重力肌群伸展强化康复锻炼在腰椎间盘突出症患者治疗中的应用
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摘要
目的探讨重力肌群伸展强化康复锻炼在腰椎间盘突出症(LDH)患者治疗中的应用。方法选取2016年1月～2018年4月在我院骨科门诊就诊LDH患者70例,随机分为观察组与对照组,各35例。两组患者均予以腰椎牵引治疗,观察组在此基础上予以重力肌群伸展康复锻炼。两组均干预8周。观察并比较两组患者治疗前和治疗8周后腰背部疼痛评分和腰椎功能情况,并比较临床效果。结果治疗8周后,两组患者的VAS评分和ODI评分均较前明显下降,差异有统计学意义(P<0.05或P<0.01),且治疗后观察组患者下降值较对照组患者改善更明显,差异有统计学意义(P<0.05);同时观察组患者的临床总有效率为94.29%,明显高于对照组的77.14%,差异有统计学意义(χ~2=4.20,P<0.05)。结论重力肌群伸展康复锻炼用于LDH患者效果较确切,能明显减轻腰背部疼痛,更好改善腰椎功能。
Objective To investigate the application of gravity muscle group stretching and intensive rehabilitation exercise in the treatment of patients with lumbar disc herniation(LDH). Methods 70 patients with LDH who were diagnosed in the orthopedic clinic from January 2016 to April 2018 in our hospital were selected and randomly divided into observation group and control group, with 35 cases in each group. Both groups of patients were given lumbar traction for treatment. On the basis of this, the observation group was given the rehabilitation exercise of the gravity muscle group. Both groups were intervened for 8 weeks. The low back pain score and lumbar function were observed and compared between the two groups before treatment and 8 weeks after treatment, and the clinical effects were compared.Results After 8 weeks of treatment, the VAS score and ODI score of the two groups were significantly lower than before, and the differences were statistically significant(P<0.05 or P<0.01). After treatment, the decrease value in the observation group was improved more significant than that in the control group, and the difference was statistically signif icant(P<0.05); at the same time, the total clinical effective rate in the observation group was 94.29%, which was signifi cantly higher than that of 77.14% in the control group. The difference was statistically significant(χ~2=4.20, P<0.05).Conclusion Gravity muscle group stretching and rehabilitation exercise is more effective in the patients with LDH,which can significantly reduce low back pain and improve lumbar function.
Objective To investigate the application of gravity muscle group stretching and intensive rehabilitation exercise in the treatment of patients with lumbar disc herniation(LDH). Methods 70 patients with LDH who were diagnosed in the orthopedic clinic from January 2016 to April 2018 in our hospital were selected and randomly divided into observation group and control group, with 35 cases in each group. Both groups of patients were given lumbar traction for treatment. On the basis of this, the observation group was given the rehabilitation exercise of the gravity muscle group. Both groups were intervened for 8 weeks. The low back pain score and lumbar function were observed and compared between the two groups before treatment and 8 weeks after treatment, and the clinical effects were compared.Results After 8 weeks of treatment, the VAS score and ODI score of the two groups were significantly lower than before, and the differences were statistically significant(P<0.05 or P<0.01). After treatment, the decrease value in the observation group was improved more significant than that in the control group, and the difference was statistically signif icant(P<0.05); at the same time, the total clinical effective rate in the observation group was 94.29%, which was signifi cantly higher than that of 77.14% in the control group. The difference was statistically significant(χ~2=4.20, P<0.05).Conclusion Gravity muscle group stretching and rehabilitation exercise is more effective in the patients with LDH,which can significantly reduce low back pain and improve lumbar function.
引文
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[20]王强,赵文杰,张斌,等.髋-腰综合征病理基础及生物力学机制[J].中国组织工程研究,2015,19(33):5371-5377.
[21]梁伟明,邹宇聪,李义凯.重力肌群伸展强化锻炼对腰椎间盘突出症患者功能康复的影响[J].中国全科医学,2013,16(6C):2146-2149.
[22]苏绍华.重力肌群锻炼对老年机械性腰痛腰椎间盘突出症的干预效果[J].中国老年学杂志,2017,37(22):5664-5666.
[23]梁伟明,邹宇聪,林友,等.神经根型颈椎病患者颈部重力肌群静力收缩后放松训练的临床疗效观察[J].实用医学杂志,2013,29(14):2319-2321.
[24]陈小刚,林瑞新,李桂锦,等.腰部核心肌群锻炼对腰椎间盘突出症患者腰背伸肌群的生物力学影响[J].中医正骨,2018,30(5):71-73.
