自我推拿对腰椎间盘突出症患者痊愈后JOA及VAS评分的影响

Effect of self-massage on JOA and VAS scores in patients with lumbar disc herniation after recovery

目的分析自我推拿对腰椎间盘突出症治愈后患者一段时间内日本骨科协会评估治疗分数(JOA)和视觉模拟评分法(VAS)评分变化的影响。方法选取2016年4月—2017年9月在广西中医药大学第一附属医院东葛院区推拿科门诊及病房就诊的经治疗达到腰椎间盘突出症痊愈标准的患者160例,按照随机数字表法将其分为治疗组和对照组,每组80例。治疗组采用自我推拿操作,对照组采用“飞燕式”背伸肌锻炼,每天治疗2次,20 d为1个疗程,两组均为3个疗程。在每疗程结束时对两组进行JOA和VAS评分评估与比较。结果JOA评分比较:组间比较、时间点比较及交互作用差异均有高度统计学意义(P<0.01)。组内比较:与治疗20 d后比较,治疗40、60 d后两组JOA评分均降低,且治疗60 d后的JOA评分低于治疗40 d后,差异均有高度统计学意义(P<0.01)。组间比较:治疗20、40 d后,两组JOA评分比较,差异无统计学意义(P>0.05);治疗60 d后,治疗组JOA评分高于对照组,差异有高度统计学意义(P<0.01)。VAS评分比较:组间比较、时间点比较及交互作用差异均有高度统计学意义(P<0.01)。组内比较:与治疗20 d后比较,治疗60 d后治疗组VAS评分升高,差异有统计学意义(P<0.05)。与治疗40 d后比较,治疗60 d后对照组VAS评分升高,差异有高度统计学意义(P<0.01)。组间比较:在治疗20、40、60 d后,两组VAS评分比较,差异均有高度统计学意义(P<0.01)。结论临床已治愈的腰椎间盘突出症患者可以借助自我推拿以提高JOA评分和降低VAS评分,值得临床推广。

Objective To analyze the effect of self-massage on the changes of the Japanese orthopaedic association evaluates treatment scores(JOA)and visual analogue scale(VAS)scores in patients with lumbar disc herniation after a period of time.Methods A total of 160 patients,who were determined to meet the criteria of recovery from lumbar disc herniation after receiving treatment in the outpatient clinic and ward of the Department of Massage of Dongge Hospital,the First Affiliated Hospital of Guangxi University of Chinese Medicine from April 2016 to September 2017,were enrolled.They were divided into the treatment group and the control group according to the random number table method,with 80 patients in each group.The treatment group adopted self-massage treatment,while the control group adopted“Feiyan-style”dorsal extensor muscle exercise,which was treated twice a day,with 20 days as one course of treatment,and both groups had three courses of treatment.Results JOA score comparison:the differences in intergroup comparison,time point comparison and interaction were highly significant(P<0.01).Intra-group comparison:compared with 20 days after treatment,JOA score of both groups decreased after 40 and 60 days of treatment,and JOA score of 60 days after treatment was lower than that of 40 days after treatment,the differences were highly statistically significant(P<0.01).Comparison between groups:after 20 and 40 days of treatment,there was no statistically significant difference in JOA scores between the two groups(P>0.05).After 60 days of treatment,JOA score in the treatment group was higher than that in the control group,and the difference was highly significant(P<0.01).Comparison of VAS scores:the differences in intergroup comparison,time point comparison and interaction were highly significant(P<0.01).Intra-group comparison:VAS score in the treatment group increased after 60 days of treatment compared with that after 20 days of treatment,and the difference was statistically significant(P<0.05).VAS scores in the control group increased after 60 days of treatment compared with 40 days after treatment,and the difference was highly statistically significant(P<0.01).Comparison between groups:after 20,40 and 60 days of treatment,VAS scores of the two groups were compared,and the differences were highly statistically significant(P<0.01).Conclusion Clinically cured patients with lumbar disc herniation can use self-massage to improve JOA score and reduce VAS score,which is worthy of clinical promotion.