腰椎旋转复位法治疗BMI指数增高患者退行性腰椎滑脱症疗效观察
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摘要
目的:观察腰椎旋转复位法治疗退行性腰椎滑脱症BMI指数增高患者的临床疗效。方法:在535例退行性腰椎滑脱症患者中选取符合标准的286例BMI指数增高患者(BMI指数>24),其中治疗组149例,对照组137例。治疗组患者予以腰椎旋转复位法配合腰椎康复操治疗,对照组患者予以腰椎牵引联合腰围固定干预治疗。两组均在治疗后观察JOA评分、VAS评分及疗效指数变化情况。结果:治疗后两组JOA评分均明显高于治疗前,VAS评分都明显降低,且差异均有统计学意义(P<0.01),治疗组治疗后JOA评分、VAS评分及疗效指数均优于对照组,且差异有统计学意义(P<0.01)。结论:腰椎旋转复位法可以有效的改善超重及肥胖患者的腰部疼痛及功能活动,临床疗效确切。
Objective:To observe the clinical effect of lumbar rotation reduction in the treatment of patients with degenerative spondylolisthesis with increased BMI index. Methods:In 535 patients with degenerative lumbar spondylolisthesis,286 patients who met the standard of BMI index increased(BMI index>24 kg/m2),including 149 cases in the treatment group and 137 cases in the control group. The treatment group received lumbar rotation reduction method combined with lumbar rehabilitation;the control group received lumbar traction combined with lumbar fixation. JOA score,VAS score and therapeutic index were observed in the two groups after treatment. Results:After treatment,the JOA scores of the two groups were significantly higher than those before treatment,VAS scores were significantly decreased,and the differences were statistically significant(P<0.01),the treatment group after treatment JOA score,VAS score and efficacy index were better than the control group,and the difference was statistically significant(P<0.01). Conclusion:Lumbar rotation reduction can effectively improve the waist pain and functional activity of overweight and obese patients,and the clinical effect is explicit.
Objective:To observe the clinical effect of lumbar rotation reduction in the treatment of patients with degenerative spondylolisthesis with increased BMI index. Methods:In 535 patients with degenerative lumbar spondylolisthesis,286 patients who met the standard of BMI index increased(BMI index>24 kg/m2),including 149 cases in the treatment group and 137 cases in the control group. The treatment group received lumbar rotation reduction method combined with lumbar rehabilitation;the control group received lumbar traction combined with lumbar fixation. JOA score,VAS score and therapeutic index were observed in the two groups after treatment. Results:After treatment,the JOA scores of the two groups were significantly higher than those before treatment,VAS scores were significantly decreased,and the differences were statistically significant(P<0.01),the treatment group after treatment JOA score,VAS score and efficacy index were better than the control group,and the difference was statistically significant(P<0.01). Conclusion:Lumbar rotation reduction can effectively improve the waist pain and functional activity of overweight and obese patients,and the clinical effect is explicit.
引文
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[16]Zdero R,Shah S,Mosli M,et al. The effect of the screw pull-out rate on cortical screw purchase in unreamed and reamedsynthetic long bones[J]. Proceedings of the Institution ofMechanical Engineers Part H:Journal of engineering inmedicine,2010,224(3):503-513.
[17]Vibert BT,Sliva CD,Herkowitz HN. Treatment of instabilityand spondylolisthesis:surgical versus nonsurgical treatment[J].Clinical orthopaedics and related research,2006,443:222-227.
[18]李娜.退行性腰椎滑脱症保守治疗后配合中医护理临床观察[J].辽宁中医药大学学报,2017,19(6):219-221.
[19]彭海,刘金成,李进选.中医正骨推拿手法治疗退行性腰椎滑脱症临床研究[J].亚太传统医药,2017,13(13):113-114.
[20]任飞龙,郭俊,王洪伟,等.经皮椎间孔镜治疗肥胖患者腰椎间盘突出症的疗效分析[J].局解手术学杂志,2017,26(12):881-885.
[21]Kalichman L,Guermazi A,Li L,et al. Association between age,sex,BMI and CT-evaluated spinal degeneration features[J].JBack Musculoskelet Rehabil,2009,22(4):189-195.
[22]许建文,冀晶,钟远鸣,等.肥胖女性腰椎间盘突出症椎间盘退变的病例对照研究[J].广西中医学院学报,2011,14(3):38-39.
[23]Fanuele JC,Abdu WA,Hanscom B,et al. Association betweenobesity and functional status in patients with spine disease[J].Spine,2002,27(3):306-312.
