摘要
目的:基于超声及表面肌电技术观察悬吊循经弹拨技术对腰椎间盘突出症的功能影响及机制探讨。方法:将236例腰椎间盘突出症患者按照随机数字表法分为循经弹拨治疗组(A组)、悬吊运动疗法组(B组)、悬吊循经弹拨技术治疗组(C组)、常规治疗组(D组),每组59例。分别给予循经弹拨法、悬吊运动疗法、悬吊循经弹拨法、常规治疗,记录患者治疗前和治疗4周后的疼痛视觉模拟评分法(VAS)评分、日本骨科协会(JOA)下腰痛评价表得分、腰背肌及主要核心肌群关键肌厚度、平均功率频率(MPF)、积分肌电(IEMG)。并观察4组治疗前后的疗效比较。结果:C组有效率高于其他3组(P<0.05);治疗后4组VAS评分均较治疗前显著降低(P<0.05),C组降低更明显(P<0.05),治疗后4组JOA下背痛评分均较治疗前显著增加(P<0.05),但C组增加更明显(P<0.05);B组、C组与治疗前比较,患者腰背肌及主要核心肌群关键肌厚度均增加(P<0.05),且C组增加更明显(P<0.05);B组、C组与治疗前比较,患者腰背肌及主要浅表核心肌群关键肌MPF、IEMG均增加(P<0.05),且C组增加更明显(P<0.05);A组、D组患者腰背肌及主要核心肌群关键肌厚度、MPF、IEMG与治疗前比较,差异均无统计学意义(P>0.05)。结论:悬吊循经弹拨技术在缓解腰椎间盘突出症疼痛和改善患者腰椎活动度方面有较好的疗效,可能与肌肉组织学与电生理学改变,即腰背肌及主要核心肌群关键肌肌肉厚度增加及其耐力和肌力提高有关。
Objective: To explore the clinical effect and therapeutic mechanism of sling and massage exercise technique on lumbar disc herniation(LDH) based on musculoskeletal ultrasonography(MSUS) and surface electromyography. Methods: A total of 236 LDH patients were collected. The eligible patients were divided into massage treatment group(group A), sling exercise therapy group(group B), and sling and massage exercise technique group(group C), and routine treatment group(group D) by random number table method, with 59 cases in each group. All the above groups were treated for 4 weeks. Japanese Orthopaedic Association(JOA) scores,visual analogue score(VAS), the changes in thickness of local core stable muscles, the mean power frequency(MPF) and the integrate electromyogram(IEGM) were used to evaluate the clinical efficacy before treatment and after four weeks’ treatment. Results: The ef fective rate of group C was higher than that of the other three groups(P<0.05). After four weeks’ treatment, VAS scores were all decreased(P<0.05), and group C were better than the other three groups(P<0.05) respectively. After four weeks’ treatment, the JOA scores of the four groups were all higher than those before treatment(P<0.05), and group C was superior to the other three groups(P<0.05). The thickness of the back muscle, MPF, IEGM of group B and C after treatment were all higher than before. Group C was higher than group B(P<0.05). There was no significant difference before and after treatment in group A and D(P>0.05). Conclusion:Sling and tuina exercise technique has better effect in relieving pain and improving lumbar motion. This may be related to the increasing thickness of lumbar dorsal muscle and core muscle group, and enhancing muscle endurance and muscle strength of lumbar dorsal muscle for changing the muscle histology and electrophysiology.
作者
李丽
王芹
冯梓芸
孙敬龙
鹿海峰
LI Li;WANG Qin;FENG Ziyun;SUN Jinglong;LU Haifeng(The Second A ffilialed Hospital of Shandong University of Traditional Chinese Medicine,Jinan,Shandong 250001,China)
出处
《康复学报》
CSCD
2019年第3期13-16,21,共5页
Rehabilitation Medicine
基金
山东省重点研发计划项目(2017GSF19114)
关键词
腰椎间盘突出症
循经弹拨法
悬吊运动疗法
超声
表面肌电
lumbar disc herniation
massage
sling exercise therapy muscle
musculoskeletal ultrasonography
surface electromyography
