中医推拿手法与康复一体化保守治疗退行性腰椎滑脱患者的多中心研究  

A multi-centre study of conservative treatment of patients with degenerative spondylolisthesis treated with integration of traditional Chinese massage manipulation and rehabilitation

作　　者：李旭雪 刘英[1] 任义财 王兰兰 韩声禄 周勋[3] LI Xu-xue;LIU Ying;REN Yi-cai;WANG Lan-lan;HAN Sheng-lu;ZHOU Xun(Sichuan Orthopedic Hospital,Chengdu 610041,China;Sichuan Integrated Traditional Chinese and Western Medicine Hospital,Chengdu 610041,China;Sports Hospital Affiliated to Chengdu Institute of Physical Education,Chengdu 610041,China)

机构地区：[1]四川省骨科医院,四川成都610041 [2]四川省中西医结合医院,四川成都610041 [3]成都体育学院附属体育医院,四川成都610041

出　　处：《实用医院临床杂志》2023年第1期79-82,共4页Practical Journal of Clinical Medicine

基　　金：四川省中医药管理局专项课题(编号:2020LC0174);四川省医学会(尚安通)课题(编号:2021SAT18)。

摘　　要：目的评估中医正骨推拿与康复一体化治疗退变性腰椎滑脱患者的临床效果。方法2019年1月至2021年7月共纳入退变性腰椎滑脱患者80例,采用随机数字表法分为观察组41例,对照组39例。观察组采用中医正骨推拿+针刺疗法+腰椎康复操,对照组采用腰椎牵引+针刺疗法+佩戴腰围。比较两组治疗前后腰椎稳定性指标:腰椎前凸角(LLA)、骶骨水平角(SHA)、腰骶角(LSA)及临床疗效、视觉疼痛模拟量表(VAS)评分及日本骨科学会下腰痛评分表(JOA)评分,随访12月。结果两组治疗前LLA、SHA、LSA比较,差异无统计学意义(P>0.05),治疗结束后两组LLA、SHA、LSA水平明显低于治疗前,且观察组改善优于对照组(P<0.05)。两组治疗结束后及治疗后3、6、12月VAS评分、JOA评分均较治疗前明显改善(P<0.01),两组比较差异无统计学意义(P>0.05)。治疗6月、12月时,观察组VAS评分、JOA评分改善优于对照组,差异有统计学意义(P<0.05)。结论中医推拿手法与康复一体化治疗退变性腰椎滑脱患者的中远期临床效果明显,可缓解患者症状,提高患者日常生活质量,值得推广。Objective To evaluate the mid-to-long-term clinical effect in the treatment of degenerative lumbar spondylolisthesis(DLS)with the integration of traditional Chinese medicine(TCM)bone setting massage and rehabilitation.Methods From January 2019 to July 2021,a total of 160 DLS patients were enrolled.Complete data of 41(observation group)and 39(control group)were finally obtained.The observation group was treated with TCM bone setting massage+acupuncture+lumbar rehabilitation exercises.The control group was treated with lumbar traction+acupuncture+waist circumference.The indexes of lumbar stability such as lumbar lordosis angle(LLA),sacral horizontal angle(SHA)and lumbosacral angle(LSA),clinical efficacy,visual analog pain scale(VAS)score and Japanese Orthopedic Association Low Back Pain Scale(JOA)score before and after treatment were compared between the two groups.The patients were followed up for 12 months.Results There was no significant difference in LLA,SHA and LSA between the two groups before treatment(P>0.05).After treatment,the levels of LLA,SHA and LSA in the two groups were significantly lower than those before treatment,and the improvement in the observation group was better than that in the control group(P<0.05).The VAS score and the JOA score in the two groups after treatment and 3,6,12 months after treatment were significantly improved when compared with those before treatment(P<0.01),and there was no significant difference between the two groups(P>0.05).During the follow-up of 6 months and 12 months,the VAS score and the JOA score in the observation group were better than those in the control group(P<0.05).Conclusions The combination of traditional Chinese massage and rehabilitation has obvious mid-to-long-term clinical effects in the patients with DLS.It can alleviate the symptoms and improve the quality of daily life of the patients.It is worth popularizing.

关 键 词：退行性腰椎滑脱 保守治疗 中远期随访 

分 类 号：R496[医药卫生—康复医学]