中医推拿手法对下腰痛患者疼痛症状及健康调查简表、日常生活活动能力评定量表评分的影响

Effect of traditional chinese medicine manipulation in improvement of pain symptoms and SF-36 and ADL scores in patients with low back pain

目的研究中医推拿手法对下腰痛患者疼痛症状及健康调查简表(SF-36)、日常生活活动能力评定量表(ADL)评分的影响。方法将82例下腰痛患者按照随机数字表法分为2组,对照组41例予常规治疗,治疗组41例在对照组治疗基础上予中医推拿手法治疗。比较2组治疗前后疼痛视觉模拟评分(VAS)、疼痛自我效能问卷(PSEQ)评分、血清5-羟色胺(5-HT)、β-内啡肽(β-EP)水平、SF-36评分、ADL评分、汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分。结果2组治疗后疼痛VAS均较本组治疗前降低(P<0.05),且治疗组治疗后低于对照组(P<0.05),2组治疗后PSEQ评分均升高(P<0.05),且治疗组治疗后高于对照组(P<0.05)。2组治疗后血清5-HT、β-EP水平均较本组治疗前升高(P<0.05),且治疗组治疗后均高于对照组(P<0.05)。2组治疗后疼痛SF-36各维度及ADL评分均较本组治疗前升高(P<0.05),且治疗组治疗后均高于对照组(P<0.05)。2组治疗后HAMA、HAMD评分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。结论中医推拿手法对下腰痛患者疼痛症状改善效果显著,且能提高患者生活质量、日常生活活动能力,缓解焦虑、抑郁等负性情绪,值得推广应用。

Objective To study the effects of traditional Chinese medicine(TCM)manipulation in improvement of pain symptoms andthe scores of 36-item Short-Form Health Survey(SF-36)and Activity of Daily Living Scale(ADL)in patients with low back pain(LBP).Methods Eighty-twoLBP patients were randomly assigned to the control group(n=41)and the experimental group(n=41).All patients were given conventional rehabilitation,those in the experimental group were additionally given TCM manipulation.A 1-monthrehabilitation treatment was performed.The score of pain visual analog scale(VAS),pain self-efficacy questionnaire(PSEQ),SF-36,ADL,Hamilton Anxiety Rating Scale(HAMA),and Hamilton Depression Rating Scale(HAMD),as well as serum levels of 5-hydroxytryptamine(5-HT)and β-endorphin(β-EP)were included as comparators between groups before and after intervention.Results Afterintervention,VAS score in the both groups was significantly lower than that before intervention(P<0.05),while PSEQscore was significantly higher(P<0.05),the experimental was superior to the control group for VAS and PSEQ score(both P<0.05).After intervention,the serum levels of 5-HT and β-EP in the both groups were significantly higher than those before intervention(P<0.05),the increases were more pronounced in the experimental group relative to the control group(P<0.05).After intervention,the SF-36 and ADL scores in the both groups were significantlyhigher than those before intervention(P<0.05),but HAMA and HAMD scores were significantly lower(P<0.05),and there were significant differences in scores of SF-36,ADL,HAMA and HAMDbetween the two groups(all P<0.05).Conclusion TCM manipulation has a significant effect on the improvement of pain symptoms in LBP patients,and it can improve patients'quality of life,ADL,and relieve anxiety,depression and other negative emotions,which is worth popularizing and applying.