中医特色康复联合核心肌群训练在椎间盘源性腰痛中的应用

Application of traditional Chinese medicine characteristic rehabilitation combined with core-muscle training in discogenic low back pain

目的探讨中医特色康复联合核心肌群训练治疗椎间盘源性腰痛(DLBP)的效果及对患者腰椎功能、多裂肌横截面积、腰大肌横截面积的影响。方法选取2018年5月至2020年6月收治的180例DLBP患者作为研究对象,采用随机数字表法分为3组,每组60例。中医组用中医特色康复治疗,训练组用核心肌群训练,联合组加用中医特色康复联合核心肌群训练,均于治疗8周后进行疗效观察。统计对比3组疗效、视觉模拟评分法(VAS)、功能障碍指数问卷表(ODI)评分、Rdand Morris问卷(RMQ)、多裂肌横截面积、腰大肌横截面积。结果联合组治疗8周后总有效率(100.00%)高于中医组(81.67%)、训练组(85.00%),差异有统计学意义(P<0.05);联合组治疗4、8周后VAS评分、ODI评分低于中医组、训练组,差异有统计学意义(P<0.05);联合组治疗4、8周后多裂肌横截面积、腰大肌横截面积及RMQ评分高于中医组、训练组,差异有统计学意义(P<0.05);中医组、训练组各指标比较,差异无统计学意义(P>0.05)。结论中医特色康复联合核心肌群训练应用于DLBP患者中效果显著,能减轻疼痛,改善患者病情。

Objective To investigate the effect of traditional Chinese medicine(TCM)characteristic rehabilitation combined with core-muscle training on lumbar function,multifidus muscle cross-sectional area,psoas cross-sectional area in the treatment of discogenic low back pain(DLBP).Methods With reference to the principle of randomized controlled experiment,a total of 180 patients with DLBP from May 2018 to June 2020 were selected as the study subjects and equally divided into 3 groups using a random number table.TCM Group was treated with TCM characteristic rehabilitation,train group with core-muscle training,and combined group with TCM characteristic rehabilitation plus core-muscle training,After 8 weeks of treatment,the treatment efficacy was observed,and the visual analog scale(VAS),dysfunction index questionnaire(ODI),Rdand Morris questionnaire(RMQ),multifidus muscle cross-sectional area,psoas cross-sectional area were compared among the three groups.Results After 8 weeks of treatment,the total effective rate in group C was significantly higher than that of TCM group and train group(100.00%vs 81.67%vs 85.00%,P<0.05).The VAS score and ODI score on weeks 4 and 8 in combined group were significantly lower than those of groups TCM and train(P<0.05).The scores of multifidus muscle cross-sectional area,psoas cross-sectional area,and RMQ on weeks 4 and 8 were significantly higher in group C than in groups TCM and train(P<0.05).The above indexes in TCM groups were comparable to train group(P>0.05).Conclusion The application of TCM characteristic rehabilitation plus core-muscle training was effective in reducing pain and improving condition in DLBP patients.