Comparison of pain media and inflammatory factors after percutaneous transforaminal endoscopic discectomy and traditional fenestration operation treatment of protrusion of lumbar intervertebral disc

Objective:To compare the differences in pain mediators and inflammatory factors after percutaneous transforaminal endoscopic discectomy and traditional fenestration operation treatment of protrusion of lumbar intervertebral disc. Methods:80 patients with protrusion of lumbar intervertebral disc treated in our hospital between March 2013 and December 2015 were collected and divided into observation group and control group (n=40) according to randomized parallel contrast. Control group received traditional fenestration operation and observation group received percutaneous transforaminal endoscopic discectomy. Before operation and 1 week after operation, fluorescence spectrophotometry was used to determine serum pain medium levels;ELISA was used to determine pro-inflammatory factor and anti-inflammatory factor levels. Results:Before operation, differences in serum pain medium and inflammatory factor levels were not statistically significant between two groups (P>0.05). 1 week after operation, serum pain media norepinephrine (NE), dopamine (DA), 5-hydroxytryptamine (5-HT), prostaglandin E2 (PGE2) and substance P (SP) levels as well as pro-inflammatory factors interleukin-1β(IL-1β), interleukin-6 (IL-6), interleukin-18 (IL-18) and tumor necrosis factor alpha (TNF-α) levels of observation group were lower than those of control group (P<0.05) while serum anti-inflammatory factors interleukin-4 (IL-4), interleukin 10 (IL-10), soluble tumor necrosis factor receptor I (sTNF-RI) levels were higher than those of control group (P<0.05). Conclusions:Percutaneous transforaminal endoscopic discectomy can effectively treat protrusion of lumbar intervertebral disc and is more advantageous in alleviating patients’ perception of pain and reducing inflammation.

Conservative Treatment of Lumbar Intervertebral Disc Prolapse by Epidural Injection Combined with Massage under Traction

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80 CASES OF PROLAPSE OF LUMBAR INTERVERTEBRAL DISC TREATED BY ROUND-SHARP NEEDLE

Objective: To observe the therapeutic effect of round-sharp needle for prolapse of lumbar intervertebral disc. Methods: A total of 80 cases of lumbar intervertebral disc prolapse were treated by puncturing Qihaishu (气海俞 BL 24), Guanyuanshu (关元俞 BL 26), etc., with round-sharp needle, once every week, continuously for 4 sessions. Results: After the treatment, of the 80 cases, 56 (70 %) were cured, 16 (20%) improved,and 8 (10)%) failed, with an effective rate of 90%. Conclusion: Round-sharp needle works well in the treatment of prolapse of lumbar intervertebral disc.

TREATMENT OF 247 CASES OF PROLAPSE OF LUMBAR INTERVERTEBRAL DISC WITH COMPREHENSIVE PLUM-BLOSSOM MAGNETIC NEEDLE THERAPY

Objective: To observe the therapeutic effect of comprehensive plum-blossom magnetic needle therapy on prolapse of lumbar intervertebral disc. Methods: 247 cases of prolapse of lumbar intervertebral disc were treated first with manual treatment and then with plum-blossom magnetic needle therapy and effect-increasing pad therapy at specified points and reactive points. Results: After treatment for 2 therapeutic courses,153 cases were cured accounting for 61.94%, 71 cases were markedly effective accounting for 28.75%, 22 cases were improved accounting for 8.91% and the rest one failed,accounting for 0.45%. Conclusion: The comprehensive plum-blossom magnetic needle therapy has a better therapeutic effect on prolapse of lumbar intervertebral disc.

CLINICAL OBSERVATION ON TREATMENT OF 80 CASES OF PROLAPSE OF LUMBAR INTERVERTEBRAL DISC BY COMBINATION OF ACUPUNCTURE AND MEDICINE

cases of prolapse of lumbar intervetebral disc were randomly divided into treatment and control groups. 80 cases in treatment group were treated with combination of acupuncture, oral administration of Chinese medicinal herbs, traction, point injection and intravenous drip of energy dehydration mixture; 70 cases in control group were managed by combination of acupuncture, oral administration of herbal medicines, traction, acupoint injection (without energy dehydration mixture). The results showed that the curative rate and the total effective rate of the treatment group were 91.25% and 98.75% separately, while those of the control group 62.86% and 92.86% respectively. Comparison of the curative rate between the 2 groups showed a remarkable significance (P<0.01). The observation demonstrated that combined treatment of prolapse of lumbar intervertebral disc with traditional Chinese and Western medicine is an effective approach.

