“三法十式”手法治疗腰椎间盘突出症的临床疗效观察
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摘要
研究背景:
腰椎间盘突出症(简称LDP)是骨伤科的常见病,多发病,是引起腰腿痛最常见的病因。本病多发于青壮年,对患者的生活和工作可造成很大影响。国外的研究表明,约有60～80%的人在一生中某个时期要受到下腰痛的困扰,在成人丧失劳动力的原因中,下腰痛排第3位,而其中坐骨神经痛约占下腰痛的25%,而腰椎间盘突出症正是引起坐骨神经痛的主要病因。目前,国际上公认的治疗方法分手术治疗和非手术治疗两大类,对该病的治疗国内外的学者首选非手术治疗。其中,约80～90%的LDP患者可以通过非手术治疗而取效,而手法是非手术治疗中最常用和疗效较为肯定的方法。在这方面,祖国传统医学中的手法推拿占有重要地位,因此,研究和发展腰椎间盘突出症的保守治疗的方法,具有重要的意义。
研究目的:
通过观察比较“三法十式”手法与常规保守方法(中药内服+牵引+物理治疗)治疗腰椎间盘突出症,确定“三法十式”手法治疗腰椎间盘突出症的临床疗效。
研究方法:
按纳入与排除标准,选取广东省中医院珠海医院骨科门诊以及住院患者,采用随机对照研究方法,将符合要求的80例腰椎间盘突出症患者随机分为治疗组(40例)和对照组(40例)。治疗组采用“三法十式”手法治疗,对照组采用常规保守方法(中药内服+牵引+物理治疗)治疗,两组患者均以10天为一个疗程。每一组患者均采用国际通用的JOA评定量表及VAS评分量表为观察指标,观察记录两组患者的临床症状、体征、治疗前后以及1个月后复诊随访的评分,比较两组患者治疗前后以及1个月后复诊随访的评分。
研究结果:
共纳入80例患者,入选的病例随机分配为“三法十式”手法治疗组(1组)、常规保守治疗组(2组),组间病例数比为1:1。其中手法治疗组男性患者19例、女性患者21例,平均年龄43.10岁,病程最长为4年8个月,最短为2个月;对照组男性23例、女性17例,平均年龄41.83岁,病程最长为4年2个月,最短为3个月。2组患者治疗前JOA评分分别为:10.57±4.01、10.27±4.25;VAS评分分别为:5.30±1.64、5.50±1.46。2组患者在性别、年龄、病程、治疗前JOA评分及VAS评分等方面均无差异(P＞0.05),2组病例具有可比性。两组患者无脱落、剔除病例。治疗结束后(10天)治疗组及对照组患者JOA评分分别为:22.27±2.92、22.57±2.40,3个月后复诊随访JOA评分分别为:20.53±2.64、21.06±2.57;VAS评分分别为:1.97±1.14、1.77±1.40,1个月后复诊随访VAS评分分别为:2.20±0.66、1.80±0.99。治疗组和对照组JOA评分改善率为优、良、中、差的病例分别为11例(占27.5%)、21例(占52.5%)、6例(占15.0%)、2例(占5.0%)和14例(占35.0%)、22例(占55.0%)、3例(占7.5%)、1例(占2.5%)。“三法十式”手法治疗组和常规保守治疗组疗效经统计学处理无显著差异(P＞0.05)。
结论:
“三法十式”手法和常规保守方法治疗腰椎间盘突出症有相当的疗效。
Background:
Lumbar disc herniation(LDP)is the frequently-occurring and common disease of the orthopedics,which is the most common causes of low back pain.The disease be more to happen in young adults and can cause very serious impact of the patients' live and work.Foreign studies show that about 60 to 80 percent of the people in a certain period in their lives to be plagued by low back pain.In the reasons for the loss of labor in adults,low back pain ranked No.3.Sciatica is about 25%of low back pain, and the lumbar disc herniation is a major cause of sciatica.At present, internationally recognized that the treatment divided in to two categories,the surgical treatment and non-surgical treatment.Most scholars of home and abroad preferred non-surgical treatment.In fact, about 80 to 90 percent patients of the LDP can take effect with non-surgical treatment,and the manipulation is the most commonly used and the certainly effect method.In this regard,the manipulation occupies an important position in traditional chinese medicine.Therefore, researching and developing the conservative treatment methods of lumbar disc herniation have great significance.
Objective:
Comparing 'Ten-Three Manipulations' to conventional conservative methods(internal herbs+traction+physical therapy)treat the patient of lumbar disc herniation.Obsver the clinical efficacy of 'Ten-Three Manipulations' in the treatment of lumbar disc herniation.
