目的通过累积Meta分析方法评价核心稳定性训练对腰椎间盘突出患者疼痛、功能障碍的影响。方法计算机检索中国知网、万方数据库、维普数据库、MEDLINE、Embase、CINAHL、PEDro、Rehabilitation&Sports Medicine Source、Cochrane Lib...目的通过累积Meta分析方法评价核心稳定性训练对腰椎间盘突出患者疼痛、功能障碍的影响。方法计算机检索中国知网、万方数据库、维普数据库、MEDLINE、Embase、CINAHL、PEDro、Rehabilitation&Sports Medicine Source、Cochrane Library中关于采用核心稳定性训练干预腰椎间盘突出症患者的随机对照试验,并追踪其参考文献。由两名研究者独立筛选文献,并采用PEDro量表对纳入的文献进行偏倚风险评价。采用Stata MP 16.0软件进行累积Meta分析。结果共纳入18篇文献,共纳入1347例患者。累积Meta分析显示,与常规康复治疗相比,核心稳定性训练可以改善腰椎间盘突出症患者的腰椎功能[MD=2.58(95%CI:1.60,3.56),P<0.001],减轻功能障碍的严重程度[MD=-5.82(95%CI:-8.72,-2.86),P<0.001],减轻疼痛[MD=-0.89(95%CI:-1.20,-0.58),P<0.001]。结论现有的研究已证实核心稳定性训练可以改善腰椎间盘突出患者的腰椎功能,减轻疼痛,但对功能障碍的改善程度尚需要更多可靠的随机对照实验予以验证。展开更多
Objectives:To investigate the clinical and therapeutic effects of acupuncture at the pain-sensitive points of patients with chronic nonspecific low back pain and optimize the acupuncture treatment for chronic nonspeci...Objectives:To investigate the clinical and therapeutic effects of acupuncture at the pain-sensitive points of patients with chronic nonspecific low back pain and optimize the acupuncture treatment for chronic nonspecific low back pain.Methods:Using the FDK 20 pressure algometer,the pain-sensitive points were probed in 30 patients with chronic nonspecific low back pain.The top 5 points that elicited the most painful reaction were selected and stimulated with an even-needling technique after deqi.The needles were retained for 30 min.TDP irradiation was concurrently administered.The treatment was administered once daily on weekdays(Monday to Friday) and discontinued for 2 days during the weekend(Saturday and Sunday).The treatment lasted for 2 consecutive weeks.The changes in the range of motion(ROM) of the lumbar vertebrae,visual analogous scale(VAS) score,and the Oswestry disability index(ODI) score of the lumbar vertebrae were assessed before treatment and after 5 and 10 treatment sessions.Results:Compared with the data before treatment,the spinal ROM increased after 5 and 10 treatment sessions in the patients with chronic nonspecific low back pain.The ROM after 10 treatment sessions was remarkably wider than that after 5 treatments,with statistical significance(all P<0.05).Compared with that before treatment,the immediate VAS score showed statistically significant reduction after 5 treatment sessions(P<0.05).Moreover,compared with the score after 5 treatment sessions,the immediate VAS score reduced after 10 treatment sessions,but without any statistical significance.After 5 and 10 treatment sessions,the ODI score was reduced in the patients and it was significantly different from that before treatment(both P<0.05).Conclusion:Acupuncture at the pain-sensitive points alleviates pain and improves lumbar vertebral function in patients with chronic nonspecific low back pain.Thus,further research is needed to confirm whether acupuncture can be a better intervention for chronic nonspecific low back pain.展开更多
基金Supported by Special Funds of Fujian Provincial Finance Department and Education Department:x2018002Clinical Special Project of School Management of Fujian University of Traditional Chinese Medicine:xb2020150。
文摘Objectives:To investigate the clinical and therapeutic effects of acupuncture at the pain-sensitive points of patients with chronic nonspecific low back pain and optimize the acupuncture treatment for chronic nonspecific low back pain.Methods:Using the FDK 20 pressure algometer,the pain-sensitive points were probed in 30 patients with chronic nonspecific low back pain.The top 5 points that elicited the most painful reaction were selected and stimulated with an even-needling technique after deqi.The needles were retained for 30 min.TDP irradiation was concurrently administered.The treatment was administered once daily on weekdays(Monday to Friday) and discontinued for 2 days during the weekend(Saturday and Sunday).The treatment lasted for 2 consecutive weeks.The changes in the range of motion(ROM) of the lumbar vertebrae,visual analogous scale(VAS) score,and the Oswestry disability index(ODI) score of the lumbar vertebrae were assessed before treatment and after 5 and 10 treatment sessions.Results:Compared with the data before treatment,the spinal ROM increased after 5 and 10 treatment sessions in the patients with chronic nonspecific low back pain.The ROM after 10 treatment sessions was remarkably wider than that after 5 treatments,with statistical significance(all P<0.05).Compared with that before treatment,the immediate VAS score showed statistically significant reduction after 5 treatment sessions(P<0.05).Moreover,compared with the score after 5 treatment sessions,the immediate VAS score reduced after 10 treatment sessions,but without any statistical significance.After 5 and 10 treatment sessions,the ODI score was reduced in the patients and it was significantly different from that before treatment(both P<0.05).Conclusion:Acupuncture at the pain-sensitive points alleviates pain and improves lumbar vertebral function in patients with chronic nonspecific low back pain.Thus,further research is needed to confirm whether acupuncture can be a better intervention for chronic nonspecific low back pain.