Systematic evaluation and meta-analysis of acupuncture treatment for residual pain after lumbar disc herniation

Objective:To systematically evaluate the effectiveness and safety of acupuncture in the treatment of postoperative residual pain in lumbar disc herniation,and to provide evidence for its clinical treatment.Methods:A randomized controlled trial(RCT)of all acupuncture treatments for postoperative lumbar disc herniation in PubMed,CBM,CNKI,Wanfang,VIP,E mbase,and Cochrane libraries was published by May 2019,followed by RevMan5.3 software for meta-analysis.Results:11 randomized controlled trials were included in 855 patients,including 428 in the experimental group and 427 in the control group,with a ratio of 1:1.The results of the meta-analysis showed that the overall effective rate of the experimental group[RR=1.22,95%CI(1.15,1.29),P<0.00001],visual analogue pain(VAS)score[MD=1.59,95%CI(1.22,1.95),P<0.00001],Japanese Orthopaedic Association evaluation treatment score(JOA)[MD=5.66,95%CI(2.58,8.74),P=0.0003],the incidence of adverse hair loss[RR=0.35,95%CI(0.18,0.71),P=0.003]were significantly better than the control group,the difference was statistically significant.Conclusion:Acupuncture has obvious advantages in the treatment of residual pain after lumbar disc herniation,which can significantly relieve postoperative pain and improve quality of life.However,the conclusions of this study need to be further verified by the large sample and high quality literature.

Comparison of microendoscopic discectomy and open discectomy for single-segment lumbar disc herniation

BACKGROUND Lumbar disc herniation is a common disease.Endoscopic treatment may have more advantages than traditional surgery.AIM To compare the clinical efficacy and safety of microendoscopic discectomy(MED)and open discectomy with lamina nucleus enucleation in the treatment of singlesegment lumbar intervertebral disc herniation.METHODS Ninety-six patients who were operated at our hospital were selected for this study.Patients with single-segment lumbar disc herniation were admitted to the hospital from March 2018 to March 2019 and were randomly divided into the observation group and the control group with 48 cases in each group.The former group underwent lumbar discectomy and the latter underwent laparotomy and nucleus pulpectomy.Surgical effects were compared between the two groups.RESULTS In terms of surgical indicators,the observation group had a longer operation time,shorter postoperative bedtime and hospital stay,less intraoperative blood loss,and smaller incision length than the control group(P<0.05).The excellent recovery rate did not differ significantly between the observation group(93.75%)and the control group(91.67%).Visual analogue scale pain scores were significantly lower in the observation group than in the control group at 1 d,3 d,1 mo,and 6 mo after surgery(P<0.05).The incidence of complications was significantly lower in the observation group than in the control group(6.25%vs 22.92%,P<0.05).CONCLUSION Both MED and open discectomy can effectively improve single-segment lumbar disc herniation,but MED is associated with less trauma,less bleeding,and a lower incidence of complications.

Comparison of the pain and inflammatory stress after percutaneous transforaminal endoscope discectomy and open fenestration discectomy

Objective:To study the differences in pain and inflammatory stress after percutaneous transforaminal endoscope discectomy and open fenestration discectomy.Methods: Patients with lumbar intervertebral disc herniation who underwent surgical treatment in our hospital between January 2013 and January 2017 were selected and randomly divided into two groups: Percutaneous transforaminal endoscope discectomy (PTED) group and control group. Patients in PTED group received percutaneous transforaminal endoscope discectomy, while control group received open fenestration discectomy. Serum levels of pain substances SP, NPY, PGE2 and NGF, inflammatory mediators IFN-γ, TNF-α, IL-17 and MMP3 as well as stress response substances Cor, NE, OH-, O2- and MDA of two groups of patients were determined the same day after surgery and 3 days after surgery.Results: The same day after surgery and 3 d after surgery, serum SP, NPY, PGE2, NGF, IFN-γ, TNF-α, IL-17, MMP3, Cor, NE, OH-, O2- and MDA levels of PTED group were significantly lower than those of control group. Conclusion: Percutaneous transforaminal endoscope discectomy for lumbar intervertebral disc herniation causes less postoperative pain and inflammatory stress than open fenestration discectomy.

