超声波联合牵引治疗对跳水运动员腰椎间盘突出症的疗效观察

Effect of Ultrasound Combined with Traction in Treatment of the Diving Athletes with Lumbar Intervertebral Disc Protrusion

目的:研究超声波联合牵引治疗对跳水运动员腰椎间盘突出症的疗效作用。方法:随机选取2014年3月~2016年3月广东省二沙体育训练中心符合腰椎间盘突出症的跳水运动员60例,采用随机数字表法将患者分为对照组与观察组,每组各30例。对照组给予常规腰椎间盘推拿、针刺治疗及平板支撑锻炼,观察组在对照组的基础上给予超声波及牵引治疗。两组均连续治疗14天。记录两组患者治疗前、后的症状和体征改变情况,采用Oswestry功能障碍评分量表(ODI)进行疗效评价。检查两组患者治疗前、后血清白介素(IL)-6的浓度水平。观察两组患者恢复正常训练所需时间。结果:观察组总有效率为93.33%,对照组总有效率为70.00%,差异有统计学意义(?2=5.46,P=0.02)。两组患者治疗后ODI评分方面,对照组总评分明显低于观察组(9.05±3.38 vs 14.24±4.46分),差异有统计学意义(P<0.05)。同时,对照组治疗后疼痛评分(1.63±0.51 vs 2.79±0.84分)、提举评分(2.33±0.68 vs 2.75±0.59分)、行走评分(0.74±0.39 vs1.68±0.48分)、坐立评分(0.31±0.08 vs 1.44±0.21分)、站立评分(0.47±0.25 vs 0.69±0.34分)、社会评分(0.59±0.14 vs 1.37±0.68分)及旅行评分(0.77±0.30 vs 1.25±0.26分)均低于观察组,差异有统计学意义(P<0.05),而两组治疗后生活评分(0.86±0.27 vs 0.99±0.29分)、睡眠评分(1.35±0.76 vs 1.28±0.77分)相当,差异无统计学意义(P>0.05)。再者,观察组患者治疗后IL-6明显低于对照组,差异有统计学意义(P<0.05)。对照组患者恢复正常训练所需时间为(34.29±7.51)天,观察组患者恢复正常训练所需时间为(26.19±5.48)天,两组恢复正常训练所需时间比较,差异有统计学意义(t=4.77,P=0.00)。结论超声波配合牵引治疗和平板支撑锻炼核心肌群,能够改善腰椎间盘突出症跳水运动员的临床症状,在腰痛水平、行走状况、坐立状况、站立状况、旅行情况等方面具有显著疗效,其可能通过减少血清IL-6从而实现抑制炎症反应的作用。

Objective： To investigate the effect of ultrasound combined with traction in the treatment of the diving athletes with lumbar intervertebral disc protrusion （LIDP）. Methods： 60 diving athletes with LIDP from Guangdong Ersha Sports Training Center were randomly recruited during March 2014 to March 2016, who were divided into control and observation groups by random number table and in each group contain 30 patients. Patients in control group were treated with the conventional massage, muscle strength exercise and acupuncture for the lumbar, while patients in observation group were additionally treated with the ultrasound and traction therapy. Both groups were treated with 14 days. The signs and symptoms of baseline and after therapy were observed and the Oswestry disability index （ODI） was used to evaluate the clinical effect. The serum concentrations of interleukin-6 was tested. The time needed to resume training was collected as well. Results： The total effective rate of observation group was 93.33%, and 70.00% in the control group, and the difference was statistically significant （X^2=5.46, P=0.02）. On the aspects of ODI, the total scores in the control group were obviously less than the observation one （9.05±3.38 vs 14.24±4.46, P〈 0.05）. Meanwhile, after treatment, the scores of pain （1.63±0.51 vs 2.79±0.84）, lifting （2.33±0.68 vs 2.75±0.59）, walking （0.74±0.39 vs 1.68±0.48）, sitting （0.31±0.08 vs 1.44±0.21）, standing （0.47±0.25 vs 0.69±0.34）, society （0.59±0.14 vs 1.37±0.68） and traveling （0.77±0.30 vs 1.25±0.26） in the control group were obviously less than the observation one, and all differences were statistically significant （P 〈 0.05）. However, the scores of life （0.86±0.27 vs 0.99±0.29） and sleeping （1.35±0.76 vs 1.28±0.77） in each group has no differences （P〉0.05）. Furthermore, the serum concentration of IL-6 in the observation group was significantly less than the control group （P〈0.05）. In addition, the time needed to resume training in the control group was 34.29±7.51 days while it was just 26.19±5.48 days in the observation one （P〈 0.05）. Conclusion： Ultrasound therapy, cooperated traction treatment and muscle strength exercise could improve the core muscle groups and the manifestations of the diving athletes with LIDP, especially in the aspects of back pain, walking, sitting, standing, and traveling. And its mechanism might be reducing the secretion oflL-6 in order to suppress the inflammation.