[2]Elseberq CL,Salziq D,Czermak P.Bioreactor expansion of human mesenchymal stem cells according to GMP requirements[J].Methods Mol Biol,2015,1283(10):199-218.
[3]Han KT,Lee HJ,Park EC,et al.Length of stay and read-mission in lumbar intervertebral disc disorder inpatients by hospital characteristics and volumes[J].Health Policy,2016,120(9):1008-1016.
[4]Atlas SJ,Keller RB,Wu YA,et al.Long-term outcomes of surgical and nonsurgical management of sciatica secondary to a lumbar disc herniation:10 year results from the Maine Lumbar Spine Study[J].Spine,2005,30(8):927-935.
[5]Liu C,Zhou Y.Percutaneous endoscopic lumbar diskectomy and minimally invasive transforaminal lumbar interbody fusion for recurrent lumbar disk herniation[J].World Neurosur,2017,98(2):14-20.
[6]吕慧,邹宇聪,梁伟明.重力肌群伸展强化锻炼治疗伴有活动性功能障碍的强直性脊柱炎患者的效果研究[J].中国全科医学,2013,16(6):695-698.
[7]管新民,周建华,胡亚威,等.86例腰椎间盘突出症相关危险因素分析[J].医学综述,2014,20(15):2875-2876.
[8]胡有谷.腰椎间盘突出症[M].第4版.北京:人民卫生出版社,2011:370.
[9]Piper BF,Dibble SL,Doddm J,et al.The revised Piper Fatigue Scale:psychometric evaluation in women with breast cancer[J].Oncol Nurs Forum,1998,25(4):677-684.
[10]张启富.腰椎间盘突出症非手术治疗综述[J].颈腰痛杂志,2008,21(5):477-480.
[11]刘绮,马超,伍少玲,等.Oswestry功能障碍指数评定慢性腰痛患者的效度分析[J].中国康复医学杂志,2010,25(3):228-231.
[12]Jin-peng Zhang,Qiang Tang,Lu-wen Zhu.Electroacupuncture combined with iontophoresis of Chinese medicine for lumbar intervertebral disc herniation[J].Journal of Acupuncture and Tuina Science,2015,13(2):105-110.
[13]Gun WL,Ryu JH,Kim JD,et al.Comparison of lumbar discectomy alone and lumbar discectomy with direct repair of pars defect for patients with disc herniation and spondylolysis at the nearby lumbar segment[J].Spine J,2015,15(10):2172-2181.
[14]Sokunbi OG,Kachalla FG.Effects of acupuncture,corestability exercises,and treadmill walking exercises in treating a patient with postsurgical lumbar disc herniation:Aclinical case report[J].J Acupun,2015,8(1):48-52.
[15]Li Y,Fredrickson V,Resnick DK.How should we grade lumbar disc herniation and nerve root compression?Asystematic review[J].Clin Orthop Relat Res,2015,473(6):1896-2902.
[17]郭伟,韩磊,李艺,等.腰段脊柱多体动力学模型模拟脊柱关节手法力学分析研究[J].中华中医药杂志,2016,31(11):4707-4710.
[18]Wang XS,Sun RF,Ji Q,et al.A meta-analysis of interlaminar minimally invasive discectomy compared to conventional microdiscectomy for lumbar disk herniation[J].Clin Neuro Neurosurg,2014,127(12):149-157.
[19]王亮,卢旭华.退行性腰椎侧凸生物力学的研究进展[J].中国骨科临床与基础研究杂志,2013,5(4):241-245.
[20]王强,赵文杰,张斌,等.髋-腰综合征病理基础及生物力学机制[J].中国组织工程研究,2015,19(33):5371-5377.
[21]梁伟明,邹宇聪,李义凯.重力肌群伸展强化锻炼对腰椎间盘突出症患者功能康复的影响[J].中国全科医学,2013,16(6C):2146-2149.
[22]苏绍华.重力肌群锻炼对老年机械性腰痛腰椎间盘突出症的干预效果[J].中国老年学杂志,2017,37(22):5664-5666.
[23]梁伟明,邹宇聪,林友,等.神经根型颈椎病患者颈部重力肌群静力收缩后放松训练的临床疗效观察[J].实用医学杂志,2013,29(14):2319-2321.
[24]陈小刚,林瑞新,李桂锦,等.腰部核心肌群锻炼对腰椎间盘突出症患者腰背伸肌群的生物力学影响[J].中医正骨,2018,30(5):71-73.