“三维牵引”加正骨推拿手法治疗Ⅰ°退行性腰椎滑脱症38例

Treating 38 Cases ofⅠ°Degenerative Spondylolisthesis by"Three Dimensional Traction"and Bone Setting Manipulation

目的:观察"三维牵引"加正骨推拿手法治疗I°退行性腰椎滑脱症的临床疗效。方法:将114例患者随机分为A、B、C组,每组38例,A组采用正骨推拿手法进行治疗,B组采用三维牵引进行治疗,C组采用三维牵引与正骨推拿手法联合治疗。观察3组临床疗效,治疗前后腰椎功能评分(Japanese orthopaedic association scores,JOA)、功能障碍指数(oswestry disability index,ODI)、疼痛评分(visual analog scale,VAS)的变化情况,并对腰痛、下肢放射痛、间歇性跛行、直腿抬高等临床体征进行评分。结果:总有效率C组显著高于A、B组,差异有统计学意义(P<0.05);B组与A组比较,差异无统计学意义(P>0.05)。JOA、VAS评分、ODI指数治疗前后3组组内比较,差异均有统计学意义(P<0.05);治疗后C组与A、B组比较,差异也有统计学意义(P<0.05);治疗后B组与A组比较,差异无统计学意义(P>0.05)。腰痛、下肢放射痛、间歇性跛行、直腿抬高等症状评分治疗前后3组组内比较,差异均有统计学意义(P<0.05);治疗后C组与A、B组比较,差异也有统计学意义(P<0.05);治疗后B组与A组比较,差异无统计学意义(P>0.05)。结论:三维牵引与正骨推拿手法进行联合治疗I°退行性腰椎滑脱症具有显著疗效。

Objective: To observe clinical effects of "three dimensional traction" and bone setting manipulation in treating Ⅰ° degenerative spondylolisthesis. Methods: All 114 patients were randomized into the groups of A, B and C, 38 cases each group, group A adopted bone setting manipulation, group B "three dimensional traction" and group C used both. To observe clinical effects of three groups, JOA, ODI and VAS before and after treating, to score clinical syndromes such as lumbago, radiation pain of lower limbs, intermittent claudication, straight leg raising and others. Results: Total effective rate of group C was significantly higher than that of group A and B, and the difference had statistical meaning(P<0.05);the difference had no statistical meaning between group B and A(P>0.05). The difference was statistically significant in JOA, VAS scores and ODI indexes between three groups(P<0.05);the difference had statistical meaning when group C was compared with group B and A after treating(P<0.05);the difference showed no statistical meaning when group B was compared with group A after treating(P>0.05). The difference showed statistical meaning in the scores of lumbago, radiation pain of lower limbs, intermittent claudication, straight leg raising among three groups(P <0.05);the difference showed statistical meaning when group C was compared with group B and A after treating(P<0.05);the difference had no statistical meaning when group B was compared with group A after treating(P >0.05). Conclusion: Three dimensional traction and bone setting manipulation in treating Ⅰ° degenerative spondylolisthesis could gain notable clinical effects.