[24]李晓燕,姜勇,胡楠,等.2010年我国成年人超重及肥胖流行特征[J].中华预防医学杂志,2012,46(8):683-686.
[25]Sing D,Yue J,Metz L,et al. Obesity is an independent riskfactor of early complications after revision spine surgery[J].Spine,2016,41(10):E632-640.
[2]李怡岚,郑战伟,宋俊岭,等.针刺加用参茸延龄片治疗退行性腰椎滑脱症临床观察[J].陕西中医,2017,38(5):658-660.
[3]闫广辉,李志赏,赵磊,等.退行性腰椎滑脱症患者椎旁肌变化的影像学分析[J].中国临床研究,2017,30(4):509-511.
[4]彭海,刘金成,李进选.中医正骨推拿手法治疗退行性腰椎滑脱症临床研究[J].亚太传统医药,2017,13(13):113-114.
[5]李晓燕,姜勇,胡楠,等.2010年我国成年人超重及肥胖流行特征[J].中华预防医学杂志,2012(8):683-686.
[6]韩静,王亚平,张炜,等.中药健脾祛湿法结合运动干预肥胖症临床疗效观察[J].时珍国医国药,2017,28(8):1924-1926.
[7]曾业龙,陈东,赖美桂,等.体重指数对腰椎牵引治疗腰椎间盘突出症效果影响[J].右江民族医学院学报,2013,35(1):32-33.
[8]Kirkaldy-Willis WH,Farfan HF. Instability of the lumbar spine[J].Clin Orthop Relat Res,1982,165:110-112.
[9]朱立国,于杰,高景华,等.中医正骨推拿手法治疗退行性腰椎滑脱症的临床研究[J].北京中医,2006(10):579-582.
[10]孙树椿.实用推拿手法彩色图谱[M].北京:中国医药科技出版社,1988:48,139.
[11]于杰,朱立国,高景华,等.退行性腰椎滑脱症治疗与康复方案的临床研究[J].中国中医骨伤科杂志,2016,24(11):11-14.
[12]井上骏一.腰痛治疗成绩判定基准[J].日本整形外科学会杂志,1986,60:391-394.
[13]刘键.三种手术方式治疗老年人退行性腰椎滑脱的疗效比较[D].吉林:吉林大学,2009.
[14]Derman PB,Albert TJ. Interbody fusion techniques in thesurgical management ofdegenerative lumbar spondylolisthesis[J].Current reviews in musculoskeletal medicine,2017,10(4):530-538.
[15]Epstein NE,Hollingsworth RD. Nursing review of diagnosis andtreatment of lumbar degenerative spondylolisthesis[J].Surgicalneurology international,2017,8:246.
[16]Zdero R,Shah S,Mosli M,et al. The effect of the screw pull-out rate on cortical screw purchase in unreamed and reamedsynthetic long bones[J]. Proceedings of the Institution ofMechanical Engineers Part H:Journal of engineering inmedicine,2010,224(3):503-513.
[17]Vibert BT,Sliva CD,Herkowitz HN. Treatment of instabilityand spondylolisthesis:surgical versus nonsurgical treatment[J].Clinical orthopaedics and related research,2006,443:222-227.
[18]李娜.退行性腰椎滑脱症保守治疗后配合中医护理临床观察[J].辽宁中医药大学学报,2017,19(6):219-221.
[19]彭海,刘金成,李进选.中医正骨推拿手法治疗退行性腰椎滑脱症临床研究[J].亚太传统医药,2017,13(13):113-114.
[20]任飞龙,郭俊,王洪伟,等.经皮椎间孔镜治疗肥胖患者腰椎间盘突出症的疗效分析[J].局解手术学杂志,2017,26(12):881-885.
[21]Kalichman L,Guermazi A,Li L,et al. Association between age,sex,BMI and CT-evaluated spinal degeneration features[J].JBack Musculoskelet Rehabil,2009,22(4):189-195.
[22]许建文,冀晶,钟远鸣,等.肥胖女性腰椎间盘突出症椎间盘退变的病例对照研究[J].广西中医学院学报,2011,14(3):38-39.
[23]Fanuele JC,Abdu WA,Hanscom B,et al. Association betweenobesity and functional status in patients with spine disease[J].Spine,2002,27(3):306-312.
[24]李晓燕,姜勇,胡楠,等.2010年我国成年人超重及肥胖流行特征[J].中华预防医学杂志,2012,46(8):683-686.
[25]Sing D,Yue J,Metz L,et al. Obesity is an independent riskfactor of early complications after revision spine surgery[J].Spine,2016,41(10):E632-640.