| 陈家正,吕立江,郑巧平,等.五步复位法治疗腰椎间盘突出症临床观察[J].浙江中医药大学学报,2021,45(4):425-429. |
| 五步复位法治疗腰椎间盘突出症临床观察 |
| Clinical Observation of Five-step Manipulation Method in Treating Lumbar Disc Herniation |
| DOI：10.16466/j.issn1005-5509.2021.04.019 |
| 中文关键词: 腰椎间盘突出症 五步复位法 推拿 VAS评分 ODI 临床疗效 |
| 英文关键词: lumbar disc herniation five-step manipulation method Tuina visual analogue scale Oswestry disability index clinical effect |
| 基金项目:国家自然科学基金项目(81774442)；国家临床重点专科建设项目(国卫医发[2013]42号)；浙江省重大疾病中医药防治中心项目(浙中医药[2018]9号)；浙江省中医药科技计划项目(浙卫发[2019]52号) |
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| 中文摘要: |
| [目的]观察五步复位法治疗腰椎间盘突出症的临床疗效。[方法]将2018年4月至2019年6月于浙江中医药大学附属第三医院住院的符合标准的124例腰椎间盘突出症患者按随机数字表法分为两组，五步复位法组63例采用五步复位法治疗，传统推拿法组61例采用传统推拿法治疗，两组患者均隔日治疗1次，每周3次，1周为1个疗程。治疗2个疗程及随访1年后观察临床疗效，并比较两组患者治疗前后疼痛视觉模拟评分(visual analogue scale，VAS)及改良腰椎功能障碍指数(Oswestry disability index，ODI)。[结果]治疗后五步复位法组总有效率为90.5%，传统推拿法组总有效率为86.9%，组间比较差异有统计学意义(P＜0.05)；1年后随访五步复位法组总有效率为87.3%，传统推拿法组总有效率为73.8%，组间比较差异有统计学意义(P＜0.05)。两组患者治疗后及1年后随访VAS评分、ODI均较治疗前降低，差异有统计学意义(P＜0.01)。组间比较，治疗后五步复位法组VAS评分、ODI均较传统推拿法组降低，差异有统计学意义(P＜0.01)；1年后随访时五步复位法组VAS评分同传统推拿法组差异无统计学意义(P＞0.05)，ODI低于传统推拿法组，差异有统计学意义(P＜0.05)。[结论]五步复位法治疗腰椎间盘突出症可明显缓解疼痛、改善患者腰椎功能，且具有可操作性强、疗效显著等特点，值得临床推广应用。 |
| 英文摘要: |
| [Objective] To observe the clinical effects of five-step manipulation method in treating lumbar disc herniation(LDH). [Methods] One hundred and twenty-four patients with LDH who were hospitalized in The Third Affiliated Hospital of Zhejiang Chinese Medical University from April 2018 to June 2019 were randomly divided into two groups. 63 cases in five-step manipulation method group were treated with five-step manipulation method， and 61 cases in traditional Tuina group were treated with traditional Tuina. Both groups were treated once every other day， three times a week as a course of treatment. The clinical efficacy was observed after 2 courses of treatment and 1 year follow-up， and the visual analogue scale(VAS) and modified Oswestry disability index(ODI) were compared between the two groups before and after treatment， and the patients were followed up one year later. [Results] After treatment， the total effective rate of five-step manipulation method group was 90.5%， and that of traditional Tuina group was 86.9%， there was significant difference between the two groups in clinical efficacy(P＜0.05). After one year follow-up， the total effective rate of five-step manipulation method group was 87.3%， and that of traditional Tuina group was 73.8%， there was significant difference between the two groups(P＜0.05). The VAS score and ODI of the two groups after treatment and 1 year follow-up were significantly lower than those before treatment(P＜0.01). Comparison between groups， after treatment VAS score and ODI of five-step manipulation method group were lower than those of traditional Tuina group(P＜0.01). One years later， there was no significant difference in VAS score between five-step manipulation method group and traditional Tuina group(P＞0.05); the ODI was lower than that of traditional Tuina group， and the difference between the two groups was statistically significant(P＜0.05). [Conclusion] Five-step manipulation method can significantly relieve pain and improve lumbar function of patients with LDH. It has the characteristics of strong operability and significant curative effect， which is worthy of clinical application. |
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