推拿手法结合爬行器训练治疗腰椎间盘突出症的临床效果

The clinical effect of massage manipulation combined with crawl training in the treatment of lumbar disc herniation

目的探讨推拿手法配合爬行器训练治疗腰椎间盘突出症(LDH)患者的临床效果。方法将2015年6月～2016年12月在上海中医药大学附属岳阳中西医结合医院脊柱科诊治的LDH患者60例,采用随机数字表法分为对照组和观察组,每组各30例。两组患者均给予推拿治疗,观察组在推拿基础上配合爬行器辅助训练。观察两组患者治疗前后视觉模拟评分法(VAS)评分、日本骨科协会评估治疗(JOA)评分,随访3个月观察复发情况。结果治疗后两组VAS评分均较治疗前明显降低,差异有统计学意义(P <0.05);且观察组VAS评分较对照组显著降低,差异有统计学意义(P <0.05);治疗后两组JOA评分均较治疗前明显提高,差异有统计学意义(P <0.05);且观察组JOA评分较对照组显著提高,差异有统计学意义(P <0.05);治疗后对照组总有效率为76.7%,观察组总有效率为86.6%,两组间差异有统计学意义(P <0.05);治疗结束后3个月对两组患者进行电话回访统计复发率,对照组复发率为43.3%,观察组复发率为30.0%,两组比较差异有统计学意义(P <0.05)。结论推拿结合爬行器训练治疗LDH患者较单纯推拿治疗在降低VAS评分及提高JOA评分上效果更加显著,且复发率更低。

Objective To investigate the clinical effect of massage manipulation combined with crawl training on patients with lumbar disc herniation （LDH）. Methods From June 2015 to December 2016, 60 cases of LDH were treated in Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine ,which were randomly divided into control group and observation group by random number table method, with 30 cases in each group. Both groups were given massage manipulation, and the observation group was assisted with crawler training on the basis of massage manipulation. Visual analogue scale （VAS） score and Japanese orthopedic association （JOA） score were observed before and after treatment, and recurrence was observed 3 months after follow-up. Results After treatment, the VAS scores in the two groups were significantly lower than those before treatment, the differences were statistically significant （P ＜ 0.05）, the VAS score of the observation group was significantly lower than that of the control group, and the difference was statistically significant （P ＜ 0.05）. The JOA scores of the two groups after treatment were higher than those before treatment, and the differences were statistically significant（P ＜ 0.05）, and the observation group was more obviously than the control group in the JOA score increase, and the difference was statistically significant （P ＜ 0.05）. The total effective rate of control group after treatment was 76.7 %, the total efficiency of the observation group was 86.6%, there was statistically significant difference between the two groups （P ＜ 0.05）. In the two groups, the recurrence rate was measured by telephone back in 3 months after the treatment, the recurrence rate of control group was 43.3%, the observation group had a recurrence rate of 30.0%, the two groups had a statistical differences （P ＜ 0.05）. Conclusion The combination of massage manipulation combined with crawler training for LDH patients is more significant in reducing VAS score and improving JOA score than simple massage manipulation, and has a lower recurrence rate.