Ultrasound, Fluoroscopic-Guided Caudal, Lumbar Epidural Steroid Injections and Blinding Paraspinal Lumbosacral Steroid Injections in Patients with Low Back Pain with Radiculopathy

Background and Aims: Low back pain (LBP) is considered one of the most common health conditions in the world right now, and it affects many individuals throughout different stages of their lives. Chronic LBP (CLBP) was estimated to be between 5% and 10%, defined as LBP that lasts for 12 weeks. The most common causes of CLBP with radiculopathy are lumbar disc prolapse (LDP) and degenerative facet osteoarthropathy (DFO);the aim of this study is to investigate the efficacy of ultrasound (US) guided, fluoroscopy (FL) guided, Caudal Epidural Steroid Injection (CESI), lumbar epidural steroid injections (LESI), and blinding lumbosacral steroid injections (LSPSI) in patients with CLBP with radiculopathy. Patients and Methods: This is a randomized prospective study that was conducted at the department of rheumatology at Al Azhar University Hospital in Egypt between November 2020 and August 2021. A total of 100 patients with refractory CLBP with radiculopathy were enrolled in the study. Consequently, they were divided into 2 groups: the first consisted of fifty patients with CLBP and radiculopathy caused by LDP, as determined by lumbosacral magnetic resonance imaging (MRI), and the second group consisted of fifty patients with refractory low back pain and radiculopathy caused by DFO, as determined by lumbosacral plain x-rays and lumbosacral MRI. The following procedures were performed: US-guided CESI, FL-guided CESI, FL-guided LESI, US-guided LESI, and blinding LSPSI. Results: In the LDP group, there is a statistically significant difference between considered spinal nerve roots as regards Visual Analogue Scale (VAS) (at 2 months). Likewise, a statistically significant difference was found between blinding LSPSI and US-Guided LESI with respect to VAS (baseline) and VAS (2 months) (P-value = 0.018 and 0.003, respectively). Statistically significant differences were reported in VAS (2 months) for both FL-guided LESI and FL-guided CESI groups. Considering the VAS of studied spinal nerve roots in the DFO group, there is a statistically significant difference between the examined spinal nerve roots with respect to Oswestry Disability Index (ODI) (2 months). Similarly, there is a statistically significant difference in VAS (2 months) between US-guided LESI and para-spinal roots and FL-guided LESI and para-spinal roots (P-value = 0.038 and 0.021, respectively). Additionally, there is a statistically significant difference between the US-guided CESI, FL-guided CESI, FL-guided LESI, and spinal nerve roots with respect to ODI (at 2 months). (P-value = 0.033, 0.025 and 0.005, respectively). Conclusion: US is excellent in guiding CESI and LESI and should be the preferred alternative when FL is not provided, with a similar treatment outcome compared to FL-CESI and LESI.

Systematic evaluation and Meta-analysis 0f the improvement of pain and function after total knee replacement by percutaneous electrical stimulation

Objective:To systematically evaluate the effectiveness and safety of acupuncture in the treatment of postoperative residual pain in lumbar disc herniation, and to provide evidence for its clinical treatment. Methods A randomized controlled trial (RCT) of all acupuncture treatments for postoperative lumbar disc herniation in PubMed, CBM, CNKI, Wanfang, VIP, Embase and Cochrane libraries was published by May 2019, followed by RevMan5.3 software for meta-analysis. Results 11 randomized controlled trials were included in 855 patients, including 428 in the experimental group and 427 in the control group, with a ratio of 1:1. The results of the meta-analysis showed that the overall effective rate of the experimental group [RR=1.22, 95%CI(1.15, 1.29), P<0.00001], visual analogue pain (VAS) score [MD=1.59, 95%CI(1.22, 1.95), P<0.00001], Japanese Orthopaedic Association evaluation treatment score(JOA)[MD=5.66, 95%CI (2.58, 8.74), P=0.0003], the incidence of adverse hair loss [RR=0.35, 95%CI(0.18, 0.71), P=0.003]were significantly better than the control group, the difference was statistically significant. Conclusions Acupuncture has obvious advantages in the treatment of residual pain after lumbar disc herniation, which can significantly relieve postoperative pain and improve quality of life. However, the conclusions of this study need to be further verified by the large sample and high quality literature.

