非手术脊柱减压系统结合麦肯基疗法治疗腰椎间盘突出症的临床效果

Clinical effect of non-operative spinal decompression system combined with McKenzie therapy in the treatment for lumbar disc herniation

目的观察非手术脊柱减压系统结合麦肯基疗法治疗腰椎间盘突出症的临床效果。方法选取2020年9月至2021年7月天津市人民医院康复医学科收治的95例腰椎间盘突出症患者,按照随机数字表法将其分成对照组1(31例)、对照组2(32例)和联合组(32例)。对照组1给予非手术脊柱减压系统治疗,对照组2给予麦肯基疗法治疗,联合组给予非手术脊柱减压系统联合麦肯基疗法治疗。三组均接受4周治疗,每周不间断治疗5 d。比较两组治疗前后的视觉模拟评分法(VAS)评分、Oswestry功能障碍指数(ODI)、日本骨科学会(JOA)腰椎功能评分、竖脊肌表面肌电信号的均方根值(RMS)和屈伸比(FER)。比较两组临床疗效。结果治疗过程中,对照组1脱落1例,对照组2和联合组各脱落2例,最终纳入研究90例。治疗后,三组VAS评分、ODI、RMS均低于治疗前,JOA腰椎功能评分、FER高于治疗前,且联合组VAS评分、ODI、RMS均低于对照组1、2,JOA腰椎功能评分评分、FER高于对照组1、2,差异有统计学意义(P<0.05)。治疗后,联合组临床疗效优于对照组1、2,差异有统计学意义(P<0.05)。结论非手术脊柱减压系统结合麦肯基疗法可使腰背肌肉力量提高,加强脊柱稳定性肌群和功能,进一步减轻肌肉紧张程度,缓解临床症状,从而提高腰椎功能和日常生活能力。

Objective To observe the clinical effect of non-operative spinal decompression system combined with McKenzie therapy in the treatment for lumbar disc herniation.Methods A total of 95 patients with lumbar disc herniation admitted to the Department of Rehabilitation Medicine,Tianjin People’s Hospital from September 2020 to July 2021 were selected and divided into control group 1(31 cases),control group 2(32 cases),and combined group(32 cases)according to random number table method.The control group 1 was treated with non-operative spinal decompression system,and the control group 2 was treated with McKenzie therapy,the combined group was treated with non-operative spinal decompression system combined with McKenzie therapy.All of the three groups received four weeks of treatment,five days of continuous treatment per week.Visual analogue scale(VAS)score,Oswestry disability index(ODI),Japanese Orthopaedic Association(JOA)lumbar function score,root mean square(RMS)value of semg signal on erector spine surface,and flexion and extension ratio(FER)were compared between the two groups before and after treatment.The clinical efficacy of the two groups was compared.Results During the treatment,there were one case of detachment in control group 1,two cases in control group 2,and two cases in combined group,and 90 cases were eventually included in the study.After treatment,VAS score,ODI,and RMS in the three groups were lower than those before the treatment,JOA lumbar function score and FER were higher than those before the treatment,and VAS score,ODI,and RMS in the combined group were lower than those in the control group 1 and 2,while JOA lumbar function score and FER were higher than those in the control group 1 and 2,the differences were statistically significant(P<0.05).After treatment,the clinical efficacy of combined group was better than control group 1 and 2,the difference was statistically significant(P<0.05).Conclusion Non-operative spinal decompression system combined with McKenzie therapy can improve the strength of lumbodorsal muscles,strengthen the stability of spinal muscles and function,further reduce muscle tension,relieve clinical symptoms,and thus improve the function of lumbar spine and the ability of daily living.