腰椎管注药与棘突牵引配合骨盆牵引治疗腰椎管狭窄症的疗效观察  

Treatment of Lumbar Spinal Stenosis by Lumbar Canal Injection and Spinous Traction Combined with Pelvic Traction

作　　者：徐振文[1] 郑威 吴建华[1] 谢学儒[1] 伍泽鑫 李嵩鹏 XU Zhen-wen;ZHENG Wei;WU Jian-hua;XIE Xue-ru;WU Ze-xin;LI Song-peng(The Third Department of Orthopedics,Huizhou Hospital of Traditional Chinese Medicine,Huizhou Guangdong 516000)

机构地区：[1]惠州市中医医院骨三科,广东惠州516000

出　　处：《世界中西医结合杂志》2020年第10期1909-1913,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：广东省中医药局科研项目(20143033);2017年度惠州市科技计划项目(20170719214051)。

摘　　要：目的分析腰椎管注药与棘突牵引配合骨盆牵引治疗腰椎管狭窄症(LSS)的临床价值。方法根据患者治疗意愿将120例LSS患者分为试验①组,试验②组,试验③组,试验④组,试验⑤组,试验⑥组,每组20例。6组均给予常规治疗方案,在此基础上,试验①组行单纯腰椎管注药,试验②组行腰椎管注药+骨盆牵引,试验③组行单纯棘突牵引,试验④组行棘突牵引+骨盆牵引,试验⑤组行腰椎管注药+棘突牵引,试验⑥组行腰椎管注药+棘突牵引+骨盆牵引,所有试验治疗观察周期为1周(腰椎管注药仅接受1次),分别于治疗前、治疗后1 d、治疗后7 d及治疗后30 d进行疼痛(VAS)评分、功能障碍(ODI)及腰部功能(JOA评分)评价。结果治疗前,6组VAS评分、ODI及JOA评分比较,差异无统计学意义(P>0.05);治疗后1 d及7 d,6组VAS评分、ODI及JOA评分较本组治疗前均呈整体改善趋势,治疗后30 d,试验①组、试验②组、试验③组及试验④组VAS评分、ODI较本组治疗后7 d有所增加,JOA评分较本组治疗后7 d有所降低,但试验⑤组及试验⑥组仍呈改善趋势,且治疗后试验⑥组上述指标改善情况整体优于其他各组(P<0.05),差异有统计学意义。结论腰椎管注药与棘突牵引配合骨盆牵引治疗LSS效果显著,可有效缓解患者腰部疼痛,改善功能障碍,有利于提高腰椎功能。Objective To analyze the clinical value of lumbar spinal canal injection and spinous process traction combined with pelvic traction in the treatment of lumbar spinal stenosis(LSS).Methods 120 LSS patients were divided into test ① group,test ② group,test ③ group,test ④ group,test ⑤ group,test ⑥ group according to the patient’s treatment willingness,with 20 cases in each group.The 6 groups were all given the conventional treatment plan.On this basis,the test group ① received pure lumbar spinal canal injection,the test group ② received lumbar spinal canal injection +pelvic traction,the test group ③ received pure spinous process traction,and the test ④ group received spinous process Traction + pelvic traction,test ⑤ group underwent lumbar spinal canal injection + spinous process traction,test ⑥ group underwent lumbar spinal canal injection + spinous process traction + pelvic traction,all experimental treatment observation period is 1 week(lumbar spinal canal injection only accepts 1 Times),before treatment,1 d after treatment,7 d after treatment,and 30 d after treatment,the pain(VAS score),dysfunction(ODI) and waist function(JOA score) were evaluated.Results Before treatment,the VAS scores,ODI and JOA scores of the 6 groups were not statistically different(P >0.05);1 d and 7 d after treatment,the VAS scores,ODI and JOA scores of the 6 groups showed overall improvement compared with before treatment Trend,30 days after treatment,the VAS score and ODI of the test ① group,test ② group,test③ group,and test ④ group increased compared with 7 d after treatment,and JOA score decreased compared with 7 d after treatment,but test ⑤ group And the test group ⑥ still showed an improvement trend,and the improvement of the above indicators in the test group ⑥ after treatment was better than that of the other groups,the difference was statistically significant(P<0.05).Conclusion Lumbar spinal canal injection and spinous process traction combined with pelvic traction have a significant effect on

关 键 词：腰椎管狭窄症 腰椎管注药 棘突牵引 骨盆牵引 疼痛 腰椎功能 

分 类 号：R681.5[医药卫生—骨科学]