核心区力量训练和电针干预对大学生腰肌劳损有协同治疗作用
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摘要
背景:腰肌劳损病因不明,属于非特异性腰痛,其不仅影响生活与工作,也造成沉重医疗负担与间接社会成本。目的:探讨核心区力量训练与电针对大学生腰肌劳损的干预作用。方法:研究方案的实施符合广西师范大学对研究的相关伦理要求。选择80名大学生腰肌劳损志愿者,所有受试者对试验方案均知情同意并签署了知情同意书。随机将80名受试者分为对照组、电针组、核心区力量组、电针核心区力量组。对照组不采取任何干预措施,电针组采用电针干预,核心区力量组采用核心区力量训练干预,电针核心区力量组采用电针和核心区力量的联合干预。干预时间为7周,记录治疗前、治疗后的目测类比评分与疼痛症状积分,并追踪4个月观察其复发率。结果与结论:①与干预前相比,电针组、核心区力量组、电针核心区力量组的目测类比评分、疼痛症状综合评分均显著下降(P <0.05);②干预后电针组、核心区力量组、电针核心区力量组的目测类比评分及疼痛症状综合评分均显著小于对照组,其中电针核心区力量组疼痛症状综合评分又显著小于电针组、核心区力量组(P <0.05);③核心区力量组、电针核心区力量组的痊愈率高于电针组,核心区力量组、电针核心区力量组的疗效优于电针组(P <0.05);④核心区力量组、电针核心区力量组的复发率低于电针组(P <0.05);⑤结果说明,电针与核心区力量训练对大学生腰肌劳损均有治疗作用,但核心区力量训练的疗效优于电针,复发率也低于电针;电针联合核心区力量训练对大学生腰肌劳损具有协同治疗作用。
BACKGROUND: The etiology of lumbar muscle strain is unclear, and it is a kind of specific disease. Lumbar muscles strain not only affects quality of life and work, but also causes heavy medical burden and indirect social costs.OBJECTIVE: To explore the effect of electropuncture and core strength training on lumbar muscle strain in college students.METHODS: The study was in accordance with the ethics requirements of Guangxi Normal University. Eighty college students with lumbar muscle strain were selected, and they signed the informed consents. The participants were randomized into control group(no intervention),electropuncture group, core strength training group, electropuncture with core strength training group. The intervention time was 7 weeks. The Visual Analogue Scale scores and pain system scores at baseline and after treatment were recorded. The recurrence was measured after 4 months of follow-up.RESULTS AND CONCLUSION:(1) The Visual Analogue Scale scores and pain system scores in the electropuncture, core strength training,and electropuncture with core strength training groups were significantly decreased compared with the baseline scores(P < 0.05).(2) The Visual Analogue Scale scores and pain system scores in the electropuncture, core strength training, and electropuncture with core strength training groups were significantly lower than those in the control group after intervention, and the scores in the electropuncture with core strength training group were significantly lower than those in the electropuncture and core strength training groups(P < 0.05).(3) The healing rate in the core strength training and electropuncture with core strength training groups was significantly higher than that in the electropuncture group, and the treatment efficacy in the core strength training and electropuncture with core strength training groups was significantly superior to the electropuncture group(P < 0.05).(4) The recurrence in the core strength training and electropuncture with core strength training groups was significantly lower than that in the electropuncture group(P < 0.05).(5) These results indicate that electropuncture and core strength training both have certain treatment efficacy for lumbar muscle strain in college students and core strength training is better than electropuncture, with lower recurrence. The synergistic effect of the combination of core strength training and electropuncture for lumbar muscle strain in college students is remarkable.
BACKGROUND: The etiology of lumbar muscle strain is unclear, and it is a kind of specific disease. Lumbar muscles strain not only affects quality of life and work, but also causes heavy medical burden and indirect social costs.OBJECTIVE: To explore the effect of electropuncture and core strength training on lumbar muscle strain in college students.METHODS: The study was in accordance with the ethics requirements of Guangxi Normal University. Eighty college students with lumbar muscle strain were selected, and they signed the informed consents. The participants were randomized into control group(no intervention),electropuncture group, core strength training group, electropuncture with core strength training group. The intervention time was 7 weeks. The Visual Analogue Scale scores and pain system scores at baseline and after treatment were recorded. The recurrence was measured after 4 months of follow-up.RESULTS AND CONCLUSION:(1) The Visual Analogue Scale scores and pain system scores in the electropuncture, core strength training,and electropuncture with core strength training groups were significantly decreased compared with the baseline scores(P < 0.05).(2) The Visual Analogue Scale scores and pain system scores in the electropuncture, core strength training, and electropuncture with core strength training groups were significantly lower than those in the control group after intervention, and the scores in the electropuncture with core strength training group were significantly lower than those in the electropuncture and core strength training groups(P < 0.05).(3) The healing rate in the core strength training and electropuncture with core strength training groups was significantly higher than that in the electropuncture group, and the treatment efficacy in the core strength training and electropuncture with core strength training groups was significantly superior to the electropuncture group(P < 0.05).(4) The recurrence in the core strength training and electropuncture with core strength training groups was significantly lower than that in the electropuncture group(P < 0.05).(5) These results indicate that electropuncture and core strength training both have certain treatment efficacy for lumbar muscle strain in college students and core strength training is better than electropuncture, with lower recurrence. The synergistic effect of the combination of core strength training and electropuncture for lumbar muscle strain in college students is remarkable.
