徒手冲击疗法对假性腰椎滑脱患者腰椎结构和功能的影响

Effect of freehand shock therapy on structure and function in patients with degenerative lumbar spondylolisthesis

目的探讨徒手冲击疗法对假性腰椎滑脱患者腰椎结构和功能的影响。方法选取58例于郴州市第一人民医院康复科就诊的假性腰椎滑脱患者,采用随机数字表法分为对照组与观察组,每组29例。对照组患者采用常规康复治疗,观察组患者在常规治疗的基础上联合徒手冲击疗法进行治疗。主观结局指标采用视觉模拟量表(VAS)评分、日本骨科协会评估表(JOA)评分,客观结局指标采用站立位腰椎X线侧位片,分别在治疗前与每疗程结束后评估并统计数据,比较疗效差异。结果观察组患者治疗显效率及总有效率均高于对照组,差异均有统计学意义(P<0.05);2组患者不同疗程结束后VAS及JOA评分比较,差异均有意义(P<0.05)。除观察组中第2疗程和第3疗程结束后VAS、JOA评分差异无统计学意义(P>0.05)外,2组患者其余各疗程结束后的VAS及JOA评分差异均有统计学意义(P<0.05);2组患者治疗结束后的腰椎滑脱改善程度比较,差异有统计学意义(P<0.05)。结论探讨徒手冲击疗法联合常规康复治疗对假性腰椎滑脱患者的疗效优于单一常规康复治疗,有助于减轻患者疼痛,改善患者腰椎滑脱的结构和功能,值得在临床推广应用。

Objective To investigate the effects of freehand shock therapy on the lumbar spine structure and function in patients with degenerative lumbar spondylolisthesis.Methods Fifty-eight patients with degenerative lumbar spondylolisthesis who were treated at the Rehabilitation Department of the First People's Hospital of Chenzhou were selected.They were randomly assigned to a control group and an observation group,with 29 cases in each group.The patients in the control group received conventional rehabilitation treatment,while the patients in the observation group received freehand shock therapy in addition to conventional treatment.The subjective outcome measurements included visual analog scale(VAS)scores and the Japanese Orthopaedic Association(JOA)evaluation scores.The objective outcome measure was assessed using standing lumbar spine X-ray lateral films,and the data were evaluated and analyzed before treatment and at the end of each treatment course to compare the differences in efficacy.Results The marked response rate and overall response rate in the observation group were significantly higher than those in the control group(P<0.05).The VAS and JOA scores at the end of different treatment courses were significantly different between the two groups(P<0.05),except for the lack of statistical significance in the VAS and JOA scores at the end of the second and third treatment courses in the observation group(P>0.05).The improvement in lumbar spondylolisthesis after treatment was significantly different between the two groups(P<0.05).Conclusion The combination of freehand shock therapy and conventional rehabilitation treatment is more effective than a single conventional rehabilitation treatment in patients with degenerative lumbar spondylolisthesis.It helps alleviate pain and promote the structure and function of the lumbar spine in patients with spondylolisthesis,holding promise for a wider clinical application.