平乐郭氏正骨理筋手法改善腰椎间盘突出症患者腰背肌生物力学性能研究

Study on Guo's Bone-setting Manipulation of Pingle in Improving Biomechanical Properties of Lumbodorsal Muscles in Patients with Lumbar Disc Herniation

目的:探讨平乐郭氏正骨理筋手法改善腰椎间盘突出症患者腰背肌生物力学性能的疗效。方法:采用SAS软件,将80例符合标准的腰椎间盘突出症患者随机分为试验组与对照组,每组40例。试验组患者采用平乐郭氏正骨理筋手法治疗,对照组患者采用常规手法治疗,治疗周期为10 d。选用日本骨科学会腰痛评分(JOA)评价临床疗效,采用肌张力/压痛测定仪和表面肌电反馈仪检测患者的压痛阈、肌张力、屈伸松弛比(FRR)。结果:治疗后,试验组总有效率为95.0%,对照组为85.0%,两组比较差异有统计学意义(P<0.05),试验组疗效优于对照组;两组患者的JOA评分较治疗前均显著升高(P<0.05),且试验组的治疗前后评分差值大于对照组(P<0.05)。治疗后,两组患者的压痛阈较治疗前明显提高(P<0.05),肌张力、FRR较治疗前明显降低(P<0.05),且试验组患者的肌张力、FRR明显低于对照组(P<0.05)。结论:平乐郭氏正骨理筋手法治疗腰椎间盘突出症临床疗效较佳,能够改善患者的腰背肌群疼痛症状、软组织硬度及生物力学性能。

Objective： To explore the effects of Guo＇ s bone-setting manipulation of Pingle in improving the biomechanical properties of lumbodorsal muscles in patients with lumbar disc herniation. Methods： Eighty patients of lumbar disc herniation who met the inclusion criteria were randomly divided into the test group and control group by SAS software, 40 cases in each group. The patients in the test group were treated with Guo＇ s bone-setting manipulation of Pingle and the patients in the control group were treated with conventional manipulation. The treatment course was 10 days. The clinical effect was evaluated by Japanese Orthopedics Association （JOA） score and the pressure pain threshold, muscle tension and flexion-relaxation ratio （FRR） were detected by muscle tension/pressure pain determinator and electromyography. Results： After treatment, the total effective rates of the test group and the control group were 95.0% and 85.0% respectively, with statistical difference between the two groups （P 〈 0.05 ）, and the effect of the test group was superior to the control group. The JOA score of both groups was obviously increased （P 〈 0.05 ）, and the score difference between before and after treatment of the test group was greater than that of the control group （ P 〈 0.05 ）. After treatment, the pressure pain threshold of both groups was obviously increased （ P 〈 0.05） and the muscle tension and FRR were obviously decreased （P 〈 0.05 ） ; the muscle tension and FRR of the test group were obviously lower than those of the control group （ P 〈 0.05 ）. Conclusion： Guo＇ s bone-setting manipulation of Pingle shows good effects in the treatment of lumbar disc herniation and can improve the pain, soft tissue stiffness and biomechanical properties of lumbodorsal muscles.