引文
[1]Qaseem A,Wilt TJ,McLean RM,et al.Noninvasive Treatments for Acute,Subacute,and Chronic Low Back Pain:A Clinical Practice Guideline From the American Col ege of Physicians.Ann Intern Med.2017;66(7):514-530.
[2]中国康复医学会脊柱脊髓专业委员会专家组.中国急/慢性非特异性腰背痛诊疗专家共识[J].中国脊柱脊髓杂志,2016,26(12):1134-1138.
[3]National Institute for Health and Care Excellence.Low back pain and sciatica in over 16s:assessment and management(NG59).https://www.nice.org.uk/guidance/ng 59,2016.
[4]宋丰军,胡建锋,张红,等.理筋促通手法配合膀胱经走罐治疗腰肌劳损80例临床分析[J].辽宁中医杂志,2015,42(7):1248-1259.
[5]宋斌,宋红,王鸿儒,等.腰宁汤联合麝香止痛贴膏治疗寒湿瘀阻型慢性腰肌劳损的临床评价[J].中国实验方剂学杂志,2016,22(18):159-163.
[6]张宏发.火针配合小针刀治疗慢性腰肌劳损58例[J].中国针灸,2014,34(6):572.
[7]付蔷,李超,崔清国.针灸配合中医定向透药治疗腰肌劳损疗效观察[J].中国实验方剂学杂志,2016,35(2):192-194.
[8]莫凯祺.针刺配合放血疗法治疗慢性腰肌劳损症37例[J].中国实验方剂学杂志,2017,20(1):27-28.
[9]黄萍萍,廖军,郑佳璇,等.艾灸疗法治疗腰腿痛的文献研究[J].时珍国医国药,2015,26(2):407-408.
[10]秦玉革,王峰,秦玉恒,等.国家中医药管理局.中医意气针灸疗法综合治疗寒湿型腰肌劳损临床研究[J].中国针灸,2015,35(11):1117-1119.
[11]木志友,邹蕊,李亮.改善慢性腰肌劳损康复治疗手段的比较研究[J].北京体育大学学报,2014,37(12):67-71.
[12]中共中央国务院.“健康中国2030”规划纲要[Z].2016.10.
[13]国家中医药管理局.中医病症诊断疗效标准[J].南京:南京大学出版社,1994:151-190.
[14]南登昆,郭正成.康复医学临床指南[M].北京:科学出版社,1999:10-17.
[15]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:6342-6345.
[16]袁秀丽.盲针治疗腰椎间盘突出症临床观察[J].中国针灸,2004,24(3):173.
[17]励瑞芬,;向东.电针治疗腰肌分损疗效的对比研究[J].上海医药,2012,33(8):33-34.
[18]王安利,矫玮.运动康复技术[M].北京:北京体育大学出版社,2015.
[19]赵星,罗冬梅,单西瑶,等.腰椎稳定性对NLBP患者躯干肌群形态机能特性的影响[J].北京体育大学学报,2016,39(7):52-58.
[20]黎涌明,于洪军,资薇,等.论核心力量及其在竞技体育中的训练一起源问题发展[J].体育科学,2008,28(4):19-29.
[21]汪敏加,张艺宏,宋思琦.核心稳定性运动对慢性非特异性腰痛患者腰骶结构的影响[J].首都体育学院学报,2017,29(5):459-462
[22]陈炳霖,郭佳宝,李欣,等.青年慢性非特异性腰痛患者腰部本体感觉及其与肌力的相关性[J].中国康复医学杂志,2017,32(2):187-191.
[23]Puntumetakul R,Chalermsan R,Hlaing SS,et al.The effect of core stabilization exercise on lumbar joint position sense in patients with subacute non-specific low back pain:a randomized controlled trial.JPhys Ther Sci,2018;30(11):1390-1395.
[24]Alanazi MH,Parent EC,Dennett E.Effect of stabilization exercise on back pain,disability and quality of life in adults with scoliosis:a systematic review.Eur J Phys Rwhab Med.2018;54(5):647-653.
