骨盆倾斜腰椎牵引治疗腰椎间盘突出症的临床疗效观察

Observation on the Clinical Efficacy of Pelvic Tilt Lumbar Traction in Treating Lumbar Disc Herniation

目的：比较骨盆倾斜腰椎牵引与普通腰椎牵引治疗腰椎间盘突出症的临床疗效。方法：选取符合入选条件的腰椎间盘突出症患者60例，采用随机双盲对照试验（疗效评估者与患者对治疗不知情），随机将患者分为试验组（30例）和对照组（30例）。2组患者均接受常规康复治疗，包括嘱患者卧床休息，推拿手法治疗及常规药物治疗。试验组患者在常规康复治疗基础上使用骨盆倾斜腰椎牵引，对照组使用普通腰椎牵引。分别评估治疗前、1个疗程、3个疗程和5个疗程后患者的视觉模拟评分（VAS）、中医病证诊断疗效及Oswestry功能障碍指数（ODI）。结果：（1）在治疗1、3、5个疗程后试验组和对照组患者VAS评分和ODI指数相对治疗前均有所改善。其中1个疗程后试验组和对照组的改善对比没有显著性差异，而3、5个疗程后试验组的改善明显优于对照组；（2）治疗1个疗程后，试验组的有效率为56．7％，而对照组的有效率为50％，二者无统计学显著性差异（P〉0．05）：而治疗3个疗程和5个疗程后，试验组的有效率（83.3％，90％）均比对照组高（60％，63．3％），且差异均具有统计学显著性意义（P〈0．05）。结论：腰椎间盘突出症治疗前期，骨盆倾斜腰椎牵引和普通腰椎牵引在治疗效果上并无明显差异，而在治疗后期（3～5个疗程）骨盆倾斜腰椎牵引能够更有效地改善腰椎间盘突出症患者的症状和功能。因此值得临床推广骨盆倾斜腰椎牵引对腰椎间盘突出症的治疗。

Objective： To compare the clinical effect of pelvic tilt lumbar traction and common lumbar traction in the treatment of lumbar disc herniation. Methods： Sixty patients with lumbar disc herniation were randomly divided into the experimental group and control group （30 cases each group）. Both of the two groups received the conventional rehabilitation therapy, including bed rest, manipulative therapy and routine medication treatment. But patients in the experimental group were treated with pelvic tilt lumbar traction on the basis of conventional rehabilitation therapy, while the control group were treated with common lumbar traction. The Visual Analog Scale （VAS）, Diagnosis and Therapeutic Effect of TCM Diseases and Oswestry Disability Index（ODI） of the two groups were evaluated before and after 1 courses, 3 courses and 5 courses of the treatment. Results： （ 1 ） Compared with before treatment, both of VAS and ODI in the two groups have improved after 1 courses, 3 courses and 5 courses of the treatment. There was no significant difference between the two groups after 1 course of treatment, but the differences between the two groups after 3 and 5 courses of treatment were statistically significant respectively; （2） After 1 course of treatment, effective rate of the experimental group and control group were 56.7% and 50% respectively, and there was no signifi- cant difference between the two groups in this time （ P 〉 0. 05 ） ; After 3 and 5 courses of treatment, the effective rate of the experimental group（83.3% ,90% ） was higher than that of the control group （60% ,63.3% ） at the two time periods, and there was significant difference respectively （ P 〈 0.05 ）. Conclusions： In the early stage of treating lumbar disc herniation , there was no significant difference in clinical efficacy between the experimental group and the control group; But in the later stage （after 3 and 5 courses of treatment）, pelvic tilt lumbar traction can more effectively improve the symptoms and function in patients with lumbar disc herniation.