功能锻炼对慢性下腰痛患者生活质量的影响

Influence of functional exercises on quality of life in patients with chronic low back pain

目的:观察以导引为主的功能锻炼对慢性下腰痛(CLBP)患者的临床疗效及生活质量的影响。方法:纳入71例慢性下腰痛患者,随机分为两组:针灸疗法加功能锻炼组36例、针灸疗法组35例。两组患者均采用针灸治疗,治疗周期为1个月;针灸疗法加功能锻炼组患者在针灸治疗同时进行腰部导引锻炼,治疗周期为3个月。评价两组患者的疼痛视觉模拟量表(VAS)评分、Roland-Morris功能障碍调查表(Roland-Morris Disability Questionnaire,RMDQ)评分,比较两组的临床疗效。结果:治疗1个月后,两组患者的疼痛VAS评分较治疗前均明显降低(P<0.01);但两组患者的VAS评分组间比较,其差异无统计学意义(P>0.05)。治疗1个月、3个月后,两组患者的RMDQ评分较治疗前均显著降低(P<0.01);且治疗3个月后,针灸疗法加功能锻炼组患者的RMDQ评分低于针灸疗法组(P<0.05)。治疗3个月后,针灸疗法加功能锻炼组的临床总有效率为88.57%、针灸疗法组为72.73%,两组临床疗效比较差异有统计学意义(P<0.05)。结论:针灸疗法结合功能锻炼治疗慢性下腰痛,有助于提高长期疗效,改善患者的功能障碍和生活质量。

Objective: To observe the effects of daoyin-based functional exercises on the clinical efficacy and the quality of life in patients with chronic low back pain( CLBP). Methods: Seventy-one patients with CLBP were included and randomly divided into two groups: 36 cases in the first group( acupuncture & functional exercises group) and 35 cases in the second group( acupuncture group).All the patients were treated with acupuncture with a course of one month; the patients in the first group were treated with waist daoyin exercises additionally,with a course of 3 months. The visual analogue scale( VAS) score and the Roland-Morris Disability Questionnaire( RMDQ) score were evaluated,and the clinical efficacy was compared. Results: After 1-month treatment,the VAS scores of both groups were significantly decreased compared with before treatment( P<0.01),but there was no statistical difference on the VAS score between the two groups( P>0.05). After 1-month and 3-month treatment,the RMDQ scores of both groups were significantly decreased compared with before treatment( P<0.01),and after 3-month treatment,the RMDQ score of the acupuncture & functional exercises group was lower than that of the acupuncture group( P<0.05). After 3-month treatment,the clinical total effective rates of the acupuncture &functional exercises group and the acupuncture group were 88. 57% and 72. 73%,and there was statistical difference on the clinical efficacy between the two groups( P<0.05). Conclusion: Compared with the acupuncture therapy alone,the therapy of acupuncture combined with functional exercise can help to enhance the long-term clinical efficacy and improve the functional disorder and the quality of life in the treatment of CLBP.