牵抖冲压法和常规牵引法治疗腰椎间盘突出症的对比研究  

A comparative study of draw-shake-ram manipulation versus conventional lumbar traction for treatment of lumbar disc herniation

作　　者：杨晗丹 范德辉[2] 刘建[2] 林锦坤 苏美意[2] 张振宇[2] 吴晶晶[2] 康健[2] 邓玲琳 

机构地区：[1]广州中医药大学,广东广州510006 [2]广东省第二中医院,广东广州510095 [3]重庆市铜梁区中医院,重庆402560

出　　处：《中医正骨》2016年第12期26-30,共5页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：广州市科技和信息化局重大民生科研课题(2014Y2-00045)

摘　　要：目的:比较牵抖冲压法和常规牵引法治疗腰椎间盘突出症的临床疗效。方法:将90例腰椎间盘突出症患者随机分为2组,每组45例,分别采用牵抖冲压法和常规牵引法治疗。每天均治疗1次,7次为1个疗程,疗程间休息2 d,共治疗2个疗程。分别于治疗前和治疗2个疗程后比较2组患者腰痛视觉模拟量表(visual analog scale,VAS)评分、改良日本骨科学会(Japanese orthopaedic association,JOA)腰痛疾患评分和腰部软组织张力,并于治疗2个疗程后参照《中药新药临床研究指导原则》中腰椎间盘突出症的疗效评价标准比较2组患者的总体疗效。结果:①腰痛VAS评分。治疗前2组患者腰痛VAS评分比较,差异无统计学意义[(7.74±0.72)分,(7.52±0.67)分,t=1.501,P=0.137];治疗2个疗程后,牵抖冲压组腰痛VAS评分低于常规牵引组[(2.17±1.42)分,(3.57±1.58)分,t=4.421,P=0.000],牵抖冲压组和常规牵引组腰痛VAS评分均低于治疗前(t=21.362,P=0.000;t=23.128,P=0.000)。②改良JOA腰痛疾患评分。治疗前2组患者改良JOA腰痛疾患评分比较,差异无统计学意义[(10.24±2.15)分,(10.62±1.73)分,t=0.924,P=0.358];治疗2个疗程后,牵抖冲压组改良JOA腰痛疾患评分高于常规牵引组[(23.56±3.21)分,(19.02±4.13)分,t=5.822,P=0.000],牵抖冲压组和常规牵引组改良JOA腰痛疾患评分均高于治疗前(t=15.440,P=0.000;t=12.584,P=0.000)。③腰部软组织张力。治疗前2组患者患侧、健侧腰部软组织位移比较,组间差异均无统计学意义[(5.72±0.17)mm,(5.67±0.15)mm,t=1.480,P=0.143;(6.10±0.16)mm,(6.07±0.18)mm,t=0.836,P=0.406]。治疗2个疗程后,牵抖冲压组患侧和健侧腰部软组织位移均大于常规牵引组[(6.71±0.18)mm,(5.91±0.19)mm,t=20.505,P=0.000;(7.28±0.21)mm,(6.11±0.16)mm,t=29.729,P=0.000];牵抖冲压组患侧和健侧腰部软组织位移均大于治疗前(t=26.823,P=0.000;t=29.983,P=0.000);常规牵引组患侧腰部软组织位移大于治疗前(t=6.651,P=0.000),健侧腰部Objective： To compare the clinical curative effects of draw - shake - ram manipulation versus conventional lumbar traction for treatment of lumbar disc herniation （LDH）. Methods ： Ninty patients with LDH enrolled in the study were randomly divided into 2 groups ,45 cases in each group. The patients were treated with draw - shake - ram manipulation（ group A） and conventional lumbar traction （ group B ） respectively, once a day for 2 course of treatment,7 times for each course with a 2 - day rest - insertion between courses. The vis- ual analog scale（VAS） scores and modified Japanese orthopaedic association（JOA）scores for low back pain and lumbar soft tissue tensionwere compared between the 2 groups before the treatment and after 2 - course treatment, and the total clinical curative effects were also compared between the 2 groups according to the therapeutic effect criterion of LDH which was extracted from Guiding principles of clinical research on new Chinese medicine after 2 - course treatment. Results： There was no statistical difference in low back pain VAS scores be- tween the 2 groups before treatment（7.74 ＋/- 0.72 vs 7.52 ＋/- 0. 67 points, t = 1. 501, P = 0. 137 ）. The low back pain VAS scores were lower in group A compared to group B after 2 - course treatment （2.17 ＋/- 1.42 vs 3.57 ＋/- 1.58 points, t = 4. 421, P = 0.000） and the low back pain VAS scores decreased in both of the 2 groups （ t = 21. 362, P = 0. 000 ; t = 23. 128, P = 0. 000）. There was no statistical differ- ence in modified JOA low back pain scores between the 2 groups before treatment （10.24 ＋/-2.15 vs 10.62 ＋/- 1.73 points, t = 0. 924, P = 0. 358）. The modified JOA low back pain scores were higher in group A compared to group B after 2 - course treatment （23.56 ＋/- 3.21 vs 19.02 ＋/-4.13 points, t = 5. 822,P = 0. 000）and the modified JOA low back pain scores increased in both of the 2 groups （t = 15. 440,P =0. 000;t = 12.584,P =0.000）. There wasno statistical difference in th

关 键 词：椎间盘移位 腰椎 牵引术 牵抖冲压法 临床试验 

分 类 号：R274.9[医药卫生—中西医结合]