[25]Young KJ,Je CW,Hwa ST.Effect of proprioceptive neuromuscular facilitation integration pattern and swiss ball training on pain and balance in elderly patients with chronic back pain.J Phys Ther Sci.2015;27(10):3237-3240.
[26]Kumar T,Kumar S,Nezamuddin M,et al.Efficacy of core muscle strengthening exercise in chronic low back pain patients.J Back Musculoskelet Rehabil.2015;28(4):699-707.
[2]中国康复医学会脊柱脊髓专业委员会专家组.中国急/慢性非特异性腰背痛诊疗专家共识[J].中国脊柱脊髓杂志,2016,26(12):1134-1138.
[3]National Institute for Health and Care Excellence.Low back pain and sciatica in over 16s:assessment and management(NG59).https://www.nice.org.uk/guidance/ng 59,2016.
[4]宋丰军,胡建锋,张红,等.理筋促通手法配合膀胱经走罐治疗腰肌劳损80例临床分析[J].辽宁中医杂志,2015,42(7):1248-1259.
[5]宋斌,宋红,王鸿儒,等.腰宁汤联合麝香止痛贴膏治疗寒湿瘀阻型慢性腰肌劳损的临床评价[J].中国实验方剂学杂志,2016,22(18):159-163.
[6]张宏发.火针配合小针刀治疗慢性腰肌劳损58例[J].中国针灸,2014,34(6):572.
[7]付蔷,李超,崔清国.针灸配合中医定向透药治疗腰肌劳损疗效观察[J].中国实验方剂学杂志,2016,35(2):192-194.
[8]莫凯祺.针刺配合放血疗法治疗慢性腰肌劳损症37例[J].中国实验方剂学杂志,2017,20(1):27-28.
[9]黄萍萍,廖军,郑佳璇,等.艾灸疗法治疗腰腿痛的文献研究[J].时珍国医国药,2015,26(2):407-408.
[10]秦玉革,王峰,秦玉恒,等.国家中医药管理局.中医意气针灸疗法综合治疗寒湿型腰肌劳损临床研究[J].中国针灸,2015,35(11):1117-1119.
[11]木志友,邹蕊,李亮.改善慢性腰肌劳损康复治疗手段的比较研究[J].北京体育大学学报,2014,37(12):67-71.
[12]中共中央国务院.“健康中国2030”规划纲要[Z].2016.10.
[13]国家中医药管理局.中医病症诊断疗效标准[J].南京:南京大学出版社,1994:151-190.
[14]南登昆,郭正成.康复医学临床指南[M].北京:科学出版社,1999:10-17.
[15]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:6342-6345.
[16]袁秀丽.盲针治疗腰椎间盘突出症临床观察[J].中国针灸,2004,24(3):173.
[17]励瑞芬,;向东.电针治疗腰肌分损疗效的对比研究[J].上海医药,2012,33(8):33-34.
[18]王安利,矫玮.运动康复技术[M].北京:北京体育大学出版社,2015.
[19]赵星,罗冬梅,单西瑶,等.腰椎稳定性对NLBP患者躯干肌群形态机能特性的影响[J].北京体育大学学报,2016,39(7):52-58.
[20]黎涌明,于洪军,资薇,等.论核心力量及其在竞技体育中的训练一起源问题发展[J].体育科学,2008,28(4):19-29.
[21]汪敏加,张艺宏,宋思琦.核心稳定性运动对慢性非特异性腰痛患者腰骶结构的影响[J].首都体育学院学报,2017,29(5):459-462
[22]陈炳霖,郭佳宝,李欣,等.青年慢性非特异性腰痛患者腰部本体感觉及其与肌力的相关性[J].中国康复医学杂志,2017,32(2):187-191.
[23]Puntumetakul R,Chalermsan R,Hlaing SS,et al.The effect of core stabilization exercise on lumbar joint position sense in patients with subacute non-specific low back pain:a randomized controlled trial.JPhys Ther Sci,2018;30(11):1390-1395.
[24]Alanazi MH,Parent EC,Dennett E.Effect of stabilization exercise on back pain,disability and quality of life in adults with scoliosis:a systematic review.Eur J Phys Rwhab Med.2018;54(5):647-653.
[25]Young KJ,Je CW,Hwa ST.Effect of proprioceptive neuromuscular facilitation integration pattern and swiss ball training on pain and balance in elderly patients with chronic back pain.J Phys Ther Sci.2015;27(10):3237-3240.
[26]Kumar T,Kumar S,Nezamuddin M,et al.Efficacy of core muscle strengthening exercise in chronic low back pain patients.J Back Musculoskelet Rehabil.2015;28(4):699-707.