整脊法联合腰椎牵引康复治疗寒湿质腰椎间盘突出症的临床研究

Curative Clinical Research of Chiropractic Therapy Combined with Lumbar Traction in the Treatment of Patients with Lumbar Disc Prolapse of Cold-dampness Type

目的：观察整脊法联合腰椎牵引康复治疗治疗寒湿质腰椎间盘突出症的临床疗效。方法：我院门诊2014年3月~2016年4月接诊的寒湿质腰椎间盘突出症患者88例（筛选入组95例,7例脱落）作为研究对象,按随机数字表法分为观察组和对照组,每组44例。对照组给予单纯的牵引治疗,观察组在对照组基础上给予中医整脊法治疗。采用疼痛视觉模拟评分法（VAS）和日本骨科学会的下腰痛评分法（M-J0A）分别评价2组患者治疗前后整体疼痛改善程度和下腰痛改善程度,此外比较2组治疗前后的X线片的变化,并参照Stauffer-Coventry＇s（SC）疗效评定标准评价治疗疗效。结果：观察组总有效率为90.91%（40/44）,对照组为70.45%（31/44）,差异具有统计学意义（x2=5.906,P〈0.05）;经X线片比较,2组曲度变直、腰椎侧弯、腰椎后凸、患椎间隙变窄均较治疗前显著降低（P〈0.05）,治疗后组间比较亦具有显著差异（P〉0.05）,观察组改善更明显;经VAS评分和M-J0A评分结果比较,2组治疗后评分均较治疗前显著降低（P〈0.05）,治疗后组间比较亦具有显著性差异（P〈0.05）,观察组变化更明显。结论：中医整脊法联合腰椎牵引在治疗寒湿质腰椎间盘突出症患者过程中腰椎牵引和中医整脊可互补不足,使治疗作用更能到位,临床效果较单一使用牵引更为显著,减轻了患者的疼痛,临床症状得到了明显的改善,值得在临床推广使用。

Objective： To observe the clinical curative effects of chiropractic therapy combined lumbar traction in the treatment of patients with lumbar disc prolapse of cold-dampness type. Methods： 88 patients with lumbar disc prolapse of cold-dampness type as the research object, filter into the group of 95 cases, 7 cases of loss, who were accepted in our hospital outpatient from March 2014 to April 2016. According to the random number table method, they were randomly divided into the observation group and the control group, 45 cases in each group. The control group were just given the pure traction treatment, while the observation group were given chiropractic therapy of traditional Chinese medicine based on the treatment of the control group. By using visual analog pain score （VAS） and Japanese orthopaedic society of low back pain score （ M - JOA） evaluated improving the degree of overall pain and low back pain before and after treatment, in addition compared the change of the X ray film before and after treatment, and evaluated the efficacy of the treatment with reference to Stauffer Coventry -s therapeutic effect evaluation standard of （SC） . Results： The total ef- fective rate of the observation group was 90. 91% （40/44）, while that of the control group was 70. 45% （31/44）, and there was no statistically significant difference （x2 = 5. 906, P 〈 0. 05） ; Compared with before treatment, curvature straighten, lumbar scoliosis, lumbar kyphosis, with narrow intervertebral disc of two groups were significantly lower than after treatment by the comparison of X-ray film （P 〈 0. 05）, also was compared between treatment group with significant difference （ P 〉 0. 05 ）, observation group improved more obviously; The VAS score and the M - J0A score results showed the scores of two groups after treatment were significantly lower than before treatment （ P 〈 0. 05 ）, also was compared between treatment group with significant difference （P 〈 0. 05 ）, the observa- tion group change was more obvious. Conclusion： The chiropractic therapy of traditional Chinese medicine combined with lumbar trac- tion in the process of treating patients with lumbar disc prolapse of cold-dampness type can be complementary, making the treatment more reach the designated position and the clinical effect was more significant than that of the single traction. Besides, it eased the pain of the patients and clinical symptoms were obviously improved. Therefore it is worth popularizing in clinic.