摘要
目的:确立刘氏骨伤手法联合导引功法治疗腰椎间盘突出症(lumbar disc herniation,LDH)的临床应用专家推荐意见。方法:结合文献和刘氏骨伤手法治疗LDH的临床经验,经小组讨论和专家咨询,构建刘氏骨伤手法联合导引功法治疗LDH的临床应用问题条目池,遴选中医骨伤、推拿、康复专业的相关专家,采用德尔菲法进行专家问卷调查。第1轮问卷调查完成后,根据专家意见修改或删除部分条目,形成下一轮专家调查问卷。每轮问卷调查周期均为1周。根据问卷调查的结果确立专家推荐意见。结果:构建的刘氏骨伤手法联合导引功法治疗LDH的临床应用问题条目池共有18条相关条目。共经2轮专家问卷调查。第1轮专家问卷调查共遴选出专家33位,发放问卷33份,回收有效问卷33份;第2轮专家问卷调查共遴选出专家28位,发放问卷28份,回收有效问卷28份;两轮问卷调查专家积极性均为100%,专家权威系数分别为0.91、0.96,专家权威性较高。两轮专家问卷调查,各条目的专家认同度均较高。第1轮问卷调查共删除专家意见不一致的导引功法相关条目3条,修改手法相关条目2条;第2轮问卷调查共删除专家意见不一致的导引功法相关条目1条。调查结束后,共保留专家认同度较高、意见较一致的条目14条。结论:对于刘氏骨伤手法联合导引功法治疗LDH的临床应用,专家推荐LDH的手法治疗应强调“筋”的重要性,以“筋强则骨坚,筋顺则骨正”为指导,重理筋、微调骨;手法操作应遵循“松解-整复”的顺序进行,松解类手法以“按、揉、点”为主,针对不同的病变节段整复手法应有所变化;对于合并严重骨质疏松的LDH患者及巨大型LDH患者应慎用整复类手法;LDH急性期治疗以松解类手法为主,缓解期和恢复期宜选择手法结合导引功法治疗;联合应用的导引功法动作有八段锦中的五劳七伤往后瞧、太极拳中的云�
Objective:To establish the expert recommendations for the clinical application of Liu’s orthopedic manipulation combined with Chinese Daoyin therapy in treatment of lumbar disc herniation(LDH).Methods:According to the available articles and clinical experience of Liu’s orthopedic manipulation in treating LDH,seminars and experts consultation were conducted to build a question pool for the clinical application of Liu’s orthopedic manipulation combined with Chinese Daoyin therapy in treating LDH.The experts in traditional Chinese medicine orthopedics,Tuina and rehabilitation were selected,and a questionnaire survey was conducted among them by using the Delphi method.After the first round of questionnaire survey was finished,the questionnaire was modifed with some items adjusted or deleted based on expert opinions to form a new questionnaire for the next round of expert survey.Each round of questionnaire survey lasted for one week,and the expert recommendations were established based on the results of the questionnaire survey.Results:There were 18 items in the question pool for the clinical application of Liu’s orthopedic manipulation combined with Chinese Daoyin therapy in treating LDH.Two rounds of expert questionnaire surveys were conducted.In the first round of expert questionnaire survey,33 experts were selected,and 33 questionnaires were handed out,all of which were returned and valid.In the second round of expert questionnaire survey,28 experts were selected,and 28 questionnaires were handed out,all of which were returned and valid.The experts showed the participation rates of 100%in both rounds of questionnaire surveys,with the expert authority coefficients of 0.91 and 0.96,respectively,which indicating a high level of expert authority.The experts presented high degrees of recognition for each item in the questionnaires in the two rounds of surveys.In the first round of expert questionnaire survey,3 items with inconsistent expert opinions on Chinese Daoyin therapy were deleted,and 2 items associated
作者
范志鸿
张贤
周鑫
李超
FAN Zhihong;ZHANG Xian;ZHOU Xin;LI Chao(Wuxi Hospital of Traditional Chinese Medicine,Wuxi 214000,China;Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)
出处
《中医正骨》
2023年第11期44-47,52,共5页
The Journal of Traditional Chinese Orthopedics and Traumatology
基金
无锡市科技发展资金项目(Y20222009)。
关键词
椎间盘移位
腰椎
手法
导引
调查问卷
德尔菲法
intervertebral disc displacement
lumbar vertebrae
manipulation
daoyin
surveys and questionnaires
delphi method
