李氏拔伸踩跷法治疗腰椎间盘突出症的多中心随机对照研究

Multi-center Controlled Randomized Clinical Trial of Applying LI's Artificial Traction and Caiqiao Manipulation in the Treatment of Lumbar Intervertebral Disc Protrusion

目的:观察李氏拔伸踩跷法、踩跷法、手法推拿治疗腰椎间盘突出症的疗效差异。方法:本课题采用遂宁市中医院、射洪县中医院、蓬溪县中医院、大英县中医院4个临床中心随机对照研究方法,将符合诊断标准的腰椎间盘突出症患者405例,随机分为3组,其中观察组给予针刺+李氏拔伸踩跷法,对照1组给予针刺+踩跷法,对照2组给予针刺+手法推拿。三组均予基础针刺治疗,每天治疗1次,每周休息2天;观察组中李氏拔伸踩跷法每周3次,对照1组中踩跷法每周3次,对照2组中手法推拿隔日1次,均共治疗3周。观察各组患者治疗前、治疗1周后、2周后、3周后以及治疗结束后1月的下腰痛评分(JOA)及视觉模拟评分(VAS),并比较3组疗效。结果:各组治疗后各时间点2项指标均优于治疗前(均P<0.05);治疗后1周观察组、对照一组JOA评分无差异(P>0.05),但优于对照2组(P<0.05);治疗2周后、治疗3周后以及治疗结束后1月,观察组JOA及VAS评分均优于对照1组、对照2组(均P<0.05)。治疗3周后,观察组有效率为92.13%,对照1组有效率为87.79%,对照2组有效率为84.73%,各组间疗效两两比较,均有差异(均P<0.05)。结论:三种疗法均能有效改善腰椎间盘突出症患者的症状、体征,提高生活质量,其中李氏拔伸踩跷法疗效最佳,而踩跷法又优于普通手法推拿。

Objective:To compare the difference in the clinical efficacy on lumbar disc herniation between the therapy of LI’s artificial traction and Caiqiao manipulation,Caiqiao manipulation and massage.Methods:This research method adopted a randomized control method of four clinical centers,Suining Hospital of Traditional Chinese Medicine,Traditional Chinese Medicine Hospital of Shehong County,Traditional Chinese Medicine Hospital of Pengxi County,and Traditional Chinese Medicine Hospital of Daying County.405 patients of LIDH were randomly divided into 3 groups.The observation group was treated with acupuncture and LI’s artificial traction and Caiqiao manipulation.The controlled group 1 was treated with acupuncture and Caiqiao manipulation,and the controlled group 2 was treated with acupuncture and massage.The three groups were all given acupuncture treatment.All patients took the treatment once a day,total for 3 weeks,and had 2 days of rest a week.The observation group was treated with LI’s artificial traction and Caiqiao manipulation three times a week,and the controlled group 1 was treated with Caiqiao manipulation three times a week too.The controlled group 2 was treated with massage therapy every two days.The low back pain score(JOA)and visual analogue scale(VAS)were used to perform efficacy assessment before treatment,1 week,2 weeks,3 weeks after treatment and 1 month after the end of the treatment,and compared the effects among the three groups.Results:After treatment,the two indices at each time point were superior to those before the treatment in three groups(all P<0.05).The improvements of JOA and VAS after 1 week of treatment had no significant difference(P>0.05)between the observation group and the controlled group 1,but were superior to those in the controlled group 2.The improvements of the two indices after 2 weeks and 3 weeks of treatment and 1 month after the end of the treatment in the observation group were all superior to those in the controlled group 1 and in the controlled group 2.After 3 weeks treatment,the total effective rate was 92.13%in the observation group,87.79%in the controlled group 1,and 84.73%in the controlled group 2.Paired comparison of therapeutic effects among the three groups showed significant difference(all P<0.05).Conclusion:All three treatments can effectively improve the symptoms and signs of patients with LIDH and improve the quality of life.Among them,LI’s artificial traction and Caiqiao manipulation is the most effective therapy,and Caiqiao manipulation is superior to that of massage.