调脊手法治疗退行性脊柱侧凸症临床疗效及症状复发影响因素分析  

Efficacy of Chiropractic Manipulation in the Treatment of Degenerative Scoliosis and Analysis on the Influencing Factors of Symptom Recurrence

作　　者：李路广 高景华[1,2] 孙武 高春雨[1] 罗杰[1] 杨克新[1] 李建国[1] LI Luguang;GAO Jinghua;SUN Wu;GAO Chunyu;LUO Jie;YANG Kexin;LI Jianguo(Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing 100102,China;Beijing Key Laboratory of Orthopaedic Technology of Traditional Chinese Medicine,Beijing 100102,China)

机构地区：[1]中国中医科学院望京医院,北京100102 [2]中医正骨技术北京市重点实验室,北京100102

出　　处：《中国中医药信息杂志》2021年第11期112-116,共5页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：国家中医药管理局国家中医临床研究基地业务建设科研专项课题(JDZX2015271)。

摘　　要：目的观察调脊手法治疗退行性脊柱侧凸症(DS)的疗效,分析影响DS患者经保守治疗后症状复发的可能因素。方法采用随机数字表法将120例DS患者分为治疗组和对照组各60例。治疗组予调脊手法,隔日1次。对照组予盐酸乙哌立松片,每次1片,每日3次,口服;并佩戴胸腰椎矫形支具。2组均治疗4周,随访6个月。评价2组临床疗效,观察2组治疗前后视觉模拟评分法(VAS)评分、腰椎Oswestry功能障碍指数(ODI)评分。经治疗有效的患者症状复发纳入复发组,未复发则纳入无复发组,统计可能影响症状复发的因素,进行单因素和多因素Logistic回归分析。结果治疗组脱落9例,对照组脱落10例。治疗组总有效率为88.24%(45/51),对照组为86.00%(43/50),2组比较差异无统计学意义(P>0.05)。与本组治疗前比较,2组治疗后VAS评分、ODI评分显著下降(P<0.05);2组治疗后VAS评分、ODI评分比较差异无统计学意义(P>0.05)。88例经治疗有效的患者均获得随访,症状复发22例(25.00%),无症状复发66例(75.00%)。Logistic回归分析显示,下肢症状和治疗前ODI评分是患者症状复发的独立危险因素。结论调脊手法治疗DS效果较好,可在一定程度上缓解DS患者的疼痛,改善腰椎功能。有下肢症状和腰椎功能障碍程度严重者在接受保守治疗后症状复发风险较高。Objective To observe the efficacy of chiropractic manipulation in the treatment of degenerative scoliosis(DS);To analyze the possible factors affecting the recurrence of symptoms in DS patients after conservative treatment.Methods Totolly 120 patients with DS were divided into treatment group and control group according to random number table method,with 60 cases in each group.The treatment group was treated with chiropractic manipulation,once every other day,and the control group was treated with oral eperisone hydrochloride tablets,one tablet each time,three times a day,orally;combined with thoracolumbosacral orthosis.Both groups were treated for 4 weeks and followed up for 6 months.The clinical efficacy of both groups was evaluated.Visual analogue scale(VAS)score and Oswestry disability index(ODI)score were observed before and after treatment.Patients whose symptoms have relapsed after treatment were included in the recurrence group,and those who have not relapsed were included in the recurrence-free group,in order to count the related factors that may affect the recurrence of symptoms in patients,and conduct univariate and multivariate Logistic regression analysis between groups.Results During the treatment,there were 9 cases lost in the treatment group and 10 cases lost in the control group.The total effective rate was 88.24%(45/51)in the treatment group and 86.00%(43/50)in the control group,without statistical significance(P>0.05).Compared with before treatment,the scores of VAS and ODI in the two groups decreased significantly after treatment(P<0.05).There was no significant difference in the scores of VAS and ODI between the two groups after treatment(P>0.05).The follow-up period was achieved in all the 88 patients who were effective after treatment.Symptom recurrence occurred in 22 cases(25.00%)and symptomatic recurrence free in 66 cases(75.00%).Logistic regression analysis showed that lower limb symptoms and ODI score before treatment were independent risk factors for symptom recurrence in patients.Conc

关 键 词：调脊手法 退行性脊柱侧凸症 症状复发 影响因素 多元LOGISTIC回归 

分 类 号：R274.915[医药卫生—中西医结合]