“罗森塔尔效应”在针刀治疗腰椎管狭窄症中的运用  

Application of"Rosenthal Effect"in the treatment of lumbar spinal stenosis with a needle knife

作　　者：卢笛[1] 徐彬 丁伟国[1] 许新伟[1] 徐卫星[1] LU Di;XU Bin;DING Weiguo;XU Xinwei;XU Weixing(Department of Orthopedics and Traumatology,Zhejiang Provincial Tongde Hospital,Hangzhou310012,China)

机构地区：[1]浙江省立同德医院骨伤科,浙江杭州310012

出　　处：《中国现代医生》2020年第35期62-65,共4页China Modern Doctor

基　　金：浙江省科技计划公益类项目(2017C33122)。

摘　　要：目的探讨小针刀结合骶管注射并辅以“权威期待”的心理治疗是否能提高老年腰椎管狭窄症的临床疗效。方法选取2017年1月~2018年12月我院专家门诊接诊的65例老年腰椎管狭窄症患者,将患者随机分为“罗森塔尔效应”观察组(34例)和对照组(31例);对照组采取小针刀结合骶后孔注射治疗,“罗森塔尔效应”观察组在小针刀结合骶后孔注射治疗的基础上辅以“权威期待”的心理治疗,观察比较两组临床疗效,统计比较两组患者治疗前后及两组之间疼痛视觉模拟评分法(VAS)、自踱步行走试验(SPWT)评分及综合疗效评价。结果“罗森塔尔效应”观察组痊愈患者12例,显效16例,有效4例,无效2例;对照组痊愈患者5例,显效10例,有效12例,无效4例。“罗森塔尔效应”观察组的综合疗效优于对照组(P<0.05)。与对照组相比,“罗森塔尔效应”观察组各次治疗后VAS评分均更低、SPWT评分均更高,差异有统计学意义(P<0.05)。结论证实“罗森塔尔效应”在腰椎管狭窄症的治疗中也会发生,尤其针对以“主诉重、体征轻”为主要特征的老年腰椎管狭窄症患者,在临床上通过小针刀+骶后孔注射治疗,并辅以“权威期待”的心理治疗可以使其疗效显著提高。Objective To explore whether a small needle knife combined with sacral canal injection and"authoritative expectation"can improve the clinical efficacy of lumbar spinal stenosis in the elderly.Methods A total of 65 elderly patients with lumbar spinal stenosis admitted to our specialist clinic from January 2017 to December 2018 were selected.The patients were randomly divided into the"Rosenthal Effect"observation group(34 cases)and the control group(31 cases).The control group was treated with small needle knife combined with posterior foramen injection.The Rosenthal Effect observation group was supplemented with"authoritative expectation"psychotherapy based on the treatment of the control group.The clinical efficacy of the two groups was observed and compared.The visual analogue score(VAS)score,the self-propelled walking test(SPWT)score and the comprehensive effect before and after treatment between the two groups were statistically compared.Results In the"Rosenthal Effect"observation group,there were 12 patients with recovery,16 cases with markedly effective,4 cases with effective,and 2 cases with ineffective.In the control group,there were 5 cases cured,10 cases with markedly effective,12 cases with effective,and 4 cases with ineffective.The comprehensive effect of the"Rosenthal Effect"observation group was better than that of the control group(P<0.05).Compared with the control group,"Rosenthal Effect"observation group had lower VAS score and higher SPWT score after each treatment,the difference was statistically significant(P<0.05).Conclusion It is proved that"Rosental Effect"can occur in the treatment of lumbar spinal stenosis,especially for elderly lumbar spinal stenosis patients with main feature of"heavy complaint and light signs".Clinically,the effect can be significantly improved by using a small needle knife,combined with sacral injection and"authoritative expectation"psychological treatment.

关 键 词：权威期待 罗森塔尔效应 老年人 腰椎管狭窄症 小针刀 

分 类 号：R246.9[医药卫生—针灸推拿学]