核心稳定性训练联合认知行为疗法对慢性非特异性腰痛患者疗效观察

The curative effect of core stability training combined with cognitive behavioral therapy in the treatment of patients with chronic non-specific low back pain

目的研究核心稳定性训练联合认知行为疗法(CBT)对慢性非特异性腰痛(CNLBP)患者的疗效。方法选取首都医科大学附属北京康复医院住院部收治的60例CNLBP患者,按照随机数字表法分为治疗组和对照组各30例,两组均接受核心稳定性训练,治疗组在此基础上行CBT干预。比较两组功能障碍指数(ODI)、疼痛视觉模拟评分(VAS)、精神状况自评量表(SCL-90)、腰部活动度及临床疗效,不良反应及复发情况。结果治疗后,治疗组总有效率高于对照组(P<0.05);两组VAS、ODI评分均低于治疗前,治疗组下降程度大于对照组(P<0.05);治疗组躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐惧、偏执的评分低于对照组,前屈、后伸和侧弯的活动度高于对照组(P<0.05);两组不良反应发生率及复发率比较差异无统计学意义(P>0.05)。结论核心稳定性训练联合CBT治疗CNLBP,临床疗效良好,有效改善患者心理状况和腰部活动度。

Objective To investigate the curative effect of core stability training combined with cognitive behavioral therapy(CBT)in the treatment of patients with chronic non-specific low back pain(CNLBP).Methods Sixty CNLBP patients who were admitted to inpatient department of Beijing Rehabilitation Hospital were enrolled.They were randomly divided into treatment group and control group,30 in each group.Both groups underwent core stability training.On this basis,the treatment group underwent CBT intervention.The scores of Oswestry disability index(ODI),visual analogue scale(VAS)and symptom check list 90(SCL-90),waist range of motion(ROM)and clinical curative effect were compared between the two groups.The adverse reactions and recurrences in both groups were recorded.Results After treatment,the total response rate of the treatment group was higher than that of the control group(P<0.05).After treatment,scores of VAS and ODI were decreased in both groups,and the decrease was greater in the treatment group than that in the control group(P<0.05).After treatment,scores of somatization,obsessive-compulsive symptoms,interpersonal sensitivity,depression,anxiety,hostility,fear and paranoia in the treatment group were lower than those in the control group(P<0.05).After treatment,ROM of anteflexion,rear protraction and lateral bending in the treatment group was greater than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two group(P>0.05).There was no significant difference in recurrence rate between the two groups(P>0.05).Conclusion The clinical curative effect of core stability training combined with CBT is good on CNLBP.It can effectively improve the psychological status and waist ROM of the patients.