腰腹联合手法治疗轻度退行性腰椎滑脱临床疗效及对脊柱-骨盆参数影响

Clinical Effect of Lumbar Abdominal Combined Manipulation in Treating Mild Degenerative Lumbar Spondylolisthesis and Its Impact on Spinal and Pelvic Parameters

目的:观察腰腹联合手法治疗轻度退行性腰椎滑脱(DLS)的临床疗效及对脊柱-骨盆参数的影响。方法:选取120例轻度DLS患者,按照随机数字表法分为对照组、观察A组和观察B组,每组40例。对照组给予软伤外洗一号方熏洗治疗,观察A组在对照组基础上加用常规推拿手法治疗,观察B组在对照组基础上加用腰腹联合手法治疗。3组均治疗14d,随访1个月。比较3组临床疗效及脊柱-骨盆参数[胸椎后凸角(TK)、腰椎前凸角(LL)、矢状面平衡(SVA)、骨盆入射角(PI)、骨盆倾斜角(PT)和骶骨倾斜角(SS)]。结果:观察B组总有效率92.50%,观察组A组总有效率85.00%,对照组总有效率77.50%,3组临床疗效比较,差异有统计学意义(P<0.05)。治疗14 d,3组TK、SS均较治疗前升高,LL、SVA、PI、PT均较治疗前降低,差异均有统计学意义(P<0.05)。随访1个月,3组TK、SS均较治疗14 d升高,LL、SVA、PI、PT均较治疗14 d降低,差异均有统计学意义(P<0.05)。治疗14 d、随访1个月,观察B组和观察A组TK、SS均高于同期对照组,LL、SVA、PI、PT均低于同期对照组,观察B组TK、SS均高于同期观察A组,观察B组LL、SVA、PI、PT均低于同期观察A组,差异均有统计学意义(P<0.05)。结论:腰腹联合手法治疗轻度DLS临床疗效确切,可有效改善患者的脊柱-骨盆参数。

Objective:To observe the clinical effects of lumbar abdominal combined manipulation in the treatment of mild degenerative lumbar spondylolisthesis(DLS)and its impact on spinal and pelvic parameters.Methods:A total of 120 patients with mild DLS were selected and divided into the control group,the observation group A,and the observation group B using the random number table method,with 40 patients in each group.The control group received fumigation and washing therapy with Ruanshang Waixi Prescription 1,the observation group A was treated with conventional massage therapy in addition to the control group,and the observation group B received lumbar abdominal combined manipulation in addition to the control group.All the three groups were treated for 14 days and followed up for one month.The clinical effects and spinal and pelvic parameters[thoracic kyphosis angle(TK),lumbar lordosis angle(LL),sagittal vertical axis(SVA),pelvic incidence angle(PI),pelvic tilt angle(PT),and sacral slope(SS)]were compared among the three groups.Results:The total effective rate was 92.50%in the observation group B,85.00%in the observation group A,and 77.50%in the control group,with significance in the difference(P<0.05).After 14 days of treatment,TK and SS in all the three groups were increased when compared with those before treatment,and LL,SVA,PI,and PT were decreased when compared with those before treatment,with significance in differences(P<0.05).After a one-month follow-up,TK and SS in all the three groups were increased when compared with those after 14 days of treatment,and LL,SVA,PI,and PT were declined when compared with those after 14 days of treatment,with significance in differences(P<0.05).After 14 days of treatment and one month follow-up,TK and SS in the observation group B and the observation group A were higher than those in the control group at the same time,while LL,SVA,PI,and PT were lower than those in the control group at the same time;TK and SS in the observation group B were higher than those in the observation group A at the same time,while LL,SVA,PI,and PT in the observation group B were lower than those in the observation group A at the same time;the differences were significant(P<0.05).Conclusion:The clinical effects of lumbar abdominal combined manipulation for mild DLS is definite,and it can effectively improve the spinal and pelvic parameters of patients.