摘要
目的:通过优化形成复合手法(施氏、魏氏),评价复合手法治疗腰椎间盘突出症的临床疗效并分析手法机理。方法:收集4家医院102例腰椎间盘突出症患者,采用随机对照的方法分为研究组(复合手法)和对照组(常规手法),比较两组治疗前后VAS及JOA评分、肌电图改变,并进行疗效评价。结果:共纳入病例95例,研究组47例,对照组48例。两组VAS及JOA评分比较,治疗前及治疗后1周差异均无统计学意义(P>0.05)。治疗后4周VAS评分比较,研究组(1.62±1.26)分,对照组(2.48±1.28)分,两组差异有统计学意义(P=0.001);JOA评分比较,研究组(23.40±3.47)分,对照组(21.44±3.43)分,两组差异有统计学意义(P=0.005)。两组治疗后肌电图比较,研究组胫神经运动传导速度为(46.56±2.03)m/s,对照组为(45.69±2.22)m/s,两组差异有统计学意义(P=0.049);研究组胫神经运动潜伏期为(12.54±0.87)ms,对照组为(12.93±0.33)ms,两组差异有统计学意义(P=0.005)。两组治疗后1周疗效评定差异无统计学意义;治疗后4周研究组有效率为93.62%,对照组为79.17%,两组差异有统计学意义(P=0.042)。结论:治疗后4周,复合手法与常规手法相比较,能够改善腰椎间盘突出症患者症状、体征,提高胫神经运动传导速度,并降低胫神经运动神经潜伏期。
Objective:To evaluate the clinical efficacy of composite manipulation on the treatment of lumbar disc herniation and to analyze the mechanism of action by optimizing and forming composite manipulation(Shi’s and Wei’s).Methods:102 patients with lumbar intervertebral disc herniation from 4 research units were collected.The study group was treated with compound manipulation, and the control group was treated with conventional manipulation.The changes of VAS,JOA score and EMG before and after treatment were compared between the two groups by randomized control method, and the efficacy was evaluated.Results:A total of 95 cases were included.47 cases in the study group and 48 cases in the control group.There was no significant difference in VAS and JOA scores between the two groups before treatment and 1 week after treatment(P>0.05).At 4 weeks after treatment, VAS was 1.62±1.26 in the study group and 2.48±1.28 in the control group, with significant difference between the two groups(P=0.001).JOA comparison showed that the score of the study group was 23.40±3.47,and that of the control group was 21.44±3.43,and there was significant difference between the two groups(P=0.005).After treatment, the MCV of tibial nerve was(46.56±2.03) m/s in the study group and(45.69±2.22) m/s in the control group, and there was a significant difference between the two groups(P=0.049).The incubation period of tibial motor nerve was(12.54±0.87) ms in the study group and(12.93±0.33) ms in the control group, and there was a significant difference between the two groups(P=0.005).There was no significant difference between the two groups 1 week after treatment.After 4 weeks of treatment, the effective rate of the study group was 93.62%,and that of the control group was 79.17%,and there was a statistical difference between the two groups(P=0.042).Conclusion:After 4 weeks of treatment, compared with conventional manipulation, compound manipulation can effectively improve the symptoms and signs of patients with lumbar process, increase th
作者
刘光明
李飞跃
孙波
薛斌
詹炜祎
陈建华
吴云定
王强
陈辉
LIU Guangming;LI Feiyue;SUN Bo;XUE Bin;ZHAN Weiyi;CHEN Jianhua;WU Yunding;WANG Qiang;CHEN Hui(Xiangshan Hospital of Traditional Chinese Medicine,Huangpu District,Shanghai 200020,China;Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200020,China;North Hospital of Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 201801,China;Chongming Branch,Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 201399,China)
出处
《中国中医骨伤科杂志》
CAS
2021年第12期32-36,42,共6页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
基金
上海市黄浦区专业人才梯队培养计划-拔尖人才-刘光明(2019BJ09)
第六批全国老中医药专家学术经验继承项目(国中医药人教发[2017]29号)
全国名中医药专家李飞跃传承研究工作室(MLZJGZS-2017001)
上海市黄浦区医疗卫生重点研究发展专科—中医骨伤科(HWZFK201808)
上海市中医药领军人才-孙波(ZY(2018-2020)-RCPY-1029)
黄浦区中医药领军人才-孙波(ZY-2019RCTDPY-1001)。
关键词
腰椎间盘突出症
施氏伤科
魏氏伤科
复合手法
临床研究
lumbar disc herniation
Shi’s traumatology department
Wei’s traumatology department
compound technique
clinical research
