“三步三位手法”治疗腰椎间盘突出症临床观察

Clinical Observation on "Three-step Three-position Technique" in Treating Lumbar Disc Herniation

目的:观察"三步三位手法"治疗腰椎间盘突出症的临床疗效。方法:将200例患者随机分为观察组和对照组,每组100例。2组均给予活血、消肿、止痛等基础治疗。观察组在基础治疗的同时给予三步三位手法治疗,每周3次,12次为1个疗程;对照组给予机械牵引治疗,1次/d,10次为1个疗程。治疗1个疗程后,观察2组治疗前后下腰痛评分量表(JOA)、Prolo、视觉模拟疼痛(VAS)评分、临床疗效和不良反应发生情况。结果:治疗前后JOA自觉症状评分、JOA客观体征评分、JOA总分、Prolo评分、VAS评分,2组内比较差异有统计学意义(P<0.05);治疗后JOA自觉症状评分、Prolo评分、VAS评分,2组间比较差异有统计学意义(P<0.05);随访Prolo评分,2组间比较差异有统计学意义(P<0.05);治疗后JOA客观体征评分、JOA总分、Prolo评分、2组间比较差异无统计学意义(P>0.05);随访JOA自觉症状评分、JOA客观体征评分、JOA总分、VAS评分,2组间比较差异无统计学意义(P>0.05)。总有效率观察组为95.7%,对照组为88.3%,2组比较差异有统计学意义(P<0.05)。2组均未发现明显不良反应。结论:"三步三位手法"治疗腰椎间盘突出症疗效显著,安全、可靠。

Objective:To survey clinical effects of"three-step three-position technique"in the treatment for lumbar disc herniation(LDH).Methods:Two hundred patients were randomized into the observation group and the control group,100 cases each group.Both groups accepted basic therapy including promoting blood circulation,reducing the swelling,relieving the pain and others.The observation group were treated by"three-step three-position technique"based on basic therapy,three times each week,12 times were one course;the control group were given mechanical traction,once each day,ten times were one course.After treating one course,adverse reaction,curative effects,VAS,Prolo and JOA of both groups were observed before and after treating.Results:The difference had statistical meaning in the comparisons of JOA conscious symptom score,JOA objective sign score,JOA total scores,Prolo scores and VAS scores before and after treating within both groups(P<0.05);the difference was statistically significant in the comparisons of JOA conscious symptom score,Prolo scores and VAS scores after treating between both groups(P<0.05);there was a significant difference in the comparison of Prolo scores in the follow-up period(P<0.05);the difference had no statistical meaning in the comparisons of JOA objective sign score,JOA total scores and Prolo scores after treating between both groups(P >0.05);the difference showed no statistical meaning in the comparisons of JOA conscious symptom score,JOA objective sign score,JOA total scores and VAS scores between both groups(P >0.05).Total effective rate of the treatment group was 95.7%,higher than 88.3%of the control group,and the difference had statistical meaning(P<0.05);no obvious adverse reaction has been found in both groups.Conclusion:"three-step three-position technique"is effective,safe and reliable in the treatment for LDH.