郑氏推拿手法联合康复一体化治疗退行性腰椎滑脱的疗效研究  

Therapeutic effect of integration of Zheng's massage manipulation and rehabilitation on DLS

作　　者：罗晓玲 刘愉勤 李兰[1] 司福军 毛雷 李旭雪 LUO Xiao-ling;LIU Yu-qin;LI Lan;SI Fu-jun;MAO Lei;LI Xu-xue(Department of Medical Imaging,Sichuan Province Orthopaedic Hospital,Chengdu 610000,Sichuan,China;Department of Function Test,Sichuan Province Orthopaedic Hospital,Chengdu 610000,Sichuan,China)

机构地区：[1]四川省骨科医院医学影像科,四川成都610000 [2]四川省骨科医院功检科,四川成都610000

出　　处：《川北医学院学报》2024年第8期1080-1084,共5页Journal of North Sichuan Medical College

基　　金：四川省中医药管理局科学技术研究专项(2020LC0174)。

摘　　要：目的:探究郑氏推拿法联合康复一体化保守治疗退行性腰椎滑脱(DLS)的临床疗效。方法:根据治疗方法不同将178例DLS患者分成对照组(n=92)与观察组(n=86)。对照组接受常规腰椎牵引+腰围制动治疗;观察组接受郑氏推拿联合康复一体化保守治疗。比较两组患者日本骨科协会JOA得分、视觉模拟疼痛量表(VAS)得分、影像学参数水平及生活质量健康状况调查简表(SF-36)得分。结果:治疗3周后及随访各时间点,观察组JOA得分、SF-36得分均高于对照组,VAS得分低于对照组(P<0.05);治疗12个月后,观察组头侧关节突关节角、尾侧关节突关节角及关节突-椎弓根角均低于对照组(56.31±2.04 vs.57.85±2.74、50.47±1.37 vs.51.19±2.54、101.24±2.03 vs.103.38±3.58,P<0.05);观察组临床总有效率高于对照组(98.84%vs.91.30%,P<0.05)。结论:郑氏推拿法联合康复一体化治疗退行性腰椎滑脱的中远期疗效较好,有一定的临床推广应用价值。Objective:To explore the therapeutic effect of integration of Zheng's massage manipulation and rehabilitation on degenerative lumbar spondylolisthesis(DLS).Methods:According to treatment methods,178 patients with DLS were divided into control group(n=92,conventional lumbar traction and waist circumference immobilization)and observation group(n=86,integrated conservative treatment with Zheng's massage manipulation and rehabilitation).Japanese Orthopaedic Association(JOA)scores,Visual Analogue Scale(VAS)scores,imaging parameters and the 36-Item Short Form Health Survey(SF-36)scores of the two groups were compared.Results:JOA scores and SF-36 scores of observation group were higher than those of control group,and VAS scores were lower than those of control group after 3 weeks of treatment and at different time points of follow-up(P<0.05).After 12 months of treatment,cephalic and caudal zygapophysial joint angles,and zygapophysial-pedicle angle in observation group[(56.31±2.04),(50.47±1.37)and(101.24±2.03)]were lower than those in control group[(57.85±2.74),(51.19±2.54)and(103.38±3.58)](P<0.05).The total clinical response rate in observation group(98.84%)was higher than that in control group(91.30%)(P<0.05).Conclusion:Applying the integration of Zheng's massage manipulation and rehabilitation to treat DLS has good mid-long-term therapeutic effects,and has certain clinical promotion and application value.

关 键 词：退行性腰椎滑脱 郑氏推拿手法 康复一体化保守治疗 日本骨科协会评分 

分 类 号：R274.23[医药卫生—中医骨伤科学] R681.5[医药卫生—中医学]