手法与牵引治疗腰椎间盘突出症疗效观察

Comparative analysis of curative effect of maneuver and mechanical traction for the treatment of lumbar intervertebral disc herniation

目的 观察脊柱定点旋转复位法治疗腰椎间盘突出症的临床效果。方法 310例腰椎间盘突出症患者分为两组 ,治疗组 2 5 0例采用脊柱定点旋转复位治疗 ,对照组 6 0例采用机械床牵引治疗 ,观察治疗前后症状、体征、影像学变化。结果 治疗后两组腰背部疼痛不适、下肢疼痛麻木、下肢功能、脊柱活动度与椎旁触压放射痛及直腿抬高和加强试验均有显著改善 (P <0 0 1) ;手法改善疼痛、麻木症状优于对照组 (P <0 0 5 )。两组治疗前后X线示椎间隙变化明显 (P <0 0 1和P <0 0 5 ) ,组间比较无显著差异 (P >0 0 5 )。治疗前后CT示突出物位移均有显著性差异 (P <0 0 5 )。 2 0例无效患者突出物与椎管面积比值超过 4 0 %。结论 手法、牵引法均为保守治疗腰椎间盘突出症的有效方法 ,改善疼痛麻木症状手法优于牵引法 ;突出物面积超过椎管面积 4 0 %时 ,不宜保守治疗。

Objective To observe the clinical effect of the spine fixed point of lumbar rotatory manipulation (LRM) on the treatment of the lumbar intervertebral disc herniation [HT5”H]Methods [HT5”SS]310 patients with lumbar intervertebral disc herniation were treated,in which 250 patients used the spine fixed point of LRM (as therapeutic groups) and the others with mechanical traction (as control group).The change of symptom,physical sign,X-ray and CT of the all patients were analyzed.[HT5”H]Results [HT5”SS]The changes of the pain and upset of waist and back,lower limb ache and numb,lower limb function,spine activity,radiating pain of paravertebra pressed and leg elevation and strengthen test in the both of groups were significant better (P<0 01) after the treatment.Improvement of ache and numbness in therapeutic groups was better than in the control group (P<0 05). The changes of intervertebral space on X-ray and the migration of protrudent thing on CT were significant after treatment in both groups (P<0 01 ,P<0 05),but there were not difference between two groups (P>0 05).Ratio of the protrudent thing with the area of vertebral canal was more than 40% in 20 cases without effect.[HT5”H]Conclusion [HT5”SS]Both of maneuver and mechanical traction are effective way for the lumbar intervertebral disc herniation.Maneuver is better than mechanical traction on improving pain and numb.Traditional therapy can not be used when the area of the protrudent thing is more than 40% of the vertebral canal.