| 不同作用方向的整复手法治疗腰椎间盘突出症
临床疗效观察 |
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投稿时间：2009-02-17
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| 作者 | Author | 单位 | Address | E-Mail |
| 吕立江 |
LV Li-jiang |
浙江中医药大学第三临床医学院,浙江 杭州 310053 |
The Third Clinical Medical College of Zhejiang TCM University,Hangzhou 310053,Zhejiang,China |
lvlj0288@sina.com |
| 金叶道 |
JIN Ye-dao |
温州市曙光医院 |
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| 郑如云 |
ZHENG Ru-yun |
杭州市下城区中医院 |
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| 范炳华 |
FAN Bing-hua |
浙江中医药大学第三临床医学院,浙江 杭州 310053 |
The Third Clinical Medical College of Zhejiang TCM University,Hangzhou 310053,Zhejiang,China |
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| 杨米雄 |
YANG Mi-xiong |
浙江省中医院 |
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| 应晓明 |
YING Xiao-ming |
浙江中医药大学第三临床医学院,浙江 杭州 310053 |
The Third Clinical Medical College of Zhejiang TCM University,Hangzhou 310053,Zhejiang,China |
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| 王琪凯 |
WANG Qi-kai |
温州市曙光医院 |
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| 张文波 |
ZHANG Wen-bo |
温州市曙光医院 |
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| 期刊信息：《中国骨伤》2009年，第22卷，第4期，第255-258页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
| 基金项目: |
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中文摘要:
目的：比较向前方向作用的后伸卷腰扳动定位整复手法和向左右方向作用旋转扳动整复手法治疗腰椎间盘突出症的疗效。
方法：腰椎间盘突出症209例，男131例，女78例；年龄20～79岁，其中50岁以上58例。膨出型92例，突出型69例，游离型48例。209例按随机数字表法分为治疗组(107例)和对照组(102例):治疗组采用牵引治疗仪持续牵引30 min后，用后伸卷腰扳动定位整复手法治疗；对照组采用牵引治疗仪持续牵引30 min后，用旋转腰部扳动整复手法治疗。隔1 d治疗1次，3次为1个疗程。观察患者的症状和体征(包括腰部疼痛与不适、下肢疼痛与麻木、大小便无力与会阴麻木、直腿抬高程度、下肢行走能力、工作生活能力),并按疗效标准比较两种治疗方法的治疗效果的差异。
结果：两组患者均获随访，时间1～6个月，平均3.2个月。治疗1个疗程后，治疗组与对照组的症状与体征各方面较治疗前均有较大改善(P<0.01),其中治疗组在腰部疼痛与不适、下肢行走能力方面优于对照组(P<0.05).按疗效评定标准：治疗组疗效优于对照组，两组疗效比较差异有统计学意义(P<0.01).膨出型治疗组47例，对照组45例，治疗组优于对照组(P<0.05);突出型治疗组35例，对照组34例，治疗组比对照组有效率高，但差异无统计学意义(P>0.05).游离型治疗组25例，对照组23例，对照组比治疗组有效率高，但差异无统计学意义(P>0.05).
结论：后伸卷腰扳动定位整复手法比旋转扳动整复手法治疗腰椎间盘突出症的整体疗效满意，但游离型的腰椎间盘突出症选择旋转扳动整复手法更好。 |
| 【关键词】椎间盘移位 腰椎 正骨手法 临床对照试验 |
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| The observe of clinical effect of treating lumbar intervertebral disc herniation by bone setting manipulation of different directions |
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ABSTRACT
Objective: To compare the effect between lumbar backwards flexion manipulation and rotating manipulation for treating lumbar intervertebral disc herniation.
Methods: Two hundred and nine patients of lumbar intervertebral disc herniation, male 131,female 78,the age from 20 to 79 years old,58 cases of all these patients age above 50.According to diagnosis the ladder of the 92 cases bulging type,69 hernia type,48 cases free type. The patients were randomly divided into treatment group(107 cases) and control group(102 cases). All the patients were treated with the three-dimensional computer-controlled traction therapeutic apparatus,with continued traction for 30 minutes. After traction,lumbar backwards flexion manipulation and rotating manipulation were respectively adopted in treatment group and control group(on alternate days one time,3 times as a course of treatment).The symptoms and signs (including back pain and discomfort,lower limb pain and numbness,powerless urination and defecation,numbness in perineum,straight-leg raising degree,ability of lower extremity walking,work and live) of patients were observed after treatment.
Results: All the patients were followed up from 1 to 6 months with an average of 3.2 months. After treatment,the symptoms and signs of patients have markedly improved(P<0.01),but the lower back pain and discomfort,lower limb walking ability in treatment group were better than control group(P<0.05). According therapeutic criteria, the effect of treatment group was better than of control group(P<0.01). In cases with bulging type,47 in treatment group and 45 in control group,the effect of treatment group was better than of control group(P<0.05); in cases with hernia type,35 in treatment group and 34 in control group,there was no significantly difference in effect between two groups(P>0.05);in cases of free type,25 in treatment group and 23 in control group, there was no significantly difference in effect between two groups(P>0.05).
Conclusion: The global effect of lumbar backwards flexion manipulation was satisfactory than rotating manipulation for treating lumbar intervertebral disc herniation. But rotating manipulation suited to free type. |
| KEY WORDS Intervertebral disk displacement Lumbar vertebrae Bone setting manipulation Controlled clinical trials |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 吕立江,金叶道,郑如云,范炳华,杨米雄,应晓明,王琪凯,张文波.不同作用方向的整复手法治疗腰椎间盘突出症
临床疗效观察[J].中国骨伤,2009,22(4):255~258 |
| 英文格式: | LV Li-jiang,JIN Ye-dao,ZHENG Ru-yun,FAN Bing-hua,YANG Mi-xiong,YING Xiao-ming,WANG Qi-kai,ZHANG Wen-bo.The observe of clinical effect of treating lumbar intervertebral disc herniation by bone setting manipulation of different directions[J].zhongguo gu shang / China J Orthop Trauma ,2009,22(4):255~258 |
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