| 吴双,吕智桢,周星辰,等.基于倾向性评分法探讨杠杆定位手法治疗L4/5 不同类型腰椎间盘突出症的前瞻性队列研究[J].浙江中医药大学学报,2024,48(10):1289-1293. |
| 基于倾向性评分法探讨杠杆定位手法治疗L4/5 不同类型腰椎间盘突出症的前瞻性队列研究 |
| A Prospective Cohort Study of Lever Positioning Manipulation for L4/5 Different Types of Lumbar Disc Herniation Based on Propensity Scoring |
| DOI：10.16466/j.issn1005-5509.2024.10.015 |
| 中文关键词: 腰椎间盘突出症 杠杠定位手法 倾向性评分 队列研究 临床疗效 正骨手法 推拿疗法 吕立江 |
| 英文关键词: lumbar disc herniation lever positioning manipulation propensity score cohort study clinical efficacy bonesetting technique tuina therapy LYU Lijiang |
| 基金项目:浙江省“尖兵”“领雁”重大研发攻关项目(2022C03123)；国家自然科学基金面上项目(82274672)；浙江省吕立江名老中医专家传承工作室建设项目(GZS2021026)；国家中医药管理局高水平中医药重点学科项目(GJXK2023-85) |
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| 中文摘要: |
| [目的] 基于倾向性评分匹配法探讨杠杆定位手法治疗L4/5不同类型腰椎间盘突出症的疗效差异。[方法] 采用前瞻性队列研究设计，将122例L4/5腰椎间盘突出症患者分为单侧型组、双侧型组及中央型组，匹配后得到组间协变量均衡的样本，单侧型组36例，双侧型组35例，中央型组35例。三组患者均采用杠杆定位手法治疗，每周均治疗3次，隔日1次，疗程共2周。分别于治疗前后，采用疼痛视觉模拟评分表(visual analogue scale，VAS)评分、日本骨科协会(Japanese Orthopedics Association，JOA)评分对三组患者治疗后效果差异进行评价。[结果] 在三组间不均衡的协变量年龄、性别、病程、VAS评分以及JOA评分经匹配后均达到均衡(P>0.05)。治疗2周和半年后随访结果显示，组间VAS评分与JOA评分比较差异均有统计学意义(P<0.05)，杠杆定位手法治疗腰椎间盘突出症单侧型远近期疗效均优于双侧型与中央型(P<0.05)。[结论] 运用杠杆定位手法治疗同一节段腰椎间盘突出症，单侧型椎间盘突出症临床疗效优于双侧型及中央型。 |
| 英文摘要: |
| [Objective] Based on the propensity score matching method to explore the therapeutic effect of lever positioning manipulation in the treatment of L4/5 different types of lumbar disc herniation. [Methods] A prospective cohort design was used to select 122 patients with L4/5 lumbar disc herniation and divide them into unilateral group， bilateral group and central group. Samples with balanced covariates were obtained after matching， including 36 patients in unilateral group，35 patients in bilateral group and 35 patients in central group. All patients in the three groups were treated with leverage positioning technique， and all patients in the three groups were treated 3 times a week， once every other day， for a total of 2 weeks. Pain Visual Analogue Scale(VAS) score and Japanese Orthopaedic Association(JOA) score were observed before and after treatment to evaluate the differences in the postoperative effects of the three groups. [Results] The covariates of age， sex， course of disease， VAS score and JOA score were all balanced after matching (P>0.05). The results of following-up after 2 weeks and 6 months of treatment showed that the VAS score and JOA score were statistically significant (P<0.05)， the distant and near term curative effect of lever positioning manipulation in the treatment of unilateral lumbar disc herniation was better than bilateral and central disc herniation(P<0.05). [Conclusion] The clinical efficacy of unilateral lumbar disc herniation is superior to bilateral and central disc herniation in the treatment of the same segment of lumbar disc herniation with leverage positioning manipulation. |
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