脊柱调衡手法与药物治疗退变性脊柱侧凸症的病例对照研究

Case control study on spinal leveraging manipulation and medicine for the treatment of degenerative scoliosis

目的：对比脊柱调衡手法与药物治疗对退变性脊柱侧凸症患者的疼痛及功能状态的影响。方法 ：2010年7月至2013年6月,将38例退变性脊柱侧凸症患者采用掷硬币的方法随机分为脊柱调衡手法组（手法组）和药物组。手法组20例,其中男9例,女11例,年龄58~74岁,平均（66.63±7.73）岁,病程3~8个月,平均（5.65±2.58）个月;采用脊柱调衡手法（依次循经理筋、松解痉挛、整骨扳拿、通络放松法）治疗,时间30 min,1次/d,4 d为1疗程,共9个疗程。药物组男8例,女10例,年龄57~70岁,平均（63.51±6.61）岁,病程3~5个月,平均（4.82±1.43）个月;予口服塞来昔布加盐酸乙哌立松,4 d为1疗程,共9个疗程。观察治疗前后两组患者的VAS评分、脊柱侧凸Cobb角及腰椎ODI评分。结果：治疗后,手法组VAS评分5.38±0.99与药物组6.36±1.31比较差异有统计学意义（t=2.618,P〈0.05）;手法组Cobb角（16.51±4.89）°与药物组（19.85±5.03）°比较差异有统计学意义（t=2.074,P〈0.05）;手法组腰椎ODI评分20.20±2.93与药物组26.01±3.11比较差异有统计学意义（t=5.592,P〈0.05）。结论 ：采用脊柱调衡手法治疗退变性脊柱侧凸症,能够调整脊柱两侧的肌力平衡,矫正脊柱冠状面失衡,恢复脊柱正常序列,减少和消除对神经根的压迫和刺激,缓解腰腿痛症状,改善生活质量。

Objective：To compare clinical effects of spinal leveraging manipulation and medicine for the treatment of degenerative scoliosis in pain and function. Methods：From July 2010 to June 2013,38 patients with degenerative scoliosis were randomly divided into spinal leveraging manipulation group and medicine group by coin tossing. In manipulation group,there were 9 males and 11 females aged from 58 to 74 years old with an average of（66.63±7.73）,the courses of diseases ranged from3 to 8 months with an average of（5.65±2.58）,spinal leveraging manipulation（ following meridian to straighten tendon,relieving spasm,osteopathy and massage,clearing and activating the channels and collaterals） were performed for 30 min,once a day,4 days for a period treatment,totally 9 courses. In medicine group,there were 8 males and 10 females aged from 57 to 70 years old with an average of（63.51±6.61）,the courses of diseases ranged from 3 to 5 months with an average of（4.82±1.43）,celecoxib with eperisone hydrochloride were orally taken,4 days for a period treatment,totally 9 courses. VAS score,Cobb angle and ODI score were measured. Results：After treatment,VAS score in manipulation group was（5.38±0.99）,（6.36±1.31）in medicine group,and had significant meaning（t=2.618,P0.05）; there was significant differences in Cobb angle between manipulation group（16.51±4.89）° and medicine group（19.85±5.03） °（t=2.074,P0.05）; and had obviously meaning in ODI score between manipulation group（20.20±2.93） and medicine group（26.01±3.11）（t=5.592,P0.05）. Conclusion：Spinal leveraging manipulation for degenerative scoliosis could regulate muscle balance on both side of spine,correct coronal imbalances in spine,recover normal sequence of spine,reduce and remove opperssion and stimulation of nerve root,relieve pain in leg and waist and further improve quality of life.