摘要
目的:观察腰腹联合手法对退行性腰椎滑脱(degenerative lumbar spondylolisthesis,DLS)患者腰椎功能、多裂肌肌肉形态及腹壁紧张度的影响。方法:选取120例DLS患者,按照随机数字表法分为对照组、观察A组和观察B组,每组各40例。对照组给予常规中药熏洗,观察A组给予中药熏洗+常规推拿,观察B组给予中药熏洗+腰腹联合手法,3组均治疗两周。比较治疗前后3组患者Oswestry功能障碍指数(Oswestry disability index,ODI)评分、多裂肌肌肉形态指标[前后径(antero-posterior,A-P)、横径(lateral diameter,Lat)、横截面积(cross sectional area,CSA)]及腹壁紧张度,并观察3组患者临床疗效。结果:(1)对照组有效率为65.00%,观察A组有效率为77.50%,观察B组有效率为95.00%,观察B组有效率显著高于其余两组,差异有统计学意义(P<0.05)。(2)治疗后,观察A组ODI评分为(36.68±7.19)分,观察B组ODI评分为(29.35±6.05)分;随访1个月时,观察A组ODI评分为(19.49±3.97)分,观察B组ODI评分为(14.26±2.85)分;与对照组比较,治疗后和随访1个月观察A组、B组ODI评分均显著降低;随访1个月时,3组以上指标均低于同组治疗后,且观察B组以上指标低于观察A组(P<0.05)。(3)治疗后,观察A组多裂肌A-P为(2.81±0.56) cm、Lat为(3.12±0.62) cm、CSA为(7.08±1.41) cm,观察B组多裂肌A-P为(2.94±0.58) cm、Lat为(3.31±0.65) cm、CSA为(7.28±1.45) cm;随访1个月时,观察A组多裂肌A-P为(3.01±0.60) cm、Lat为(3.35±0.67) cm、CSA为(7.42±1.48) cm,观察B组多裂肌A-P为(3.15±0.62) cm、Lat为(3.58±0.71) cm、CSA为(7.65±1.51) cm;治疗后和随访1个月,观察A组、B组多裂肌A-P、Lat、CSA水平均明显升高,且随访1个月时上述指标均高于治疗后,观察B组以上指标均高于同期观察A组(P<0.05)。(4)治疗后,观察A组腹壁紧张度2°~3°占比为16%,观察B组腹壁紧张度2°~3°占比为7%;随访1个月,观察A组腹壁紧张度2°~3°占比为8%,观察B组腹壁紧张度2°~3°占比为
Objective:To observe the effect of lumbar abdominal combined manipulation on lumbar function,multifidus muscle morphology,and abdominal wall tension in patients with degenerative lumbar spondylolisthesis(DLS).Methods:120 cases of DLS patients were selected and divided into control group,observation group A,and observation group B according to the random number table method,with 40 cases in each group.The control group was given conventional traditional Chinese medicine fumigation and washing,the observation group A was given TCM fumigation and washing+conventional massage,and the observation group B was given TCM fumigation and washing+lumbar abdominal combined manipulation.All three groups were treated for 3 weeks.The Oswestry disability index(ODI)score,multifidus muscle morphology indicators[antero-posterior(A-P),lateral diameter(Lat),cross-sectional area(CSA)]and abdominal wall tension were compared between the three groups,and the clinical efficacy of the three groups of patients were observed.Results:(1)The effective rate of the control group was 65.00%,which of the observed group A was 77.50%,and of the observed group B was 95.00%.The effective rate of the observed group B was significantly higher than that of the other two groups,and the difference was statistically significant(P<0.05).(2)After treatment,the ODI score was(36.68±7.19)in observation group A,and(29.35±6.05)in observation group B.After 1 month of follow-up,the ODI score of observation group A was(19.49±3.97)and that of observation group B was(14.26±2.85).Compared with the control group,the ODI scores of groups A and B were significantly lower after treatment and 1-month follow-up.At 1 month follow-up,the indicators above in all 3 groups were lower than those in the same group after treatment.And the indicators above in observation group B were lower than those in observation group A(P<0.05).(3)After treatment,the multifidus muscle A-P in observation group A was(2.81±0.56)cm,the Lat was(3.12±0.62)cm,and the CSA was(7.08±1.41)cm,and the m
作者
赵明宇
寇赵淅
张向东
赵启
王秋生
李无阴
李现林
董良
ZHAO Mingyu;KOU Zhaoxi;ZHANG Xiangdong;ZHAO Qi;WANG Qiusheng;LI Wuyin;LI Xianlin;DONG Liang(Luoyang Orthopedic Traumatological Hospital of Henan Province/Henan Provincial Orthopedic Hospital,Zhengzhou Henan China 450016;The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou Henan China 450000;Henan Province Hospital of Traditional Chinese Medicine/The Second Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou Henan China 450053)
出处
《中医学报》
CAS
2023年第6期1322-1328,共7页
Acta Chinese Medicine
基金
河南省中医药研究重大专项课题资助项目(2018ZYZD04)。
关键词
退行性腰椎滑脱
腰腹联合手法
多裂肌
腹壁紧张度
degenerative spondylolisthesis
lumbar abdominal combined manipulation
multifidus muscle
abdominal wall tension
