正骨推手手法治疗腰椎间盘突出症的临床研究

Therapeutic Research of Zhenggutuishou Manipulation and Traditional Cewoxieban Manipulation in the Treatment of Lumbar Disc Herniation

目的:探讨正骨推手手法治疗腰椎间盘突出症(LDH),观察临床疗效和安全性。方法:选取2015年1月至2016年3月就诊的LDH患者70例,采用随机法分为2组:治疗组35例,应用正骨推手手法治疗;对照组35例,应用传统侧卧斜板法治疗。每次手法治疗前、后及疗程结束时进行治疗效果观察和记录,包括疼痛视觉的模拟评分方法(VAS)测量腰腿痛程度,腰椎疾病治疗效果评分标准评分(JOA评分),改良的Schober评分测量腰椎的前屈活动度。手法治疗2周后进行总疗效评定,并在整个疗程中进行安全性记录。所得数据采用软件SPSS18.0统计分析,P<0.05差异有统计学意义。结果:手法治疗2周后,治疗组及对照组的VAS评分、JOA评分、改良的Schober评分(MMS),在治疗前、后自身对比差异均有统计学意义(P<0.05);VAS评分和JOA评分在两组组间对比差异无统计学意义(P>0.05);改良的Schober评分在两组组间对比差异有统计学意义(P<0.05);每次手法治疗前后,对比两组VAS评分的改善值和改良的Schober评分改善值,差异有统计学意义(P<0.05),并且治疗组的疗效要比对照组好。两组最终的疗效对比,经统计学分析两组治疗效果对比差异无统计学意义(P>0.05)。在治疗过程中,两组研究对象均未发生不良事件。结论:正骨推手手法与传统侧卧斜扳法治疗LDH均有效且有良好的安全性,但较传统侧卧斜扳法治疗LDH能快速缓解疼痛,且改善腰椎前屈活动度上优于传统侧卧斜扳法;总之,正骨推手手法能快速缓解腰腿痛,提高生活质量,且操作简单、安全有效,是一种行之有效的疗法。

Objective：To evaluate the clinical efficacy,the safety and the improving situation of lumbocrual pain of Zhenggutuishou manipulation and traditional cewoxieban manipulation for treating patients with lumbar disc herniation（LDH）.Methods：From Jan 2015 to Mar 2016,70 patients diagnosed with LDH in our hospital were randomly divided into two groups：35 cases in the treatment group were treating with Zhenggutuishou manipulation,and 35 cases in the control group were treating with cewoxieban manipulation.The degree of lumbocrual pain were scored by visual analogue scale（VAS）,the therapeutic effect in lumbar disease were scored by JOA scores,the range of lumbar flexion were scored by the modified Schober scores（MMS）.The total effect was evaluated two weeks after treatment,and the safety in the whole course were recorded.All the data were analyzed by SPSS 18.0 statistical software,and employed a significance level of 0.05.Results：The VAS scores,the JOA scores,and the MMS in treatment group and control group were significantly different before and after treatment（P〈0.05）;the VAS scores and the JOA scores had no significant difference（P〈0.05）;while the MMS were significantly different between the two groups（P〈0.05）;the improvement index of JOA scores and MMS were both significantly different in two groups（P〈0.05）before and after treatment of each time,and the treatment groupwas superiority than the control group.Analyzed by the statistics,the ultimate efficacy between two groups was notsignificantly different（P〈0.05）.There were no adverse events happened in two groups during the treatment.Conclusion：Both the Zhenggutuishou manipulation and cewoxieban manipulation are effective for treating LDH,and show a good security.Compared with traditional cewoxieban manipulation,the Zhenggutuishou manipulation can relieve the pain quickly,and has an advantage in improving the range of lumbar flexion.Above all,the Zhenggutuishou manipulation is a simple,safe and efficient therapy for treating LDH,which can relieve the lumbocrural pain quickly,and improve the quality of life.