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[不同方向整复手法治疗腰椎间盘突出症的临床疗效观察]

[The observe of clinical effect of treating lumbar intervertebral disc herniation by bone setting manipulation of different directions].

作者信息

Lü Li-jiang, Jin Ye-dao, Zheng Ru-yun, Fan Bing-hua, Yang Mi-xiong, Ying Xiao-ming, Wang Qi-Kai, Zhang Wen-bo

机构信息

The Third Clinical Medical College ofZhejiang TCM University, Hangzhou 310053, Zhejiang, China.

出版信息

Zhongguo Gu Shang. 2009 Apr;22(4):255-8.

Abstract

OBJECTIVE

To compare the effect between lumbar backwards flexion manipulation and rotating manipulation for treating lumbar intervertebral disc herniation.

METHODS

Two hundred and nine patients of lumbar intervertebral disc herniation, male 131, female 78, the age from 20 to 79 years old, 58 cases of all these patients age above 50. According to diagnosis the ladder of the 92 cases bulging type, 69 hernia type, 48 cases free type. The patients were randomly divided into treatment group (107 cases) and control group (102 cases). All the patients were treated with the three-dimensional computer-controlled traction therapeutic apparatus, with continued traction for 30 minutes. After traction, lumbar backwards flexion manipulation and rotating manipulation were respectively adopted in treatment group and control group (on alternate days one time, 3 times as a course of treatment). The symptoms and signs (including back pain and discomfort, lower limb pain and numbness, powerless urination and defecation, numbness in perineum, straight-leg raising degree, ability of lower extremity walking, work and live) of patients were observed after treatment.

RESULTS

All the patients were followed up from 1 to 6 months with an average of 3.2 months. After treatment, the symptoms and signs of patients have markedly improved (P < 0.01), but the lower back pain and discomfort, lower limb walking ability in treatment group were better than control group (P < 0.05). According therapeutic criteria, the effect of treatment group was better than of control group (P < 0.01). In cases with bulging type, 47 in treatment group and 45 in control group, the effect of treatment group was better than of control group (P < 0.05); in cases with hernia type, 35 in treatment group and 34 in control group, there was no significantly difference in effect between two groups (P > 0.05); in cases of free type, 25 in treatment group and 23 in control group, there was no significantly difference in effect between two groups (P > 0.05).

CONCLUSION

The global effect of lumbar backwards flexion manipulation was satisfactory than rotating manipulation for treating lumbar intervertebral disc herniation. But rotating manipulation suited to free type.

摘要

目的

比较腰椎后伸扳法与旋转扳法治疗腰椎间盘突出症的疗效。

方法

209例腰椎间盘突出症患者,男131例,女78例,年龄20~79岁,其中50岁以上58例。根据诊断分型,膨出型92例,突出型69例,游离型48例。将患者随机分为治疗组(107例)和对照组(102例)。所有患者均采用三维电脑控制牵引治疗仪,持续牵引30分钟。牵引后,治疗组采用腰椎后伸扳法,对照组采用旋转扳法(隔日1次,3次为1个疗程)。观察治疗后患者的症状和体征(包括腰背痛及不适、下肢疼痛及麻木、大小便无力、会阴部麻木、直腿抬高程度、下肢行走能力、工作及生活情况)。

结果

所有患者随访1~6个月,平均3.2个月。治疗后患者的症状和体征均有明显改善(P<0.01),但治疗组的下腰背痛及不适、下肢行走能力优于对照组(P<0.05)。根据疗效标准,治疗组疗效优于对照组(P<0.01)。膨出型病例中,治疗组47例,对照组45例,治疗组疗效优于对照组(P<0.05);突出型病例中,治疗组35例,对照组34例,两组疗效差异无统计学意义(P>0.05);游离型病例中,治疗组25例,对照组23例,两组疗效差异无统计学意义(P>0.05)。

结论

腰椎后伸扳法治疗腰椎间盘突出症的总体疗效优于旋转扳法,但旋转扳法适用于游离型。

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