提拉旋转斜扳法治疗混合型腰椎小关节紊乱的临床研究

Clinical research of mixed lumbar facet joint disorder treated with the lifting-rotating-pulling manipulation in the bone-setting therapy

目的探讨提拉旋转斜扳治疗混合型腰椎小关节紊乱的临床疗效及所致咔哒声的相关性。方法将80例混合型腰椎小关节紊乱的患者随机分为提拉旋转斜扳治疗(治疗组) 40例和腰椎旋转斜扳治疗(对照组) 40例。治疗组采用提拉旋转斜扳治疗,对照组采用腰椎旋转斜扳治疗,治疗后观察两组即时镇痛率、总有效率、推拿所致咔哒声响与即时镇痛疗效之间的关系。结果治疗1次后即时镇痛率治疗组为90%,对照组为75%,两组比较,差异有统计学意义(P <0. 01)。治疗组总有效率为92. 5%(37/40),对照组总有效率为82. 5%(38/40),两组比较差异有统计学意义(P <0. 01);治疗组推拿所致咔哒声响与即时镇痛疗效之间无关系(χ2=0. 031,P=0. 861);对照组推拿所致咔哒声响与即时镇痛疗效之间无关系(χ2=3. 077,P=0. 079)。结论提拉旋转斜扳治疗混合型腰椎小关节紊乱的临床疗效优于腰椎旋转斜扳治疗,镇痛疗效与咔哒声响之间无关系,和棘突错动感有关。

Objective To explore the clinical effects on mixed lumbar facet joint disorder treated with the lifting-rotating-pulling manipulation in the bone-setting therapy and the correlation with the cracking sound in the treatment.Methods A total of 80 patients of mixed lumbar facet joint disorder were randomized into a lifting-rotating-pulling manipulation group(treatment group) and a rotating-pulling manipulation group(control group),40 cases in each one. In the treatment group,the lifting-rotating-pulling manipulation was adopted. In the control group,the rotating-pulling manipulation was applied. The immediate analgesia rate,the total effective rate and the correlation of the massage-induced cracking sound with the immediate analgesia were observed after treatment in the two groups. Results After one treatment,the immediate analgesia rate was 90% in the treatment group and was 75% in the control group,indicating the significant difference(P < 0. 01). The total effective rate was 92. 5% in the treatment group and was 82. 5%,indicating the significant difference between the two groups(P < 0. 01). In the treatment group,there was no relationship between the massage-induced cracking sound and the immediate analgesia(χ2= 0. 031,P = 0. 861). In the control group,there was no relationship between the massage-induced cracking sound and the immediate analgesia(χ2= 3. 077,P = 0. 079). Conclusion The clinical effects on mixed lumbar facet joint disorder treated with the lifting-rotating-pulling manipulation in the bone-setting therapy are better than the rotating-pulling manipulation in the lumbar region. The analgesia effects are not related with the cracking sound in the treatment,but with the spinous process dislocation.