股内收肌群弹拨法治疗腰椎间盘突出症的临床效果

The clinical efficacy of manipulation of pinching thigh adductor in the treatment of lumbar disc herniation

目的评价股内收肌群弹拨法治疗腰椎间盘突出症的临床效果。方法将152例确诊为腰椎间盘突出症的患者,随机分配至组1(76例,行股内收肌群弹拨+口服布洛芬缓释胶囊+电脑中频脉冲电疗法)和组2(76例,口服布洛芬缓释胶囊+电脑中频脉冲电疗法)。记录患者人口学资料及临床特征,观测患者治疗前、治疗后及治疗后1周、2周、4周NRS、ODI、JOA及BARS评分,计算JOA评分改善率及治疗有效率。结果 (1)127例获随访,随访时间1个月,随访率84%。(2)治疗结束后两组患者NRS、ODI、JOA评分较治疗前均有明显改善,但组1均优于组2(NRS 1.45 vs 4.90;ODI 15.19%vs 45.87%;JOA 21.77 vs 8.89);治疗后1周、2周、4周组1患者三种评分无明显改变,组2患者各个时间点症状均有所缓解,在治疗后4周时两组患者疼痛程度及功能状态评分无显著性差异(NRS 0.98 vs 1.02;ODI 13.27%vs 14.24%;JOA 22.61 vs22.33)。(3)治疗结束后组1有效率明显高于组2(98.44%vs 28.57%),治疗后4周两组有效率无显著性差异(95.31%vs 92.06%)。(4)治疗后两组患者主观症状及日常活动均有明显改善,且组1优于组2,但体征治疗前、后差别不大(P>0.05)。(5)组1、组2分别至治疗后2周、4周,患者疼痛范围才有明显减小,但二者无显著性差异。结论股内收肌群弹拨法具有治疗时间短、起效快、维持时间长等特点,疗效佳,与其他疗法综合应用,早期即可显著改善患者疼痛及功能状态。

Objective To evaluate the clinical efficacy of comprehensive treatment including pinching thigh adductor in the treatment of lumbar disc herniation. Methods 152 patients with lumbar disc herniation were assigned randomly to two different groups received ibuprofen sustained release capsules and computer controlled medium frequency electrotherapy with（group 1）or without manipulation（group 2）. NRS, ODI, JOA, BARS, RIS and effective rate were recorded before and after treatment and 1 week,2 weeks,4 weeks after the treatment. Results（1）127 of 152 patients were followed up for more than 4 weeks with 84% follow-up rate.（2）NRS,ODI and JOA scores were significantly improved after treatment in both two groups, but the group 1 was more marked（NRS 1.45 vs 4.90;ODI 15.19% vs 45.87%;JOA 21.77 vs 8.89）.Finally there was no significantly difference between the two groups 4 weeks after treatment（NRS0.98 vs 1.02;ODI 13.27% vs 14.24%;JOA 22.61 vs 22.33）.（3）The total effective rate in group 1was higher than group 2（98.44% vs28.57%） after treatment.（4）The symptoms and activities of daily living of patients in both two groups were significantly improved after treatment,of which group 1 was bet-ter.（5）BARS in group 1 and group 2 had no significant decrease after treatment until separately after 2 weeks and 4 weeks. Conclusion Manipulation of pinching on thigh adductor is characterized by high efficiency of short treatment time,quick effect and long maintenance time. With comprehensive treatment,the pain and function can be improved significantly in the short time.