五步复位法治疗腰椎间盘突出症临床研究

Clinical Study on Five-Step Reduction Method for Lumbar Disc Herniation

目的:观察五步复位法治疗腰椎间盘突出症(LDH)的临床疗效,以及对突出物绝对值(D值)和突出物与神经根管夹角(AN值)的影响。方法:选取62例LDH患者,随机分为治疗组与对照组,每组31例。治疗组采用五步复位法治疗,对照组采用牵引及常规推拿手法治疗。2组均隔天治疗1次,治疗3次。比较2组临床疗效及治疗前后日本矫形外科学会(JOA)下腰痛评分、视觉模拟评分法(VAS)评分、D值和AN值。结果:治疗组临床疗效优于对照组(P<0.05)。治疗后,2组JOA评分均较治疗前升高(P<0.05),VAS评分均较治疗前降低(P<0.05);治疗组JOA评分高于对照组(P<0.05),VAS评分低于对照组(P<0.05)。治疗后,治疗组AN值大于对照组(P<0.05),2组D值比较,差异无统计学意义(P>0.05)。治疗组AN值治疗前后差值大于对照组(P<0.05)。治疗组D值治疗前后差值比较,差异无统计学意义(P>0.05)。结论:五步复位法可改善LDH患者的腰椎功能,缓解疼痛,疗效优于牵引及常规推拿手法治疗。

Objective:To observe the clinical effect of five-step reduction method for lumbar disc herniation(LDH)and its effects on absolute value of protrusion(D value)and the angle between protrusion and nerve root canal(AN value).Methods:A total of 62 cases of LDH patients were selected and randomly divided into the treatment group and the control group,with31 cases in each group.The treatment group was treated with five-step reduction method,and the control group was treated with traction and routine tuina manipulation.Both groups were treated once every other day for three times.Score of low back pain evaluated by Japanese Orthopaedic Association(JOA),Visual Analogue Scale(VAS)score,D value and AN value before and after treatment as well as clinical effects were compared between the two groups.Results:The clinical effect of the treatment group was better than that of the control group(P<0.05).After treatment,JOA scores in the two groups were increased when compared with those before treatment(P<0.05),and VAS scores were decreased(P<0.05);JOA score in the treatment group was higher than that in the control group(P<0.05),and VAS score was lower(P<0.05).After treatment,AN value in the treatment group was larger than that in the control group(P<0.05);there was no significant difference in D value between the two groups(P<0.05).The difference of AN values before and after treatment in the treatment group was larger than that in the control group(P<0.05).There was no significant difference being found in the comparison of the difference of D values before and after treatment in the treatment group(P>0.05).Conclusion:Five-step reduction method can relieve lumbar function and pain of LDH patients.Its curative effect is better than that of traction and routine tuina manipulation.