整脊手法与传统按摩手法治疗腰椎管狭窄症的临床效果随机对照研究  

A randomized controlled study on the clinical effect of spinal manipulation and traditional massage in the treatment of lumbar spinal stenosis

作　　者：曾浩彬[1] 陈茂水[1] 吴永生 ZENG Haobin;CHEN Maoshui;WU Yongsheng(Department of Orthopaedic Spine,Zhuhai Hospital of Guangdong Hospital of Traditional Chinese Medicine,Guangdong Province,Zhuhai 519015,China)

机构地区：[1]广东省中医院珠海医院骨二脊柱科,广东珠海519015

出　　处：《中国医药导报》2020年第18期103-106,共4页China Medical Herald

基　　金：广东省中医药局立项课题(20182141)。

摘　　要：目的研究整脊手法与传统按摩手法治疗腰椎管狭窄症的临床效果。方法选择2018年3月~2019年3月广东省中医院珠海医院脊柱科住院的腰椎管狭窄症患者120例为研究对象,按简单随机分组方法分为整脊手法治疗组60例,传统按摩手法对照组60例,采用日本骨科学协会评估治疗(JOA)评分、视觉模拟(VAS)评分评价临床疗效。测量治疗前后患者腰椎弓形面积、腰椎椎管的矢状位前后径变化。结果两组治疗前后JOA、VAS评分时间、组间、交互作用比较,差异有统计学意义(P <0.05),组内比较,两组治疗后、随访1个月及随访3个月JOA评分高于治疗前,VAS评分低于治疗前,组内比较,差异均有统计学意义(均P <0.05);组间比较:治疗组治疗后、随访1个月、随访3个月JOA评分高于对照组,JOA评分低于对照组,差异有统计学意义(P <0.05)。两组腰椎管中央矢状径、腰椎椎曲弓形面积组间治疗前比较,差异无统计学意义(P> 0.05);治疗后,对照组腰椎管中央矢状径、腰椎椎曲弓形面积与治疗前比较,差异无统计学意义(P> 0.05),治疗组腰椎管中央矢状径、腰椎椎曲弓形面积大于治疗前,且大于对照组,差异有统计学意义(P <0.05)。结论整脊手法治疗腰椎管狭窄症较传统按摩手法更加有效,在临床中值得推广。Objective To study the clinical effect of spinal manipulation and traditional massage in the treatment of lumbar spinal stenosis.Methods A total of 120 patients with lumbar spinal stenosis admitted to the Department of Spine Zhuhai Hospital,Guangdong Provincial Hospital of Traditional Chinese Medicine from March 2018 to March 2019 were collected.They were divided into the spinal manipulation treatment group(60 cases)and the control group(60 cases)by simple random method,and the clinical efficacy was evaluated by Japanese orthopaedic association(JOA)scores and visual analogue scale(VAS).The lumbar arch area and the sagittal anteroposterior diameter before and after treatment were measured.Results JOA,VAS scoring time,intergroup and interaction were compared before and after treatment,and the differences were statistically significant(P<0.05).JOA scores after treatment,1 month of follow-up and 3 months of follow-up were higher than that before treatment,VAS scores were lower than that before treatment,and the differences were statistically significant(all P<0.05).Comparison between groups:JOA score of the treatment group was higher than that of the control group,and JOA score was lower than that of the control group after treatment,with statistically significant difference(P<0.05).There were no statistically significant differences between the two groups before treatment in the sagittal diameter of lumbar spinal canal and the area of lumbar curvature(P>0.05).In the treatment group,the sagittal diameter of lumbar spinal canal and the area of lumbar curvature were larger than those before treatment,and the differences were statistically significant(P<0.05).Conclusion Spinal manipulation is more effective than traditional massage in the treatment of lumbar spinal stenosis,it is worth popularizing in clinic.

关 键 词：整脊手法 传统按摩手法 腰椎管狭窄症 随机对照 临床疗效 

分 类 号：R244.1[医药卫生—针灸推拿学]