推拿手法结合爬行器训练治疗腰椎间盘突出症的临床研究

Clinical study on the treatment of lumbar disc herniation with tuina therapy combined with crawler training

目的:探讨推拿手法配合爬行器训练对腰椎间盘突出症(LDH)患者的临床疗效。方法:将2015年6月至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。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。分别观察两组患者在治疗前、后视觉模拟评分法(VAS)评分、日本骨科协会评估治疗JOA评分及腰椎关节活动度情况。结果:治疗后两组VAS评分均较治疗前有明显降低(P<0.05),观察组低于对照组(P<0.05)。治疗后两组JOA评分均较治疗前有明显提高(P<0.05),且观察组高于对照组(P<0.05)。对照组总有效率76.7%,观察组总有效率86.6%,两组疗效差异有统计学意义(P<0.05);治疗后两组在腰椎活动度上均有改善(P<0.05),且治疗组改善程度优于对照组(P<0.05)。结论:推拿结合爬行器训练治疗LDH较单纯推拿治疗在降低VAS评分及提高JOA评分上更加显著。

Objective: To investigate the clinical efficacy of tuina therapy combined with crawl training on patients with lumbar disc herniation(LDH). Methods: Sixty LDH patients treated in Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine from June 2015 to December 2016, were randomly divided into control group and observation group by random number table method. Both groups were given tuina therapy, and the observation group assisted with crawler training on the basis of tuina therapy. Visual analogue scale(VAS) score, Japanese Orthopaedic Association(JOA) score and lumber range of motion(ROM) were observed before and after treatment in both groups. Results: After treatment, the VAS score in both groups were significantly lower than that before treatment(P<0.05);and observation group had the lower VAS score than control group(P<0.05). The JOA score of both groups after treatment was higher than that before treatment(P<0.05), and the observation group was significantly higher than control group(P<0.05). According to the standard of efficacy evaluation, the total effective rate of control group after treatment was 76.7%, while the total efficiency of the observation group was 86.6%, there was a statistical difference between the two groups in the efficacy ratio(P<0.05). The lumber ROM in both groups improved significantly after treatment(P<0.05), and the improvement in the treatment group was more obvious than that in the control group(P<0.05). Conclusion: Tuina therapy combined with crawler training for LDH patients is more effective in reducing VAS score and improving JOA score than simple tuina therapy with lower recurrence rate.