宫廷正骨夏氏背提法配合中药热敷治疗腰椎后关节紊乱症临床疗效观察

Observation of Curative Effect on Disorders of Lumbar Vertebral Posterior Joint by Palace Bonesetting of Xiashi Carring and Lifting Therapeutic

目的:以符合纳入标准的69例腰椎后关节紊乱症患者为研究对象,进行随机对照研究,完成腰椎后关节紊乱症的宫廷正骨治疗评价及安全性分析,进一步明确宫廷正骨夏氏背提法治疗该病的疗效、优势及安全性。方法:本项研究所有腰椎后关节紊乱症患者,均来自北京中医药大学附属护国寺中医医院,观察腰椎后关节紊乱症的患者共69例,治疗组35例,对照组34例。治疗组采用宫廷正骨夏氏背提法配合中药热敷,隔日1次;对照组采用牵引疗法配合中药热敷,隔日1次,两组疗程均为1周。分别于治疗前、治疗后1周、1个月,应用VAS评分、JOA评分及腰椎活动度进行疗效评定。结果:(1)VAS评分:治疗组患者治疗后1周及1个月VAS评分下降明显,与治疗前相比有显著差异(P<0.01);与对照组相比无统计学差异(P>0.05)。(2)JOA评分:1JOA评分自觉症状类,治疗组患者治疗后1周及1个月与治疗前相比,分数增长明显(P<0.01),治疗组评分增长较快,疗效明显优于对照组(P<0.01);2JOA评分体征类,治疗组患者治疗后1周和1个月与治疗前相比,无统计学差异(P>0.05);3JOA评分日常生活动作类,治疗组患者治疗后1周及1个月与治疗前相比,分数增长明显(P<0.01),与对照组相比无明显差异(P>0.05);4JOA总分,治疗组患者治疗后1周及1个月与治疗前相比,分数增长明显,与治疗前相比有明显差异(P<0.01);与对照组相比无明显差异(P>0.05)。(3)腰椎活动度:腰椎屈曲:治疗组在治疗后1周与1个月时活动度明显增大(P<0.01),其疗效也优于对照组(P<0.05);腰椎伸直:治疗组患者在治疗后1周腰椎活动度增加,与治疗前相比有统计学差异(P<0.05),治疗1个月后活动度进一步增加,与治疗前比有明显差异(P<0.01);与对照组相比无明显差异(P>0.05)。结论:应用宫廷正骨夏氏背提法对腰椎后关节紊乱症患者进行治疗,能够有效改善患者VAS评分、自觉症状、日常生活动作及腰椎活动度,具有起效快、操作简单、安全性高等优势。

Objective：69 cases of disorders of the lumbar vertebral posterior joint who meet the standards as objects of study,conduct random,comparative,clinical research. Complete palace bonesetting treatment＇s clinical evaluation and safety analysis for disorders of the lumbar vertebral posterior joint,further clarify the treatment＇s efficacy,advantages and safety. Methods：All patients of the study were from Huguosi hospital affiliated to Beijing university of traditional Chinese medicine. 69 cases were observed ： 35 cases were treatment group and 34 cases were the control group. Treatment group was treated with palace bonesetting and herbal fomentation treatment, once 2 days, for a week;the control group were treated by traction and herbal fomentation treatment, once 2 days, for a week.VAS score,JOA score and Lumbar activity were recorded on pretreatment,a week after treatment and a month after treatment. Results：（1）VAS score：There was a statistically significant difference of VAS between pretreatment and a week after treatment,also and a month after treatment group（P〈0.01）;but there was no difference compared with the control group（P〉0.05）.（2）JOA score：1Subjective symptoms：There was a statistically significant difference of the score between pretreatment and a week after treatment,also and a month after treatment group（P〈0.01）,and there was a statistically significant difference compared with the control group（P〈0.01）.2Signs：There was no difference of the score between pretreatment and after a week after treatment（P〉0.05）,and there there was no difference of the score between pretreatment and a month after treatment（P〉0.05）.3Daily life action：There was a statistically significant difference of the score between pretreatment and a week after treatment,also and a month after treatment group（P〈0.01）;but there was no difference compared with the control group（P〉0.05）.4Total score：There was a statistically significant difference of the score between pretreatment and a week after treatment,also and a month after treatment group（P〈0.01）;but there was no difference compared with the control group（P〉0.05）.（3）Lumbar activity：Flexion：There was a statistically significant difference of the flexion between pretreatment and a week after treatment,also and a month after treatment group（P〈0.01）;and it was better than control group（P〈0.05）. Extension：There was difference of the score between pretreatment and a week after treatment（P〈0.05）,and there was a statistically significant difference of the score between pretreatment and a month after treatment（P〈0.01）;but there was no difference compared with the control group（P〉0.05）. Conclusions：It is a deficiency treatment for patients with disorders of the lumbar vertebral posterior joint to take palace bonesetting of Xiashi carring and lifting. It can improve the VAS score,JOA score and lumbar activity,and has the advantages of rapid on set,simple opretion and security.