韦氏正骨整治手法治疗腰椎间盘突出症的临床研究

Clinical study on the therapy for a herniated lumbar intervertebral disc with Wechsler's bone setting manipulation

目的评价韦氏正骨整治手法治疗腰椎间盘突出症(LDH)的疗效。方法随机对照试验研究。选取2021年1-11月广西中医药大学附属瑞康医院脊柱外科、广西中医药大学附属瑞康医院国医大师馆50例LDH患者作为观察对象,采用随机数字表法分为2组,每组25例。对照组给予传统正骨手法治疗,观察组给予韦氏正骨整治手法治疗。2组均治疗3周。采用VAS量表评估腰腿疼痛程度,日本骨科协会评估治疗(JOA评分)评估腰椎功能;在全脊柱侧位X线片上测量骶骨倾斜角(SS)、腰椎前凸角(LL)及冠状位骨盆倾斜角数值;记录不良反应,评价临床疗效。结果观察组总有效率为92.0%(23/25)、对照组为68.0%(17/25),2组比较差异有统计学意义(χ2=4.50,P=0.034)。治疗后,观察组VAS评分低于对照组(t=16.25,P<0.01),JOA评分高于对照组(t=-29.39,P<0.01);SS[(36.00±1.87)゜比(34.16±1.57)゜,t=-10.64]、LL[(38.08±2.60)゜比(34.96±1.90)゜,t=-10.04]高于对照组(P<0.01);冠状位骨盆倾斜角[(0.47±0.14)゜比(0.69±0.14)゜,t=42.57]低于对照组(P<0.01)。2组治疗期间均未发生不良反应。结论韦氏正骨整治手法可改善LDH患者的疼痛症状,从一定程度上恢复腰椎-骨盆生物力学平衡。

Objective To evaluate the efficacy of Wechsler's bone setting manipulation in the treatment of lumbar disc herniation.Methods A randomized controlled trial was carried out.50 LDH patients from the Spinal Surgery Department of Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine and the Ruikang Hospital Traditional Chinese Medicine Master Hall Affiliated to Guangxi University of Chinese Medicine were selected as observation subjects from January to November 2021.They were divided into two groups using a random number table method,with 25 patients in each group.The control group was treated with traditional bone setting techniques,while the observation group was treated with Wechsler's bone setting correction techniques.Both groups were treated for 3 weeks.VAS scale was used to evaluate the degree of lower back and leg pain,and the Japanese Orthopedic Association was used to evaluate treatment(JOA score)to evaluate lumbar function;the sacral tilt angle(SS),lumbar lordosis angle(LL),and coronal pelvic tilt angle values were measured on the lateral X-ray film of the entire spine;adverse reactions were recorded and clinical efficacy was evaluated.Results The total effective rate of the observation group was 92.0%(23/25),and the control group was 68.0%(17/25),with statistical significance between the two groups(χ2=4.50,P=0.034).The VAS score of the observation group after treatment was lower than that of the control group(t=16.25,P<0.01);the JOA score was higher than that of the control group(t=-29.39,P<0.01).The SS[(36.00±1.87)°vs.(34.16±1.57)°,t=-10.64]and LL[(38.08±2.60)°vs.(34.96±1.90)°,t=-10.04]in the observation group were higher than those in the control group(P<0.01);the coronal pelvic tilt angle value[(0.47±0.14)°vs.(0.69±0.14)°,t=42.57]was lower in the control group(P<0.01).No adverse reactions occurred during the treatment period in both groups.Conclusion Wechsler's bone setting manipulation can improve the pain symptoms of patients with LDH,and restore the spine pelvis biomechanical balance to a certain extent.