多维牵引法治疗腰椎间盘突出症的临床研究  

A clinical study of multidimensional traction therapy for treatment of lumbar disc herniation

作　　者：刘巍峰[1] 金泳 赵莉娟 张国辉[1] LIU Weifeng;JIN Yong;ZHAO Lijuan;ZHANG Guohui(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437

出　　处：《中医正骨》2023年第11期1-4,9,共5页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：目的:探讨多维牵引法治疗腰椎间盘突出症(lumbar disc herniation,LDH)的临床疗效。方法:将106例LDH患者随机分为多维牵引组和平行牵引组,每组53例。多维牵引组采用多维度腰椎牵引方案治疗,平行牵引组采用传统腰椎牵引方案治疗;均每日牵引1次,每次20 min,每周3次,共治疗2周。记录并比较2组患者治疗前、治疗结束后的腰腿部疼痛视觉模拟量表(visual analogue scale,VAS)评分、日本骨科协会(Japanese Orthopaedic Association,JOA)腰痛疾患疗效评分及Oswestry功能障碍指数(Oswestry disability index,ODI)。结果:试验过程中2组分别有5例患者退出试验。①腰腿部疼痛VAS评分。治疗结束后,2组患者腰腿部疼痛VAS评分均低于治疗前[(6.917±0.964)分,(2.875±0.703)分,t=21.210,P=0.000;(7.021±0.978)分,(3.063±0.727)分,t=21.868,P=0.000],多维牵引组患者腰腿部疼痛VAS评分低于平行牵引组(t=1.285,P=0.002)。②JOA腰痛疾患疗效评分。治疗结束后,2组患者JOA腰痛疾患疗效评分均高于治疗前[(13.187±2.340)分,(25.729±1.783)分,t=-30.090,P=0.000;(11.166±2.086)分,(22.271±3.051)分,t=-20.648,P=0.000],多维牵引组患者JOA腰痛疾患疗效评分高于平行牵引组(t=-6.507,P=0.000)。③ODI。治疗结束后,2组患者ODI均低于治疗前[(35.458±3.268)%,(10.167±2.793)%,t=39.694,P=0.000;(37.000±5.300)%,(13.500±2.658)%,t=29.621,P=0.000],多维牵引组患者ODI低于平行牵引组(t=5.990,P=0.001)。结论:相较于平行牵引法,多维牵引法治疗LDH,能更好地缓解腰腿部疼痛和改善腰椎功能。Objective:To explore the clinical outcomes of multidimensional traction therapy for treatment of lumbar disc herniation(LDH).Methods:One hundred and six LDH patients were randomized into multidimensional traction group and parallel traction group,53 ones in each group.All patients were tractioned for 20 minutes a day,three times a week for consecutive 2 weeks.The lumbago-leg pain visual analogue scale(VAS)score,Japanese Orthopaedic Association(JOA)efficacy score for low back pain and Oswestry disability index(ODI)were recorded and compared between the 2 groups before the treatment and after the end of treatment.Results:During the trial,5 enrollees withdrew from each group.①The lumbago-leg pain VAS score decreased after the end of treatment compared to pretreatment in the 2 groups(6.917±0.964 vs 2.875±0.703 points,t=21.210,P=0.000;7.021±0.978 vs 3.063±0.727 points,t=21.868,P=0.000),and it was lower in multidimensional traction group compared with that of parallel traction group(t=1.285,P=0.002).②The JOA low back pain efficacy score increased after the end of treatment compared to pretreatment in the 2 groups(13.187±2.340 vs 25.729±1.783 points,t=-30.090,P=0.000;11.166±2.086 vs 22.271±3.051 points,t=-20.648,P=0.000),and it was higher in multidimensional traction group compared with that of parallel traction group(t=-6.507,P=0.000).③The ODI decreased after the end of treatment compared to pretreatment in the 2 groups(35.458±3.268 vs 10.167±2.793%,t=39.694,P=0.000;37.000±5.300 vs 13.500±2.658%,t=29.621,P=0.000),and it was lower in multidimensional traction group compared with that of parallel traction group(t=5.990,P=0.001).Conclusion:The multidimensional traction therapy can better alleviate lumbago-leg pain and improve lumbar function compared to parallel traction therapy in treatment of LDH.

关 键 词：椎间盘移位 腰椎 牵引术 临床试验 

分 类 号：R681.53[医药卫生—骨科学]