Methods:
Selecting the outpatients ang inpatients of orthopedics in Guangdong hospital of Traditional Chinese Medicine Zhuhai Branch by instandards and outstandards.Using randomized controlled study methods,meeting requirements of the 80 cases of lumbar disc herniation were randomly divided into treatment group(40 cases)and the control group(40 cases). The treatment group used 'Ten-Three Manipulations' and the control group used conventional conservative methods(internal herbs + traction + physical therapy),two groups are in a course of treatment for 10 days. Each group is used universal International JOA scale and VAS scale for the observation indicators.Observing andr recording the clinical symptoms,signs,the score before and after treatment and a follow-up on after the referral of each patient.Comparing the score of two groups patients before and after treatment and On a follow-up after referral.
Results:
Into a total of 80 patients,the patient were randomly divided into treatment group(40 cases)and the control group(40 cases).The group number of cases is 1:1.The treatment group of male patients were 19 cases, and 21 cases of female.The average age was 43.10 years old.The longest duration was 4 years and 8 months,and the minimum of two months.The control group of male patients were 23 cases,and 17 cases of women,The average age was 41.83 years old,The longest duration was 4 years and 2 months,and the minimum of three months.2 group patients before treatment JOA score were:10.57±4.01,10.27±4.25;VAS score were:5.30±1.64,5.50±1.46.The statistics show that 2 group patients in gender, age,course,treatment before the JOA score and VAS score were no difference(P＞0.05),2 patients are comparable.Two groups of patients with no loss,excluding cases.After the end of treatment(10 days),the treatment group and control group patients JOA score were:22.27±2.92,22.57±2.40,3 one month after referral for follow-up JOA score: 20.53±2.64,21.06±2.57,VAS score were as follows:1.97±1.14,1.77±1.40,3 one month after referral for follow-up VAS score:2.20±0.66,1.80±0.99.Treatment and control groups of JOA score improvement rate as excellent,good,medium and poor cases were 11 cases(27.5%),21 cases(52.5%),6 cases(15.0%),2 cases(5.0%)and 14 cases(35.0%),22 cases(55.0%),3 cases(7.5 percent),1 cases(2.5 percent).By Statistics the effect of 'Ten-Three Manipulations' and conventional conservative treatment to treating LDP have no significantly different(P＞0.05).
Conclusion:
'Ten-Three Manipulations' and methods of conventional conservative treatment of lumbar disc herniation have considerable effect.
腰椎间盘突出症(简称LDP)是骨伤科的常见病,多发病,是引起腰腿痛最常见的病因。本病多发于青壮年,对患者的生活和工作可造成很大影响。国外的研究表明,约有60～80%的人在一生中某个时期要受到下腰痛的困扰,在成人丧失劳动力的原因中,下腰痛排第3位,而其中坐骨神经痛约占下腰痛的25%,而腰椎间盘突出症正是引起坐骨神经痛的主要病因。目前,国际上公认的治疗方法分手术治疗和非手术治疗两大类,对该病的治疗国内外的学者首选非手术治疗。其中,约80～90%的LDP患者可以通过非手术治疗而取效,而手法是非手术治疗中最常用和疗效较为肯定的方法。在这方面,祖国传统医学中的手法推拿占有重要地位,因此,研究和发展腰椎间盘突出症的保守治疗的方法,具有重要的意义。
研究目的:
通过观察比较“三法十式”手法与常规保守方法(中药内服+牵引+物理治疗)治疗腰椎间盘突出症,确定“三法十式”手法治疗腰椎间盘突出症的临床疗效。
研究方法:
按纳入与排除标准,选取广东省中医院珠海医院骨科门诊以及住院患者,采用随机对照研究方法,将符合要求的80例腰椎间盘突出症患者随机分为治疗组(40例)和对照组(40例)。治疗组采用“三法十式”手法治疗,对照组采用常规保守方法(中药内服+牵引+物理治疗)治疗,两组患者均以10天为一个疗程。每一组患者均采用国际通用的JOA评定量表及VAS评分量表为观察指标,观察记录两组患者的临床症状、体征、治疗前后以及1个月后复诊随访的评分,比较两组患者治疗前后以及1个月后复诊随访的评分。
研究结果:
共纳入80例患者,入选的病例随机分配为“三法十式”手法治疗组(1组)、常规保守治疗组(2组),组间病例数比为1:1。其中手法治疗组男性患者19例、女性患者21例,平均年龄43.10岁,病程最长为4年8个月,最短为2个月;对照组男性23例、女性17例,平均年龄41.83岁,病程最长为4年2个月,最短为3个月。2组患者治疗前JOA评分分别为:10.57±4.01、10.27±4.25;VAS评分分别为:5.30±1.64、5.50±1.46。2组患者在性别、年龄、病程、治疗前JOA评分及VAS评分等方面均无差异(P＞0.05),2组病例具有可比性。两组患者无脱落、剔除病例。治疗结束后(10天)治疗组及对照组患者JOA评分分别为:22.27±2.92、22.57±2.40,3个月后复诊随访JOA评分分别为:20.53±2.64、21.06±2.57;VAS评分分别为:1.97±1.14、1.77±1.40,1个月后复诊随访VAS评分分别为:2.20±0.66、1.80±0.99。治疗组和对照组JOA评分改善率为优、良、中、差的病例分别为11例(占27.5%)、21例(占52.5%)、6例(占15.0%)、2例(占5.0%)和14例(占35.0%)、22例(占55.0%)、3例(占7.5%)、1例(占2.5%)。“三法十式”手法治疗组和常规保守治疗组疗效经统计学处理无显著差异(P＞0.05)。
结论:
“三法十式”手法和常规保守方法治疗腰椎间盘突出症有相当的疗效。
Background:
