主动运动与推拿治疗非特异性下腰痛:临床随机对照

Active exercise and massage for nonspecific low back pain:a clinical randomized controlled trial

目的:主动运动和中医推拿被广泛用于腰痛的治疗,比较主动运动和中医推拿对随机就诊非特异性下腰痛患者的疼痛程度和日常生活活动功能的影响。方法:实验于1996-01/1998-12在阿曼马斯喀特亚洲医学中心完成。189例非特异性下腰痛患者按就诊顺序随机分成A组(137例)主动运动加推拿治疗;B组(52例)按摩治疗;治疗前后用疼痛模拟量尺(visualanalogscale,VAS)和Oswestry腰痛残疾问卷量表Oswestrylow(backpaindisabilityindex,OSW,评定两组患者的疼痛程度和日常生活)活动受限程度。结果:A,B两组VAS和OSW指数都有下降,A组VAS指数下降明显大于B组(t=2.657,P<0.01);A组OSW指数下降亦明显大于B组(t=15.733,P<0.01)。6个月～2年随访表明A组复发率15.08%(19/126)低于B组35.42%17/48),经检验χ2=8.761,P<0.01。(结论:主动运动和按摩治疗均可减轻疼痛、改善日常生活活动功能。主动运动有利于预防复发,运动疗法是经济有效的治疗腰痛方法。

AIM:To compare the effect of active exercise and Chinese massage on pain intensity and function of activity of daily living(ADL) in the randomly diagnosed outpatients with nonspecific low back pain since that active exercise and Chinese massage have been applied in the treatment of lumbar pain.METHODS:The experiment was conducted in Asian Medical Center in Muscat,Oman from January 1996 to December 1998.A total of 189 patients with nonspecific low back pain were randomized to group A(n=137) treated with active exercise and massage therapy,and group B(n=52) treated with massage therapy only according to their admission sequence.The pain intensity and limitation degree of ADL were assessed in patients of the two groups by using visual analog scale(VAS) and Oswestry low back pain disability index(OSW).RESULTS:The indexes of both VAS and OSW were decreased in the two groups.Moreover,the index of VAS was decreased more significantly in group A than in group B(t=2.657,P< 0.01),and so was the index of OSW (t=15.733,P< 0.01).The recurrence rate of group A(15.08% ,19/126) was lower than that of group B(35.42% ,17/48) during follow up from 6 months to 2 years(χ 2=8.761,P< 0.01).CONCLUSION:Both active exercise and massage can relieve pain and improve the function of ADL in patients.Active exercise has much effect in preventing the recurrence of nonspecific low back pain,and exercise therapy is economic and effective for nonspecific low back pain.