杠杆定位手法治疗腰椎间盘突出症临床研究  

The clinic research of manipulation of lever location for treatment of lumbar disc herniation

作　　者：吕立江[1] 应晓明[1] 袁相龙[1] 宋鸿权[2] 陈伟仁[2] 汪芳俊[3] 郑如云[4] 罗华送[5] 

机构地区：[1]浙江中医药大学附属第三医院推拿科,杭州310009 [2]浙江中医药大学附属第一医院杭州 [3]浙江中医药大学附属中西医结合医院杭州 [4]杭州市下城区中医院杭州 [5]浙江中医药大学附属广兴医院杭州

出　　处：《世界中医骨科杂志》2010年第2期114-118,共5页World Journal of Traditional Chinese Orthoprdics

摘　　要：目的：观察比较杠杆定位正骨手法与平面用力推拿手法治疗腰椎间盘突出症的疗效。方法：腰椎间盘突出症367例，男211例，女156例；年龄17～78岁，其中20岁以下5例，50岁以上61例。膨出型165例，突出型117例，游离型85例。367例按随机数字表法分为治疗组（182例）和对照组（185例），治疗组采用牵引治疗仪持续牵引30min后，用杠杆定位正骨手法治疗；对照组采用牵引治疗仪30min后，用平面用力推拿手法治疗。隔1d治疗1次，3次为1个疗程。观察患者的症状和体征（包括腰部疼痛与不适、下肢疼痛与麻木、大小便无力与会阴麻木、直腿抬高程度、下肢行走能力、工作生活能力），并按疗效标准比较两种治疗方法的治疗效果的差异。结果：两组患者均获得随访，时间1～6个月，平均2．6个月。治疗1个疗程后，治疗组与对照组的症状与体征各方面较治疗前都有较大的改善（P〈0．01），其中治疗组在腰部疼痛与不适、下肢行走能力方面优于对照组（P〈0．01）。按疗效评定标准：各型治疗组疗效优于对照组，两组疗效比较差异有统计学意义（P〈0．01）。结论：杠杆定位正骨手法比平面用力推拿手法治疗腰椎间盘突出症的疗效显著，值得临床推广应用。Objective： effects to treat lumbar disc To compare the therapeutic herniation between bonesetting manipulation of lever location and plane straining manipulation.Methods：there were 211 cases male and 156 cases female among 367 patients who were 17-78 years old with lumbar disc herniation,5 cases younger than 20 years old and 67 cases older than 50 years old. And there were 165,117 and 85 cases with bulge,hernia and liberation respectively. 367 patients were divided into 182 cases in the treat group and 185 cases in the control group according to random digits table,the patients in the treat group were continuous tracted for 30 minutes by the traction machine,and then treated with bone-setting manipulation of lever location;The patients in the control group were continuous tracted for 30 minutes by the traction machine,and then treated with plane straining manipulation.all patients were treated once every other day, and one course of treatment included 3 times.To compare difference of the therapeutic effcets between two therapeutic methods according to standard of therapeutic effcets by observing the patients＇sings and symptoms, included pain and complaints on the low back,pain and numbness on the lower limbs,weakness of urination and defecation and numbness of perinaeum, degrees to raise the lower limbs straight, locomotor activity ,work ability and viability.Results：all patients were follow up from 1 month to 6 months,2.6 months average.Sings and symptoms of all patients in two groups were more improved after a course of treatment than pretherapy （P〈0.01） , pain and complaints on the low back and locomotor activity were more improved in the treat group than in the control group.According to standard of therapeutic effcets：The therapeutic effcets in the treat group of three types was surpassed in the control group,and the difference has statistical significance （P〈0.01） . Conclution：There was more therapeutic effcets to treat lumbar disc herniation with bone-setting manipulation

关 键 词：腰椎间盘突出症 正骨手法治疗 杠杆 临床研究 治疗效果 疼痛与不适 持续牵引 下肢疼痛 

分 类 号：R681.53[医药卫生—骨科学]