针灸推拿联合矫形鞋垫治疗扁平足合并慢性腰肌劳损49例

Acupuncture and massage combined with arch correction therapy in the treatment of chronic lumbar muscle strain:a clinical study of 49 cases

目的针灸推拿联合矫形鞋垫治疗扁平足合并慢性腰肌劳损的临床效果。方法选择2017年3月至2018年3月在天津市宁河区中医医院和天津医科大学总医院就诊的98例扁平足合并慢性腰肌劳损病人作为研究对象,采用随机数字表法将病人分为对照组和观察组各49例。对照组给予针灸推拿治疗,观察组在对照组的基础上给予穿戴矫形鞋垫进行足弓矫正治疗。统计两组治疗前、治疗10 d、20 d、30 d时视觉模拟评分(VAS),治疗前后采用中文版Oswestry功能障碍指数(CODI)和腰部耐力时间。结果两组治疗前、治疗10 d时VAS相比较均差异无统计学意义(P>0.05),治疗10 d、20 d、30 d时两组VAS均逐渐降低(P<0.05),观察组治疗20 d、30 d时VAS与对照组相比较均显著降低(P<0.05)。两组治疗前CODI和腰部耐力时间相比较均差异无统计学意义(P>0.05);两组治疗后CODI与治疗前相比较均显著降低(P<0.05),且观察组与同期对照组相比较显著降低[(32.05±7.03)%比(40.35±8.13)%](P<0.05);两组腰部耐力时间治疗后与治疗前相比较均显著升高(P<0.05),且观察组与同期对照组相比较显著升高[(23.54±3.05)s比(19.36±2.85)s](P<0.05)。结论针灸推拿联合矫形鞋垫治疗扁平足合并慢性腰肌劳损效果优于单纯针灸推拿。对足部有疾病的慢性腰肌劳损病人,在腰部治疗的基础上,应注重足部疾病的改善,以增加治疗效果。

Objective To investigate the clinical effect of acupuncture and massage combined with pedicle correction therapy in the treatment of chronic lumbar muscle strain.Methods Patients treated in the Tianjin Ninghe District Hospital of Traditional Chinese Medicine and Tianjin Medical University General Hospital with flat foot combined with chronic lumbar muscle strain from March 2017 to March 2018 were selected as study objects.The patients were assigned into control group(n=49)and observation group(n=49)using random number table method.The control group was treated with acupuncture and massage,and the observation group was treated with orthopedic insole on the basis of the therapy used in control group.The visual analogue scale(VAS)was observed in the two groups before treatment and at 10 d,20 d,and 30 d after treatment.The Chinese version of Oswestry disability index(CODI)and lumbar endurance time were used before and after treatment.Results There was no significant difference in VAS before treatment and at 10 d after treatment(P>0.05).The VAS of the two groups decreased gradually at 10d,20 d and 30 d after treatment(P<0.05).The VAS of the observation group was significantly lower than that of the control group at 30 d after treatment(P<0.05).The CODI and lumbar endurance time before treatment were not statistically significant between the two groups(P>0.05).The CODI of the two groups after treatment was significantly lower than that before treatment(P<0.05),and the CODI of the observation group was significantly lower than that in the control group in the same period[(32.05±7.03)%vs.(40.35±8.13)%](P<0.05).The lumbar endurance time in both groups after treatment was significantly increased in comparison with that before treatment(P<0.05).Compared with the control group in the same period,the lumbar endurance time in the observation group was significantly higher[(23.54±3.05)s vs.(19.36±2.85)s](P<0.05).Conclusions Acupuncture and massage combined with pedicle correction therapy had better effect in treating chronic lumbar muscle strain than acupuncture and massage alone.Patients with chronic lumbar muscle strain combined with foot diseases need to pay attention to the improvement of foot dis eases on the basis of lumbar treatment in order to increase the therapeutic effect.