定位扳法与斜扳法治疗腰椎间盘突出症病例对照研究  

Controlled clinical trials on the treatment of lumbar disk herniation by Dingweiban and Xieban manipulation

作　　者：周小波[1] 金涛[1] 师瑞华 王钲[1] 齐鸿[2] 黄曼博 李碧瑶 张志伟[1] 胡晓波[1] 柳曙光[3] 陈悟[2] 杨胜亚[2] 

机构地区：[1]北京按摩医院骨科,北京100035 [2]北京按摩医院按摩科 [3]北京按摩医院放射科

出　　处：《中国骨伤》2008年第12期895-898,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的:观察比较定位扳法和斜扳法治疗腰椎间盘突出症的疗效及对棘突偏歪的影响。方法:将122例门诊患者分为治疗组62例,对照组60例,分别给予定位扳法和斜扳法手法治疗,观察患者腰痛病情积分、疗效和棘突偏歪距离的变化。结果:治疗组与对照组在治疗前后及3个月后,腰痛病情积分比较差异有统计学意义(P<0.05)。治疗组治愈53例,良好5例,有效3例,无效1例;对照组治愈43例,良好6例,有效7例,无效4例;两组治疗后及3个月后随访疗效比较差异有统计学意义(P<0.05,P<0.01)。第1次扳后,治疗组L4棘突偏歪距离与对照组比较差异有统计学意义(P<0.05)。末次扳后,治疗组L4、L5棘突偏歪距离与对照组比较差异有统计学意义(P<0.05,P<0.01)。结论:定位扳法优于斜扳法,尤其利于纠正L5棘突偏歪,对腰椎间盘突出症病变节段更具针对性。Objective ：To observe and compare the clinical effect of Dingweiban and Xieban manipulation,and to compare the change of the deviation of spinous processes between two methods. Methods：One hundred and twenty-two cases were divided into two groups. Sixtytwo cases were treated with Dingweiban manipulation method and 60 cases by Xieban manipulation. The changes of Fairbank scores, the clinical effects and the difference of the deviation of the spinous processes （L3, L4, L5） from the lumbar posterior-anterior X-ray were compared. Results：The scores before and after treatment and 3 months after treatment were compared. There were significant differences between two groups （P〈0.05）by nonparametric test. The result of Dingweiban manipulation group：53 cases cured, 5 cases better, 3 cases effective and 1 case no effect. The result of clinical Xieban manipulation group ：43 cases cured ,6 cases better,7 cases effective and 4 cases no effect. The clinical effects had significant differences after treatment and 3 months after treatment（P〈0.05 ,P〈0.01 ）by nonparametric test. After the first treating, there was clear difference of the deviations＇ distance of the L4 spinous process compared with the Xieban manipulation group （P〈0.05）. After the last treating, there were clear differences of the deviation distance of the L4 and L5 spinous processes compared with the Xieban manipulation group （P〈0.05 ,P〈0.01 ）. Conclusion： Dingweiban manipulation is better than Xieban manipulation in effects and has influence on the deviation of spinous processes, especially for the L5 spinous process.

关 键 词：腰椎 椎间盘移位 骨科手法 临床对照试验 

分 类 号：R681.53[医药卫生—骨科学] R274.915.5[医药卫生—外科学]