Therapy of auricular subcutaneous penetration needling combined with row acupuncture at the meridian sinew in 103 cases of prolapse of lumbar intervertebral disc

Objective To observe the clinical efficacy of auricular subcutaneous penetration needling combining with row acupuncture at meridian sinew on prolapse of lumbar intervertebral disc. Methods One hundred and three patients with prolapse of lumbar intervertebral disc were treated with a combined treatment of auricular subcutaneous penetration needling and row acupuncture at meridian sinew. Results Of 103 patients, 46 cases were cured, 33 were markedly effective, 21 effective and 3 ineffective. The total effective rate was 97.1% （100/103）. Conclusion The combined treatment of auricular subcutaneous penetration needling and row acupuncture at meridian sinew has a significant efficacy for the treatment of prolapse of lumbar intervertebral disc.

退行性腰椎管狭窄患者椎间孔镜术后下腰痛的危险因素及风险预测模型构建

目的分析退行性腰椎管狭窄(DLSS)患者椎间孔镜术后下腰痛的危险因素及风险预测模型构建。方法本研究采用前瞻性分析,纳入2020年7月至2022年7月南阳市中心医院收治的86例行经皮椎间孔镜手术治疗的DLSS患者为研究对象,术后随访3个月,根据术后下腰痛发生情况,分为发生组和未发生组,分析两组患者临床资料,采用多因素logistic回归分析DLSS患者椎间孔镜术后下腰痛发生的影响因素,构建风险预测模型,绘制受试者工作特征(ROC)曲线评估风险模型的预测效能。结果随访3个月,86例DLSS患者行椎间孔镜术后发生下腰痛患者21例,发生率为24.42%(21/86);发生组骨质疏松、术中清理椎间隙、术后椎管内无菌性炎症、首次锻炼时间与未发生组比较,差异无统计学意义(P<0.05);经多因素logistic回归分析,结果显示,骨质疏松、术中清理椎间隙、术后椎管内无菌性炎症、首次接受锻炼时间均是DLSS患者椎间孔镜术后下腰痛发生的危险因素(P<0.05);构建风险模型,验证模型显示C-index值为0.870,具有良好区分度,绘制标准曲线显示,校准曲线和Y-X直线相近,模型准确度良好;对模型预测效能进行验证,结果显示,风险模型评估DLSS患者椎间孔镜术后下腰痛发生的曲线下面积(AUC)为0.870,95%CI为0.779~0.961,P<0.001。结论DLSS患者行椎间孔镜术后下腰痛发生率较高,合并骨质疏松、术中未清理椎间隙、有术后椎管内无菌性炎症、首次接受锻炼时间延长均是DLSS患者行椎间孔镜术后发生下腰痛的危险因素,基于以上因素构建的风险模型对DLSS患者行椎间孔镜术后是否发生下腰痛具有较高的评估价值。

Observation of efficacy on prolapse of lumbar intervertebral disc treated with body acupuncture and wrist-ankle acupuncture

Objective To observe the clinical effects of body acupuncture and wrist-ankle acupuncture on prolapse of lumbar intervertebral disc, Methods One hundred and eighty cases of prolapse of lumbar intervertebral disc were randomly divided into body acupuncture and wrist-ankle acupuncture group （observation group） and simple body acupuncture group （control group）, 90 cases in each one. In observation group, body acupuncture was applied on Ahshi points of lumbar region, lumbar Jiájǐ （夹脊EX-B 2）, Dàchángshú（大肠俞 BL 25）, etc. and wrist-ankle acupuncture was applied on lower No. 4, 5 and 6 regions. In control group, simple body acupuncture was applied on the same points as observation group. Results The lumbar vertebral function and pain scale were improved in either group in comparison before and after treatment （P〈0.05）. Concerning pain improvement, the total effective rate was 95.6% in observation group, which was superior to that （86.7%） in control group （P〈0.05）. Concerning the improvement of lumbar vertebral function, the total effective rate was 90.0% in observation group and 93.3% in control group, without significant difference between two groups （P〉0.05）. Conclusion Combined therapy of body acupuncture and wrist-ankle acupuncture demonstrates apparent analgesia in prolapse of lumbar intervertebral disc.

