基于分期指导的“导引固肾法”功能锻炼在腰椎间盘突出症中的应用效果

Application Effects of Functional Training of"Breathing Exercise Kidney-consolidating Method"Based on Staging Guidance in Patients with Lumbar Disc Herniation

目的:观察分期指导“导引固肾法”功能锻炼在腰椎间盘突出症患者中的应用效果。方法:将120例腰椎间盘突出症患者依据数字表法随机分为观察组、对照1组和对照2组各40例。观察组根据患者疾病分期,对应指导患者行“导引固肾法”功能锻炼;对照1组行一般功能锻炼;对照2组功能锻炼动作同观察组,但不按疾病分期对应锻炼。出院后继续随访并指导3组患者行相应功能锻炼至3个月。分别在功能锻炼第2周及随访3个月时评估患者腰痛视觉模拟量表(visual analog scale,VAS)评分,于第2周时评估腰椎JOA评分及其改善率、显效率和1年内复发率,同时观察治疗前后炎症因子水平。结果:功能锻炼第2周VAS评分观察组为(1.79±0.33)分,低于对照1组的(2.26±0.52)分和对照2组的(2.10±0.37)分,3个月后VAS评分观察组为(0.73±0.40)分,低于对照1组的(1.25±0.43)分和对照2组的(0.94±0.47)分;2周后JOA评分观察组为(24.35±2.64)分,高于对照1组的(19.88±4.55)分和对照2组的(22.50±3.21)分;2周后总显效率观察组为92.5%(37/40),高于对照1组的57.5%(23/40),对照2组的75.0%(30/40);1年内复发率观察组为7.5%(3/40),低于对照1组的35.0%(14/40),对照2组的15%(6/40);观察组治疗后炎症因子水平低于对照组(P<0.05)。结论:腰椎间盘突出症患者按疾病分期行“导引固肾法”功能锻炼,临床疗效优于一般功能锻炼与不按疾病分期的锻炼,并能降低复发率。

Objective:To observe the application effects of functional training of"breathing exercise kidney-consolidating method"based on staging guidance in patients with lumbar disc herniation(LDH).Methods:All 120 patients were randomized into the observation group,the control group No 1 and the control group No 2 according to number table method,with 40 cases in each group.In the observation group,the patients were instructed to perform functional training of"breathing exercise kidney-consolidating method";the control group No 1 performed general functional exercise;and the control group No 2 performed the same movements of functional exercise with the observation group,but the exercise does not correspond to the stage of the disease.The patients were followed after leaving hospital,and guided to perform the corresponding functional training in three groups till three months.To assess VAS scores during the second week of functional training and three months of follow-up,lumbar JOA scores and its improvement rate in the second week,the markedly effective rate and relapse rate within one year respectively,simultaneously to observe the levels of inflammatory factors before and after the treatment.Results:During the second week of functional training,VAS scores of the observation group were(1.79±0.33)points,lower than(2.26±0.52)points of the control group No 1 and(2.10±0.37)points of the control group No 2,VAS scores of the observation group were(0.79±0.40)points,lower than(1.25±0.43)points of the control group No 1 and(0.94±0.47)points of the control group No 2 in three months;JOA scores of the observation group were(24.35±2.64)points,higher than(19.88±4.55)points of the control group No 1 and(22.50±3.21)points of the control group No 2 in two weeks;the markedly effective rate of the observation group in two weeks was 92.5%(37/40),higher than 57.5%(23/40)of the control group No 1 and 75.0%(30/40)of the control group No 2;the relapse rate within one year of the observation group was 7.5%(3/40),lower than 35.0%(14/40)of the control group No 1 and 15.0%(6/40)of the control group No 2;the level of inflammatory factors of the observation group was lower than that of the control groups(P<0.05).Conclusion:LDH patients perform functional training of"breathing exercise kidney-consolidating method"according to the phases of the disease,its clinical effects are better than these of general functional training and the exercise which does not correspond to disease staging,and the therapy could prevent the recurrence.