| 调脊手法治疗退行性脊柱侧凸症的临床疗效观察 |
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投稿时间：2021-06-19
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| 作者 | Author | 单位 | Address | E-Mail |
| 李路广 |
LI Lu-guang |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100102, China |
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| 高景华 |
GAO Jing-hua |
中国中医科学院望京医院, 北京 100102
中医正骨技术北京市重点实验室, 北京 100102 |
Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100102, China |
gaojinghua64@sina.com |
| 高春雨 |
GAO Chun-yu |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100102, China |
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| 孙武 |
SUN Wu |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100102, China |
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| 罗杰 |
LUO Jie |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100102, China |
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| 杨克新 |
YANG Ke-xin |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100102, China |
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| 于杰 |
YU Jie |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100102, China |
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| 李建国 |
LI Jian-guo |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100102, China |
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| 王宝剑 |
WANG Bao-jian |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100102, China |
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| 杨伟 |
YANG Wei |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100102, China |
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| 庄明辉 |
ZHUANG Ming-hui |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100102, China |
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| 期刊信息：《中国骨伤》2022年，第35卷，第5期，第442-447页 |
| DOI：10.12200/j.issn.1003-0034.2022.05.007 |
| 基金项目:国家中医药管理局国家中医临床研究基地业务建设科研专项课题(编号:JDZX2015271) |
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中文摘要:
目的:观察调脊手法治疗退行性脊柱侧凸症(degenerative scoliosis,DS)的临床疗效。
方法:将2017年6月至2019年9月收治的120例DS患者通过中央随机系统分为治疗组和对照组,每组60例。治疗组采用调脊手法,隔日治疗1次,疗程4周。对照组采用盐酸乙哌立松片口服联合佩戴胸腰椎矫形(thoraco lumbo sacral orthosis,TSLO)支具治疗,每天3次口服盐酸乙哌立松片50 mg,每天佩戴TSLO支具不少于8 h,疗程4周。在病例筛选入组后,于治疗前,治疗后1、2、3、4周和疗程结束后1个月观察两组的疼痛视觉模拟评分(visual analogue scale,VAS)和Oswestry功能障碍指数(Oswestry Disability Index,ODI)。在治疗前和治疗后4周拍摄脊柱全长X线,测量并比较侧凸Cobb角,矢垂直偏距(sagittal vertical axis,SVA),腰椎前凸角(lumbar lordosis,LL)。记录治疗期间的不良反应。
结果:两组治疗后各时间点的VAS、ODI评分与治疗前比较差异均有统计学意义(P<0.001);治疗组在治疗后2周(PVAS=0.025,PODI=0.032)和治疗后3周(PVAS=0.040,PODI=0.044)的VAS、ODI评分与对照组比较差异有统计学意义,而其余时间点的VAS、ODI评分组间比较差异无统计学意义(P>0.05)。治疗组(P=0.010)和对照组(P=0.017)治疗后的Cobb角与治疗前比较差异有统计学意义,而治疗后的LL、SVA与治疗前比较均无统计学意义(P>0.05);两组治疗前后的Cobb角、LL、SVA组间比较差异均无统计学意义(P>0.05)。治疗期间,对照组出现4例轻度不良反应,治疗组未出现不良反应。
结论:调脊手法能有效缓解DS患者的疼痛和改善腰椎功能,见效快于口服盐酸乙哌立松片联合佩戴TSLO支具组,且安全性更好,并能一定程度上改善DS患者的Cobb角。 |
| 【关键词】调脊手法 骨关节炎 脊柱侧凸 随机对照 |
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| Clinical observation of chiropractic manipulation in the treatment of degenerative scoliosis |
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ABSTRACT
Objective: To observe clinical efficacy of chiropractic manipulation in the treatment of degenerative scoliosis (DS).
Methods: From June 2017 to September 2019,120 patients with degenerative scoliosis were randomly divided into treatment group (60 cases) and control group(60 cases). The patients in treatment group were treated with chiropractic manipulation once every other day for 4 weeks. The patients in control group were treated with eperisone hydrochloride tablets combined with thoracolumbar orthopedic(TSLO)brace,oral eperisone hydrochloride tablets 50 mg three times a day,wearing TSLO brace for not less than 8 hours a day. The course of treatment was 4 weeks. After the patients were selected into the group,visual analogue scale (VAS) and Oswestry Disability Index (ODI) were recorded before treatment,1,2,3,4 weeks after treatment and 1 month after treatment. The full length X-ray of the spine was taken before and 4 weeks after treatment,and the scoliosis Cobb angle,sagittal vertical axis (SVA) and lumbar lordosis (LL) were measured and compared. The adverse reactions during the treatment were recorded.
Results: There were significant differences in VAS and ODI between two groups at each time point after treatment (P<0.001),VAS and ODI at 2 weeks after treatment (PVAS=0.025,PODI=0.032) and 3 weeks after treatment(PVAS=0.040,PODI=0.044) in treatment group were significantly different from those in control group,but there was no significant difference in VAS and ODI at other time points between treatment group and control group (P>0.05). There was significant difference in Cobb angle between treatment group(P=0.010) and control group(P=0.017) after treatment,but there was no significant difference in LL and SVA between treatment group and control group. There was no significant difference in Cobb angle,LL and SVA between two groups before and after treatment. During the treatment,there were 4 mild adverse reactions in the control group and no adverse reactions in the treatment group.
Conclusion: Chiropractic manipulation can effectively relieve pain and improve lumbar function in patients with degenerative scoliosis. The onset of action is faster than that oral eperisone hydrochloride tablets combined with TSLO brace,and it has better safety and can improve Cobb angle of patients with degenerative scoliosis. |
| KEY WORDS Chiropractic manipulation Osteoarthritis Scoliosis Randomized controlled trial |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李路广,高景华,高春雨,孙武,罗杰,杨克新,于杰,李建国,王宝剑,杨伟,庄明辉.调脊手法治疗退行性脊柱侧凸症的临床疗效观察[J].中国骨伤,2022,35(5):442~447 |
| 英文格式: | LI Lu-guang,GAO Jing-hua,GAO Chun-yu,SUN Wu,LUO Jie,YANG Ke-xin,YU Jie,LI Jian-guo,WANG Bao-jian,YANG Wei,ZHUANG Ming-hui.Clinical observation of chiropractic manipulation in the treatment of degenerative scoliosis[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(5):442~447 |
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