经椎间孔入路经皮内窥镜下椎间盘切除术后类脊髓高压综合征伴代谢性酸中毒1例报告并文献复习

腰椎椎间盘突出症(LDH)是骨科常见病,其病因复杂,主要与遗传、椎间盘退行性变、发育异常、腰部外伤、姿势不当等因素相关^([1])。其发生率呈增长趋势,并呈年轻化,给患者个人、家庭和社会带来了巨大的经济和医疗负担,严重影响患者日常生活及工作^([2])。约85%的LDH患者伴有坐骨神经痛^([3]),部分患者甚至出现二便失禁^([4])。LDH首选药物、物理治疗等非手术治疗方式,但非手术治疗疗效不佳的情况下需考虑手术治疗。

Forty-six cases of postoperative pain in the waist and leg of lumbar disc herniation treated by warming needle moxibustion and electroacupuncture

Objective To explore therapeutic efficacy of warming needle moxibustion and electroacupuncture for postoperative pain in the waist and leg of lumbar disc herniation. Methods Forty-six cases were treated with warming needle moxibustion at Yaotu （腰突, extra point, the same segment of injured disc herniation）, regular acupuncture at Yaoyan （腰眼 EX-B 7）, Zhibian （秩边BL 54）, Huantiao （环跳 GB 30）, Weizhong （委中BL 40）, Yanglingquan （阳陵泉 GB 34） and electroacupuncture at Yaoto （腰突）, Zhibian （秩边 BL 54）, Yanglingquan （阳陵泉 GB 34）. The treatment was given once a day, 10 treatments made up one session, and the therapeutic effect was assessed after 2 sessions of treatment. Results After the treatment, 31 cases （67.4%） were cured, 14 cases （30.4%） were effective and i case （2.2%） was failed. The total effective rate was 97.8%. Conclusion The warming needle moxibustion combined with electroacupuncture has obvious therapeutic effect on postoperative pain in the waist and leg of lumbar disc herniation.

中医特色健康管理模式联合中药热敷对腰突症患者疼痛及功能康复的影响

目的研究探讨中医特色健康管理模式联合中药热敷对腰突症患者疼痛及功能康复的影响。方法选取2021年6月—2023年6月本院收治的100例腰突症患者为对象,随机数字表法分为观察组、对照组,每组50例。对照组以常规护理干预结合中药热敷干预,观察组在此基础上增加中医特色健康管理模式干预。评估对比两组中医症状评分、疼痛程度、康复效果、不良事件发生率。结果观察组在干预2、4、8、12周时中医症状评分低于对照组(P<0.05)。观察组在干预2、4、8、12周时视觉模拟评分低于对照组(P<0.05)。观察组在干预2、4、8、12周时日本骨科协会评估治疗评分低于对照组(P<0.05)。观察组不良事件发生率6.00%,低于对照组的22.00%(P<0.05)。结论中医特色健康管理模式联合中药热敷对腰突症效果良好,缓解中医症状和疼痛程度,恢复腰椎功能,降低各种不良事件发生。

右美托咪定联合地塞米松对腰椎术后炎症反应的影响

目的通过检测腰椎术后炎症因子水平、记录患者术后疼痛评分,探讨右美托咪定联合地塞米松对腰椎术后炎性反应和疼痛的影响。方法选取腰椎手术患者85例,将其随机分为对照组(C组,n=20)、地塞米松组(Dex组,n=21)、右美托咪定组(Dxm组,n=22)和联合组(Dex+Dxm组,n=22)。C组和Dex组在麻醉诱导前分别静脉注射生理盐水2 mL和地塞米松0.15 mg/kg;Dxm组麻醉诱导前以0.6μg/(kg·h)泵速泵注右美托咪定,10 min后改为0.3μg/(kg·h)的泵速维持至手术结束;而Dex+Dxm组在Dxm组的基础上,麻醉诱导前静脉注射地塞米松0.15 mg/kg。检测各组患者术前1天(T 0)、术后第1 d(T 1)、第2 d(T 2)、第3 d(T 3)血清中白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)和肿瘤坏死因子-α(TNF-α)水平;记录各组患者术后8 h、T 1、T 2和T 3静息与活动(VAS)评分。结果术后炎症因子水平比较:与T 0比较,4组患者血清中IL-1、IL-6、IL-10和TNF-α水平在T 1时均显著升高(P<0.05),Dex+Dxm组患者血清中IL-1、IL-6、IL-10和TNF-α水平在T 1和T 2时显著低于C组、Dex组和Dxm组(P<0.05),Dex组和Dxm组血清中IL-1、IL-6、IL-10和TNF-α水平在T 1、T 2和T 3时比较差异无统计学意义(P>0.05)。术后VAS评分比较:Dex+Dxm组患者静息与活动VAS评分在术后8 h、T 1、T 2和T 3时显著低于C组和Dex组(P<0.05),在T 2和T 3时显著低于Dxm组(P<0.05)。结论在腰椎手术中应用右美托咪定联合地塞米松可减轻患者术后炎症反应,改善患者术后急性疼痛。

