基于“筋滞骨错”理论指导下腰腹联合手法治疗腰椎手术失败综合征临床研究

Clinical Study on the Treatment of Failed Back Surgery Syndrome by Combined Manipulation of Waist and Abdomen Under the Guidance of the Theory of"Tendon Stagnation and Bone Dislocation"

目的:观察“筋滞骨错”理论指导下腰腹联合手法治疗腰椎手术失败综合征(failed back surgery syndrome,FBSS)的疗效。方法:选取2016年1月至2019年8月河南省洛阳正骨医院颈肩腰腿痛科收治的FBSS患者60例,采用随机数字表法分为对照组和治疗组,每组30例。对照组给予传统手法配合中药塌渍治疗,治疗组给予平乐正骨“筋滞骨错”理论指导下的腰腹联合手法配合中药塌渍治疗。治疗1个疗程后,采用视觉模拟评分法(visual analogue scale,VAS)及下腰痛评分系统(japanese orthopaedic association,JOA)对疗效进行评价。结果:治疗组治疗后VAS评分低于对照组,JOA评分高于对照组,差异有统计学意义(P<0.05);两组患者治疗后血清IL-1β水平低于治疗前,差异有统计学意义(P<0.05),但两组间比较差异无统计学意义(P>0.05);治疗组有效率90.0%,对照组有效率76.6%,治疗组高于对照组,差异有统计学意义(P<0.05)。结论:基于“筋滞骨错”理论指导下腰腹联合手法治疗FBSS临床疗效高于常规手法治疗。

Objective:To observe the clinical curative effect of combined manipulation of waist and abdomen under the guidance of the theory of"tendon stagnation and bone dislocation"on failed back surgery syndrome(FBSS).Methods:A total of 60 patients with FBSS treated in the Department of Neck-Shoulder-Waist-Leg Pain of Luoyang Orthopedic-Traumatological Hospital of Henan Province from January 2016 to August 2019 were selected and divided into the control group and the treatment group by random number table method,with 30 cases in each group.The control group was treated with traditional manipulation and TCM hydrotherapy while the treatment group was treated with combined manipulation of waist and abdomen under the guidance of the theory of"tendon stagnation and bone dislocation"of Pingle.After one course of treatment,visual analog scale(VAS)and Japanese Orthopaedic Association(JOA)were used to evaluate the efficacy.Results:After the treatment,the VAS score of the treatment group was lower than that of the control group,the JOA score was higher than that of the control group,and all the differences were statistically significant(P<0.05).The serum level of IL-1βin the two groups was lower than that of the same group before treatment(P<0.05),but there was no significant difference between the two groups(P>0.05).The effective rate was 90.0% in the treatment group and 76.6% in the control group.The difference was statistically significant(P<0.05).Conclusion:The clinical effect of combined manipulation of waist and abdomen under the guidance of the theory of"tendon stagnation and bone dislocation"on FBSS is higher than that of conventional manipulation.