八段锦联合椎间盘方治疗肝肾亏虚型腰椎间盘突出症疗效观察

Clinical Observation of Eight-Section Brocade Exercise Combined with Disc Decoction on the Treatment of Lumbar Intervertebral Disc Herniation with Liver and Kidney Deficiency

目的:观察八段锦功能锻炼联合椎间盘方治疗肝肾亏虚型腰椎间盘突出症的临床疗效。方法:将符合要求的66例腰椎间盘突出症患者随机分为两组,每组各33例。治疗组采用八段锦功能锻炼联合椎间盘方治疗,对照组采用五点支撑功能锻炼联合椎间盘方治疗,均治疗4周。比较治疗前、治疗2周后及4周后的日本骨科协会评估治疗腰椎评分(JOA)、视觉模拟评分法评分(VAS),并记录临床疗效和不良反应事件的差异,作为临床疗效观察有效值。结果:治疗组1例患者和对照组4例患者未能坚持完成治疗,予以剔除,两组患者治疗期间均未出现并发症。就临床疗效而言,经治疗后,治疗组治愈率为12.50%,显效率为62.50%,总有效率为93.75%;对照组治愈率为10.34%,显效率为48.29%,总有效率为89.66%。经Mann-Whitney U秩和检验,u=330.00,P=0.035,提示治疗组在治疗效果上优于对照组。经治疗后,两组患者不同时间点腰椎JOA评分、VAS评分较治疗前差异有统计学意义,即存在时间效应(F=108.565,P<0.001;F=157.456,P<0.001)。其中就JOA评分而言,治疗组优于对照组(P<0.05);且治疗4周后,治疗组明显优于对照组,差异有统计学意义(P<0.01)。就VAS评分而言,虽然治疗组评分低于对照组,但是两组差异无统计学意义(P>0.05)。结论:八段锦功能锻炼联合椎间盘方可缓解肝肾亏虚型腰椎间盘突出症患者症状,就功能评分而言其效果明显优于五点支撑功能锻炼联合椎间盘方组,更有利于腰椎肌肉功能性恢复与协调,且长期疗效更明显。但就止痛效果而言,二者无明显差异。

Objective:To observe the clinical efficacy of Eight-Section Brocade Exercise combined with disc decoction on the treatment of lumbar disc herniation(LDH) with liver and kidney deficiency and provide basis for clinical practice.Methods:66 cases with lumbar disc herniation were randomly divided into 2 groups,with 33 cases in each group.The treatment group was treated with Eight-Section Brocade Exercise combined with disc decoction,while the control group was treated with Five-Point Supporting Function Exercise combined with disc decoction.The Japanese Orthopaedic Association evaluation lumbar spine score(JOA) and visual analogue scale(VAS) were compared before treatment,after treatment for 2 weeks and 4 weeks,and the differences in clinical efficacy and adverse events were recorded as effective values for clinical efficacy observation.Results:1 patient in the treatment group and 4 patients in the control group failed to complete the treatment and were excluded,and no complications occurred during the treatment in both groups.In terms of clinical efficacy,the cure rate of the treatment group was 12.50%,the significant efficiency was 62.50% and the total effective rate was 93.75% after treatment.In the control group,the cure rate was 10.34%,the effective rate was 48.29%,and the total effective rate was 89.66%.Mann-Whitney U rank-sum test showed that the treatment group was better than the control group in treatment efficacy(U=330.00,P=0.035).In conclusion,the therapeutic efficacy of the treatment group was better than that of the control group.After treatment,lumbar JOA score and VAS score were significantly improved at different time points in 2 groups,and it has statistical significance,that is,there was time effect(F=108.565,P<0.001;F=157.456,P<0.001).In terms of JOA score,the treatment group was better than that of the control group(P<0.05).After 4 weeks of treatment,the treatment group was significantly better than that of the control group,and the difference was statistically significant(P<0.01).In terms of VAS score,although the score of the treatment group was lower than that of the control group,and there was no statistical significance between the two groups(P>0.05).Conclusion:Eight-Section Brocade Exercise combined with disc decoction can effectively relieve lumbar back pain in patients with lumbar disc herniation with liver and kidney deficiency.In terms of functional score,its efficacy is significantly better than that of Five-Point Supporting Function Exercise combined with intervertebral disc prescription group,which is more beneficial to the recovery and coordination of lumbar muscle function,and the long-term efficacy is more obvious.But in terms of analgesic efficacy,there was no significant difference between them.