八段锦锻炼联合推拿对非急性期腰椎间盘突出症患者腰痛和生活质量的影响  

Effect of BADUANJIN(八段锦) exercises combined with TUINA on low back pain and life quality of patients with non-acute-phase lumbar disc herniation

作　　者：徐星星[1] 韩璐[1] 马琳 张晶莹 XU Xingxing;HAN Lu;MA Lin;ZHANG Jingying(Hangzhou Hospital of Traditional Chinese Medicine,Hangzhou 310007,Zhejiang,China)

机构地区：[1]浙江省杭州市中医院,浙江杭州310007

出　　处：《中医正骨》2018年第12期18-22,共5页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：目的:观察八段锦锻炼联合推拿对非急性期腰椎间盘突出症患者腰痛和生活质量的影响。方法:将符合要求的90例非急性期腰椎间盘突出症患者随机分为2组,每组45例。推拿组接受腰部推拿治疗,每天1次,每次30 min,10 d为1个疗程,休息2 d后开始下一疗程,共治疗2个疗程。八段锦组在腰部推拿治疗的基础上,进行八段锦锻炼。腰部推拿治疗方法及疗程同推拿组,八段锦锻炼每周5次,每次练习时间不少于30 min,共练习12周。分别于治疗前及治疗开始后4周、8周、12周评定患者的腰部疼痛视觉模拟量表(visual analogue scale,VAS)评分和简明健康状况调查表(short form 36 health survey questionnaire,SF-36)评分。结果:①一般情况。至观察结束时,八段锦组1例试验期间失去联系、1例不能按要求进行练习,均予以剔除;推拿组1例因自觉疗效欠佳退出试验、1例因打篮球出现急性腰扭伤退出试验。②腰部疼痛VAS评分。时间因素与分组因素存在交互效应(F=9. 044,P=0. 000)。2组疼痛VAS评分总体比较,差异有统计学意义,即存在分组效应(F=24. 915,P=0. 000)。治疗前后不同时点之间疼痛VAS评分的差异有统计学意义,即存在时间效应(F=493. 262,P=0. 000)。2组疼痛VAS评分随时间变化均呈降低趋势,但2组的变化趋势不完全一致[(4. 47±0. 94)分,(2. 60±0. 49)分,(1. 51±0. 51)分,(0. 87±0. 34)分,F=250. 382,P=0. 000;(4. 87±1. 10)分,(2. 82±0. 75)分,(2. 11±0. 53)分,(1. 60±0. 49)分,F=198. 245,P=0. 000];治疗前和治疗开始后4周,2组的疼痛VAS评分比较,组间差异均无统计学意义(t=-1. 852,P=0. 067; t=-1. 662,P=0. 100);治疗开始后8周、12周,八段锦组的疼痛VAS评分均低于推拿组(t=-5. 485,P=0. 000; t=-8. 158,P=0. 000)。③SF-36评分。时间因素与分组因素存在交互效应(F=47. 838,P=0. 000)。2组SF-36评分总体比较,差异有统计学意义,即存在分组效应(F=90. 504,P=0. 000)。干预后不同时点之间SFObjective:To observe the effects of BADUANJIN(八段锦,BDJ)exercises combined with TUINA on low back pain and life quality of patients with non-acute-phase lumbar disc herniation(LDH).Methods:Ninety patients with non-acute-phase LDH enrolled in the study were randomly divided into BDJ group and TUINA group,45 cases in each group.All patients in both of the 2 groups were treated with TUINA at the low back,once a day,30 minutes at a time for two courses of treatment,10 days for each course with a 2-day restinsertion between courses.Moreover,the patients in BDJ group were treated with BDJ exercises,five times a week,at least 30 minutes at a time for consecutive 12 weeks.The low back pain visual analogue scale(VAS)scores and the short form 36 health survey questionnaire(SF-36)scores were recorded and evaluated before treatment and at 4,8 and 12 weeks after the beginning of the treatment respectively.Results:One patient lost to follow-up and one patient failed to do the exercises in BDJ group and they were excluded.Two patients in TUINA group dropped out of the trial for poor clinical effect and acute lumbar sprain due to playing basketball respectively.There was interaction between time factor and group factor in low back pain VAS scores(F=9.044,P=0.000).There was statistical difference in the low back pain VAS scores between the 2 groups in general,in other words,there was group effect(F=24.915,P=0.000).There was statistical difference in low back pain VAS scores between different timepoints before and after the treatment,in other words,there was time effect(F=493.262,P=0.000).The low back pain VAS scores presented a time-dependent decreasing trend in both of the 2 groups,while the 2 groups were inconsistent with each other in the decreasing trend of low back pain VAS scores(4.47+/-0.94,2.60+/-0.49,1.51+/-0.51,0.87+/-0.34 points,F=250.382,P=0.000;4.87+/-1.10,2.82+/-0.75,2.11+/-0.53,1.60+/-0.49 points,F=198.245,P=0.000).There was no statistical difference in low back pain VAS scores between the 2 groups before the t

关 键 词：椎间盘移位 腰椎 八段锦 推拿 腰痛 生活质量 临床试验 

分 类 号：R274.9[医药卫生—中西医结合]