McKenzie技术治疗椎间盘源性下腰痛的疗效评价及机理研究

Efficacy evaluation of McKenzie technique in the treatment of discogenic low back pain and its mechanism study

目的全面系统地评价McKenzie技术治疗椎间盘源性下腰痛的疗效,并探讨其临床机理。方法选取50例椎间盘源性下腰痛患者作为研究对象,采用McKenzie技术治疗,3次/周,共治疗6周。比较治疗前后的中文版Oswestry功能障碍指数(CODI)评分、汉译Roland-Morris功能障碍调查表(CRMDQ)评分、简式McGill疼痛问卷(SF-MPQ)评分、患者病变椎间盘中心在T2加权成像(T2WI)下的MR值的变化。结果治疗后,50例患者的CODI、CRMDQ及SF-MPQ中的疼痛分级指数评估(PRI)、疼痛视觉模拟评分法(VAS)、疼痛强度(PPI)评分分别为(9.68±5.87)、(2.32±2.02)、(8.23±4.35)、(3.36±1.64)、(1.27±0.59)分,均明显低于治疗前的(26.97±7.57)、(8.31±5.28)、(27.41±6.39)、(7.92±1.17)、(3.24±0.76)分,差异均有统计学意义(P<0.05)。治疗后,50例患者病变椎间盘中心在T2WI下的MR值(157.65±23.36)明显高于治疗前的(98.78±21.67),差异有统计学意义(P<0.05)。结论McKenzie技术治疗椎间盘源性下腰痛患者可改善椎间盘的受力情况,改善疼痛所致的功能障碍,提高患者生活质量,临床疗效确切。

Objective To comprehensively and systematically evaluate the efficacy of McKenzie technique in the treatment of discogenic low back pain,and to discuss its clinical mechanism.Methods A total of 50 patients with discogenic low back pain as study subjects were treated with McKenzie technique for 6 weeks,with 3 times/week.Comparison were made on Chinese version of Oswestry dysfunction index(CODI)score before and after treatment,Chinese version of Chinese translation of Roland-Morris dysfunction questionnaire(CRMDQ)score,short-form McGill pain questionnaire(SF-MPQ)score,changes in MR values of patients with diseased disc center under T2-weighted imaging(T2 WI)between the two groups.Results After treatment,50 patients had obviously lower CODI,CRMDQ and pain rating index(PRI),visual analogue scale(VAS),score and present pain intensity(PPI)score in SF-MPQ respectively as(9.68±5.87),(2.32±2.02),(8.23±4.35),(3.36±1.64)and(1.27±0.59)points than(26.97±7.57),(8.31±5.28),(27.41±6.39),(7.92±1.17)and(3.24±0.76)points before treatment.Their difference was statistically significant(P<0.05).After treatment,50 patients had obviously higher MR values of patients with diseased disc center under T2 WI as(157.65±23.36)than(98.78±21.67)before treatment,and the difference was statistically significant(P<0.05).Conclusion McKenzie technique shows definite clinical effect for patients with discogenic low back pain,and it can improve the stress condition of the disc,improve the dysfunction caused by pain,improve the quality of life.