石氏腰神经根松解手法对腰突症疼痛及腰椎功能的临床研究

Clinical Study of Shi′s Lumbar Nerve Root Release Manipulation on Pain and Function of Lumbar Spine in Lumbar Disc Herniation

目的 通过随机、阳性对照的临床设计,评估石氏腰神经根松解手法治疗腰椎间盘突出症(lumbar disc herniation, LDH)的有效性和安全性。方法 将LDH患者118例随机分为试验组和对照组。两组患者均先采用椎间盘臭氧消融术,然后对照组采用一般手法(腰部扌衮法),试验组采用石氏腰神经根松解手法治疗。分别于治疗前和治疗后1周、4周、13周、26周,采用Oswestry功能障碍指数(Oswestry disability index, ODI)评分评价患者腰椎功能;采用视觉模拟法评分(Visual Analogue Scale, VAS)评价患者腰腿部疼痛情况;并在治疗结束后,参照《中医病证诊断疗效标准》中LDH疗效评价标准评价综合疗效。对两组患者的评价和测量结果进行比较。结果 治疗后1周、4周、13周、26周2组患者ODI评分、VAS评分均明显低于治疗前(P<0.05),治疗后1周、4周、13周2组患者ODI评分,试验组明显低于对照组(P<0.05);治疗后各时间点试验组VAS评分均明显低于对照组(P<0.05);治疗组总优良率为98.31%(58/59),高于对照组的86.44%(52/59)(P<0.05)。结论 石氏腰神经根松解手法联合椎间盘臭氧消融术治疗腰椎间盘突出症在改善患者腰腿部疼痛和腰椎功能方面比单用臭氧消融术效果更优,值得临床推广使用。

Objective To evaluate the effectiveness and safety of Shi′s lumbar nerve root release manipulation in the treatment of lumbar disc herniation(LDH) through a randomised, positive controlled clinical design.Methods One hundred and eighteen patients with LDH were randomly divided into a test group and a control group.Both groups were treated with ozone ablation of the intervertebral disc, followed by normal manipulation(gun method of lumbar) in the control group and Shi′s lumbar nerve root release manipulation in the test group.The Oswestry disability index(ODI) score was used to evaluate the patients′ lumbar spine function before, and 1,4,13 and 26 weeks after treatment respectively.The Visual Analogue Scale(VAS) was used to evaluate the patients′ low back and leg pain and at the end of the treatment, the overall efficacy was evaluated by referring to the LDH efficacy evaluation criteria in the Diagnostic Efficacy Criteria for Chinese Medicine.The evaluation and measurement results of the two groups were compared.Results The ODI scores and VAS scores in the two groups were significantly lower than those before treatment, and 1,4,13 and 26 weeks after treatment(P<0.05).The ODI scores of patients in the two groups were significantly lower in the test group than those in the control group at 1,4 and 13 weeks after treatment(P<0.05).The VAS scores of the test group were significantly lower than those of the control group at all time points after treatment(P<0.05).The overall superiority rate of the treatment group was 98.31%(58/59),which was higher than that of the control group 86.44%(52/59)(P<0.05).Conclusion Shi′s lumbar nerve root release manipulation combined with disc ozone ablation is more effective than ozone ablation alone in treating lumbar disc herniation in terms of improving patients′ lumbar and leg pain and lumbar spine function, and is worthy of clinical promotion.