石氏伤科大推拿治疗包容性腰椎间盘突出症的疗效观察  

Clinical Observation on the Treatment of Inclusive Lumbar Intervertebral Disc Herniation with Shi's Great Manipulation Therapy

作　　者：熊轶喆 邓真[2] 沈知彼[1] 王辉昊[1] 石瑛[1] 陈元川[1] 詹红生[1] XIONG Yizhe;DENG Zhen;SHEN Zhibi;WANG Huihao;SHI Ying;CHEN Yuanchuan;ZHAN Hongsheng(Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Baoshan Branch of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201900,China.)

机构地区：[1]上海中医药大学附属曙光医院,上海201203 [2]上海中医药大学附属曙光医院宝山分院

出　　处：《中国中医骨伤科杂志》2018年第9期41-45,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：国家自然科学基金项目(81473702);上海市科学技术委员会科研计划项目(14401970402;16401970102;15401934100);上海市卫生和计划生育委员会项目(2017ZZ02024;20170242;ZXYXZ201703;ZYKC201602006;ZY3-LCPT-2-1005);詹红生上海市名老中医学术经验研究工作室建设项目(SHGZS-2017025;SZYMZYGZS4013)

摘　　要：目的:观察石氏伤科大推拿疗法对包容性腰椎间盘突出症的临床疗效。方法:对89例包容性腰椎间盘突出症患者进行大推拿治疗,在治疗后6h,3d,14d,90d分别采集患者VAS评分,Oswestry功能障碍指数(ODI)评分和直腿抬高试验角度,与治疗前及前一观察节点进行疗效前后对比,观察该治疗方法的临床疗效。结果:该治疗方案痊愈44.4%(36/81),显效30.9%(25/81),有效17.3%(14/81),无效7.4%(6/81),总有效率为92.6%.患者术前VAS评分平均(6.69±2.04)分,术后6h评分降至(5.34±2.16)分,与术前相比差异有统计学意义(t=3.012,P=0.026);术后3d评分为(3.43±2.26)分,与术后6h相比差异有统计学意义(t=3.274,P=0.017);患者术前ODI评分平均为(21.97±6.85)分,术后14d评分降至(11.69±5.64)分,与术后3d相比差异有统计学意义(t=3.024,P<0.01);术后90d评分降至(7.75±3.22)分,与术后14d相比差异有统计学意义(t=2.976,P=0.021);患者术前直腿抬高角度平均55.65°±18.64°,术后6h角度平均为82.33°±17.62°,与术前相比差异有统计学意义(t=3.012,P=0.026);术后3d角度平均为68.01°±14.74°,与术后6h相比差异有统计学意义(t=3.014,P=0.031).结论:石氏伤科大推拿疗法是治疗包容性腰椎间盘突出症安全、创伤小、有效实用的方法。Objective：To observe the clinical efficacy of continuous epidural anesthesia combined with Shi＇s great manipulation therapy.Methods：89 patients with inclusive protrusion of the lumbar intervertebral disc were treated with Shi＇s great manipulation.The Visual analogue scale（VAS）,Oswestry disability Index（ODI）and straight-leg raising test were evalua-ted at the date of 6 hours,3 days,14 days and 90 days after the treatment.All the outcomes were compared with the previous point to evaluate the curative effect after the treatment.Results：The total effective rate of the therapeutic regimen was 92.6%including recovery rate 44.4%（36/81）,apparent rate 30.9%（25/81）and effective rate 17.3%（14/81）,and the inefficiency was 7.4%（6/81）.The average VAS score of the patients was 6.69±2.04.Comparing the result of 6 hours（5.34±2.16）to preoperative（6.69±2.04）,the difference in the change of score was statistically significant（t=3.012,P=0.026）.Comparing the result of 3 days（3.43±2.26）to that of 6 hours（5.34±2.16）,the difference inthe change of score was statistically significant（t=3.274,P=0.017）.The average ODI score of the patients was 21.97±6.85.Comparing the result of 14 days（11.69±5.64）to that of 3 days（10.75±6.84）,the difference in the change of score was statistically significant（t=3.024,P〈0.01）.Comparing the result of 90 days（7.75±3.22）to that of 14 days（11.69±5.64）,the difference in the change of score was statistically significant（t=2.976,P=0.021）;The average angle of the straight-leg raising test was 55.65°±18.64°.Comparing the result of 6 hours（82.33°±17.62°）to preoperative（55.65°±18.64°）,the difference in the change of score was statistically significant（t=3.012,P=0.026）.Comparing the result of 3 days（68.01°±14.74°）to that of 6 hours（82.33°±17.62°）,the difference in the change of score was statistically significant（t=3.014,P=0.031）.Conclusion：Shi＇s great manipulation is an effective,prac

关 键 词：石氏伤科大推拿 臭氧注射 包容性腰椎间盘突出症 连续性硬膜外麻醉 

分 类 号：R681.5[医药卫生—骨科学]