)and control group(62 cases).The observation group was treated with three-dimensional pressing manipulation under suspension traction,while the control group was treated with suspension traction and pressing manipulation.The clinical effects of the two groups were evaluated.RESULTS After treatment,Japanese Orthopaedic Association(JOA)scores of the two groups increased,but the score of the observation group was 25.06±5.38,higher than that of the control group 21.47±3.96,the difference was statistically significant(t=7.014,P=0.013).The scores of Oswestry disability index(ODI)in the two groups were significantly decreased,and the observation group was 19.33±3.12,significantly lower than that of the control group(26.29±4.27),the difference was statistically significant,t=5.962,P=0.009.Compared with before treatment,the fatigue test of lumbodorsal muscle and lumbar abdominal muscle in the two groups were improved.The fatigue test of lumbar and abdominal muscles in the observation group was(50.25±4.77)s,higher than that in the control group(43.12±3.79)s,t=8.496,P=0.037;the endurance test of lumbar and abdominal muscles in the observation group was(37.18±4.77)s,higher than that in the control group(31.53±5.06)s,t=5.962,P=0.016.CONCLUSION The treatment of LDH with three-dimensional compression under suspension traction can improve JOA and ODI scores,and improve the fatigue test of lumbar dorsi and lumbar abdominal muscles,which is better than suspension traction combined with compression therapy.