整脊手法治疗腰椎管狭窄症的疗效研究  

Study on sagittal balance and curative effect of chiropractic treatment for lumbar spinal stenosis

作　　者：曾浩彬 陈茂水 ZENG Haobin;CHEN Maoshui(The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine,Guangdong Provincial Hospital of Chinese Medicine,Zhuhai 519015,China)

机构地区：[1]广州中医药大学第二附属医院珠海医院,广东省中医院珠海医院骨伤二科(脊柱科)

出　　处：《实用医学杂志》2020年第1期121-126,共6页The Journal of Practical Medicine

基　　金：广东省中医药管理局课题项目（编号：20182141)

摘　　要：目的探讨整脊手法治疗腰椎管狭窄症的作用机理,以期找到一种治疗腰椎管狭窄症更加安全有效的优化方案,为临床上进一步推广作铺垫。方法收集2018年1-12月广东省中医院珠海医院脊柱科住院腰椎管狭窄症患者共120例。对符合纳入标准的120例腰椎管狭窄症患者按简单随机法分为整脊手法治疗组60例,塞来昔布口服对照组60例,治疗疗程为两周。采用腰痛疾患疗效评定标准(JOA评分)、VAS评分作为整脊手法治疗腰椎管狭窄症前后疼痛与功能评价的标准,进行治疗前后症状、功能及改善率的量化评定;同时测量治疗前后脊柱的腰椎前凸角(LL)、骨盆入射角(PI)及椎管中央矢状径、侧隐窝矢状径以评估整脊手法的疗效及安全性,探讨其作用机理。结果JOA与VAS评分结果提示治疗组与对照组组间同期治疗后及随访差异有统计学意义(P<0.05);两组JOA、VAS评分治疗前与治疗后、随访3个月、随访6个月比较差异均有统计学意义(P<0.05)。两组患者PI测量组间同期比较差异无统计学意义(P>0.05);两组患者LL测量治疗后、随访3个月、随访6个月比较差异均有统计学意义(P<0.05);两组患者腰椎椎管中央矢状径治疗前后及随访3个月、随访6个月比较差异均有统计学意义(P<0.05);两组患者腰椎侧隐窝矢状径治疗前后及随访3个月、随访6个月比较差异均有统计学意义(P<0.05)。结论本课题研究证明整脊手法治疗腰椎管狭窄症是一种安全有效的治疗方法,该方法较非甾体类抗炎药物更有效,且无严重不良反应,可作为治疗腰椎管狭窄症的有效选择。Objective to explore the mechanism of spinal manipulation in the treatment of lumbar spinal stenosis,in order to find a more safe and effective optimal scheme for the treatment of lumbar spinal stenosis,and to pave the way for further clinical promotion.Methods From January 2018 to December 2018,120 patients with lumbar spinal stenosis in the spinal department of zhuhai hospital of guangdong traditional Chinese medicine were collected.120 patients with lumbar spinal stenosis who met the inclusion criteria were randomly divided into the spinal manipulation treatment group(60 cases)and the celecoxib oral control group(60 cases).The treatment course was two weeks.The internationally recognized efficacy evaluation indexes(JOA score)and VAS score were used as the evaluation criteria for the pain and function before and after spinal manipulation in the treatment of lum-bar spinal stenosis.At the same time,a series of parameters of spinal sagittal balance before and after treatment and sagittal diameter of spinal canal and lateral recess were measured to evaluate the efficacy and safety of spinal manipulation and explore its mechanism.Results JOA and VAS scores indicated statistical difference between the treatment group and the control group after the same treatment and follow-up,P<0.05.JOA and VAS scores of the two groups were statistically significant before and after treatment,followed up for 3 months and 6 months(P<0.05).There was no statistically significant difference between the two groups in the PI measurement group(P>0.05).The comparison of LL measurement between the two groups after treatment,follow-up for 3 months and follow-up for 6 months was statistically significant(P<0.05).The comparison of lumbar spinal canal central sagittal diameter before and after treatment,3 months‘follow-up and 6 months′follow-up in the two groups was statistically signifi-cant(P<0.05).The comparison of sagittal diameter of lumbar lateral recess between the two groups before and after treatment,3 months follow-up and 6 months

关 键 词：整脊手法 矢状位平衡 腰椎管狭窄症 临床疗效 机制研究 

分 类 号：R68[医药卫生—骨科学]