不同直腿抬高扳腿法对推拿治疗腰椎间盘突出症临床疗效的影响  

Effect of different straight leg lifting and pulling on the clinical therapeutic effect of massage on lumbar intervertebral disc herniation

作　　者：李宗霖[1] 雷龙鸣[1] 潘波洋 LI Zonglin;LEI Longming;PAN Boyang(The First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine,Nanning 530023,Guangxi,China;Guangxi University of Traditional Chinese Medicine,Nanning 530001,Guangxi,China)

机构地区：[1]广西中医药大学第一附属医院,广西南宁530023 [2]广西中医药大学,广西南宁530001

出　　处：《现代中西医结合杂志》2020年第4期343-346,406,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：国家“十一五”与“十二五”科技支撑计划项目(2007BAI48B07-2;2012BAI27B04-2);国家公益性行业(中医药行业)科研专项项目(200707023);广西科学研究与技术开发计划项目(桂科攻1598012-48);广西壮族自治区卫生厅重点科研课题(重200937);广西中医药大学研究生课题(YJSP201743)

摘　　要：目的探讨不同直腿抬高扳腿法对推拿治疗腰椎间盘突出症临床疗效的影响。方法选择2018年5月—2019年1月在广西中医药大学第一附属医院推拿科治疗的腰椎间盘突出症患者100例,随机分为对照组与观察组各50例。2组均采用相同的松解类推拿手法治疗,治疗过程中观察组采用改进的直腿抬高扳腿法,对照组采用常规的直腿抬高扳腿法。2组均以治疗6次为1个疗程,疗程之间间隔1 d,共治疗4个疗程。观察2组治疗效果及治疗前后患侧直腿抬高角度、疼痛视觉模拟评分(VAS评分)、日本骨科学会腰椎功能量表评分(JOA评分)变化和治疗过程中可能发生的不良反应。结果观察组与对照组愈显率分别为74%(37/50)、54%(27/50),总有效率分别为96%(48/50)、94%(47/50),观察组愈显率明显高于对照组(P<0.05),2组总有效率比较差异无统计学意义(P>0.05)。与治疗前比较,治疗后2组患者患侧直腿抬高角度均显著增大(P均<0.05),VAS评分均显著降低(P均<0.05),JOA评分均显著升高(P均<0.05);治疗后2组比较,观察组患侧直腿抬高角度显著大于对照组(P<0.05),VAS评分显著低于对照组(P<0.05),JOA评分显著高于对照组(P<0.05)。观察组患者均未出现疼痛症状加重等手法反应,对照组有7例患者出现不同程度的腰臀疼痛症状加重。结论在采用推拿手法治疗腰椎间盘突出症时,改进的直腿抬高扳腿法较常规的直腿抬高扳腿法疗效更为显著,可能发生的不良反应更少。Objective It is to explore the effect of different straight leg lifting and pulling on the clinical therapeutic effect of massage on lumbar intervertebral disc herniation.Methods A total of 100 patients with lumbar disc herniation treated in the Massage Department of the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine from May 2018 to July 2019 were selected and randomly divided into a control group and an observation group,50 cases in each group.Both groups were treated with the same loosening-type massage manipulation.During the treatment,the observation group was treated with improved straight leg lifting and pulling and the control group was treated with the conventional straight-leg lifting and pulling.Treating for 6 times as one course of treatment,with an interval of 1 day between the courses,both groups were treated for 4 courses of treatment.The treatment effects and changes of the lifting angle of the straight leg on the affected side,the visual analogue score of pain(VAS score),the Japanese Orthopaedic Association lumbar function scale score(JOA score)before and after treatment,and possible adverse reactions during the treatment were observed in the two groups.Results The markedly effective rate of observation group and control group were 74%(37/50)and 54%(27/50),and the total effective rates were 96%(48/50)and 94%(47/50),respectively.The markedly effective rate was significantly higher in the observation group than that in the control group(P<0.05),and there was no significant difference in the total effective rate between the two groups(P>0.05).Compared with before treatment,the lifting angle of the straight leg on the affected side was significantly increased(P<0.05),the VAS scores were significantly reduced(P<0.05),and the JOA scores were significantly increased in the both groups(P<0.05);The lifting angle of the straight leg in the observation group was significantly larger(P<0.05),the VAS score was significantly lower(P<0.05),and the JOA score was significantly hig

关 键 词：腰椎间盘突出症 推拿 直腿抬高扳腿法 JOA评分 疼痛 

分 类 号：R681.53[医药卫生—骨科学]