小针刀联合补肾活血祛痛方治疗腰椎间盘突出症临床观察

目的 探讨小针刀联合补肾活血祛痛方治疗腰椎间盘突出症(LDH)的临床效果。方法 选取2016年7月—2018年4月沈阳市中医院收治的135例患者作为研究对象,将所有患者随机分为甲组(小针刀联合补肾活血祛痛方)、乙组(补肾活血祛痛方)和丙组(小针刀),观察与对比3组患者的腰痛分级、治疗前后视觉模拟量表(VAS)评分和总体效果。结果 甲组总有效率为97.78%(44/45),高于乙组的88.89%(40/45)、丙组的82.22%(37/45),差异具有统计学意义(P<0.05);甲组治疗后VAS评分下降程度明显大于乙组和丙组;甲组治疗后Denis腰痛分级明显优于乙组和丙组,差异具有统计学意义(P<0.05)。结论对LDH患者进行小针刀联合补肾活血祛痛方治疗可以有效缓解患者的疼痛程度、缩短患者的住院时间、提升患者的生活质量,同时患者腰椎功能可以得到快速恢复,值得临床应用与推广。

基于网络药理学和分子对接探讨张氏腰痛方治疗腰椎间盘退变的作用机制

目的:基于网络药理学和分子对接的方法探讨张氏腰痛方治疗腰椎间盘退变(LIDD)的分子生物学机制。方法:通过检索数据库,筛选张氏腰痛方的活性成分和作用靶点,以及LIDD的相关基因。通过R软件筛选张氏腰痛方治疗LIDD的共同靶基因,构建“药物-成分-靶点-疾病”网络以及共同靶基因的蛋白质相互作用网络,同时挖掘网络中潜在的蛋白质功能模块。关键靶基因进行GO功能富集分析与KEEG通路富集分析,以揭示这些靶基因的潜在生物学功能和通路。结果:共筛选出202个有效成分和164个共同靶基因,包括10个核心靶基因。富集分析结果表明,张氏腰痛方治疗LIDD的靶点主要作用于晚期糖基化终产物及其受体(AGE-RAGE)信号通路、肿瘤坏死因子(TNF)信号通路、细胞凋亡和低氧诱导因子-1(HIF-1)信号通路等。这些生物过程主要参与炎症反应、氧化应激和细胞凋亡的调控。分子对接结果显示,张氏腰痛方治疗LIDD的主要活性成分divaricatol、槲皮素、O-乙酰基哥伦比亚苷元、紫堇灵、黄芪紫檀烷苷与核心靶点TNF、AKT1、白细胞介素-6、TP53、血管内皮生长因子A具有良好的结合能力。结论:本研究初步证实了张氏腰痛方治疗LIDD具有“多成分、多靶点、多通路”的特点,主要从抗炎、抗氧化应激、抑制细胞凋亡和自噬等方面发挥对LIDD的治疗作用。

通督扶阳推拿联合核心肌群训练对腰椎间盘突出症的临床效果

目的研究通督扶阳推拿联合核心肌群训练对腰椎间盘突出症(LDH)的临床效果。方法根据随机数字表法将2020年8月至2022年9月中国人民解放军联勤保障部队第九一〇医院接收的腰椎间盘突出病人(150例)分为对照组(75例,常规基础治疗)和联合组(75例,常规基础治疗+通督扶阳推拿和核心肌群训练)。对两组治疗前后生活功能障碍、疼痛程度以及腰背伸肌群力学性能进行比较。结果联合组的总有效率(94.67%比80.00%)高于对照组(P<0.05)。治疗后,联合组病人日本整形外科学会(JOA)评分[(22.98±3.77)分比(18.98±3.56)分]、平均功率[(44.03±11.09)W比(38.98±10.79)W]、腰背伸状态下峰力矩[(88.65±15.42)Nm比(79.99±15.66)Nm]明显高于对照组,VAS评分[(1.78±0.56)分比(2.39±0.67)分]、腰背屈伸比[(69.53±9.15)%比(74.42±9.52)%]明显低于对照组(P<0.05)。结论通督扶阳推拿与核心肌群训练联合治疗LDH病人的效果较好,可减轻病人疼痛,改善病人腰背伸肌群力学性能,减少其生活功能障碍。