Lumbar disc herniation(LDP)is the frequently-occurring and common disease of the orthopedics,which is the most common causes of low back pain.The disease be more to happen in young adults and can cause very serious impact of the patients' live and work.Foreign studies show that about 60 to 80 percent of the people in a certain period in their lives to be plagued by low back pain.In the reasons for the loss of labor in adults,low back pain ranked No.3.Sciatica is about 25%of low back pain, and the lumbar disc herniation is a major cause of sciatica.At present, internationally recognized that the treatment divided in to two categories,the surgical treatment and non-surgical treatment.Most scholars of home and abroad preferred non-surgical treatment.In fact, about 80 to 90 percent patients of the LDP can take effect with non-surgical treatment,and the manipulation is the most commonly used and the certainly effect method.In this regard,the manipulation occupies an important position in traditional chinese medicine.Therefore, researching and developing the conservative treatment methods of lumbar disc herniation have great significance.
Objective:
Comparing 'Ten-Three Manipulations' to conventional conservative methods(internal herbs+traction+physical therapy)treat the patient of lumbar disc herniation.Obsver the clinical efficacy of 'Ten-Three Manipulations' in the treatment of lumbar disc herniation.
Methods:
Selecting the outpatients ang inpatients of orthopedics in Guangdong hospital of Traditional Chinese Medicine Zhuhai Branch by instandards and outstandards.Using randomized controlled study methods,meeting requirements of the 80 cases of lumbar disc herniation were randomly divided into treatment group(40 cases)and the control group(40 cases). The treatment group used 'Ten-Three Manipulations' and the control group used conventional conservative methods(internal herbs + traction + physical therapy),two groups are in a course of treatment for 10 days. Each group is used universal International JOA scale and VAS scale for the observation indicators.Observing andr recording the clinical symptoms,signs,the score before and after treatment and a follow-up on after the referral of each patient.Comparing the score of two groups patients before and after treatment and On a follow-up after referral.
Results:
Into a total of 80 patients,the patient were randomly divided into treatment group(40 cases)and the control group(40 cases).The group number of cases is 1:1.The treatment group of male patients were 19 cases, and 21 cases of female.The average age was 43.10 years old.The longest duration was 4 years and 8 months,and the minimum of two months.The control group of male patients were 23 cases,and 17 cases of women,The average age was 41.83 years old,The longest duration was 4 years and 2 months,and the minimum of three months.2 group patients before treatment JOA score were:10.57±4.01,10.27±4.25;VAS score were:5.30±1.64,5.50±1.46.The statistics show that 2 group patients in gender, age,course,treatment before the JOA score and VAS score were no difference(P＞0.05),2 patients are comparable.Two groups of patients with no loss,excluding cases.After the end of treatment(10 days),the treatment group and control group patients JOA score were:22.27±2.92,22.57±2.40,3 one month after referral for follow-up JOA score: 20.53±2.64,21.06±2.57,VAS score were as follows:1.97±1.14,1.77±1.40,3 one month after referral for follow-up VAS score:2.20±0.66,1.80±0.99.Treatment and control groups of JOA score improvement rate as excellent,good,medium and poor cases were 11 cases(27.5%),21 cases(52.5%),6 cases(15.0%),2 cases(5.0%)and 14 cases(35.0%),22 cases(55.0%),3 cases(7.5 percent),1 cases(2.5 percent).By Statistics the effect of 'Ten-Three Manipulations' and conventional conservative treatment to treating LDP have no significantly different(P＞0.05).
Conclusion:
'Ten-Three Manipulations' and methods of conventional conservative treatment of lumbar disc herniation have considerable effect.
引文
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