Xiao Qing-Ming, Wu Xi-Jun, Yin Heng, Qiu Feng, Li Chao, Zhang Xian
Wuxi Hospital Affiliated to Nanjing University of Chinese Medicine, Wuxi 214071, Jiangsu, China.
Zhongguo Gu Shang. 2020 Oct 25;33(10):928-32. doi: 10.12200/j.issn.1003-0034.2020.10.008.
To explore clinical effects of manipulation therapy in treating degenerative lumbar instability based on myofascial chain theory.
Fifty-seven patients with degenerative lumbar spine instability were analyzed retrospectively from January 2018 to December 2019, and treated with massage manipulation therapy. Among them, 29 patients were treated with massage manipulation therapy based on the myofascial chain theory (myofascial chain group), including 14 males and 15 females, aged from 40 to 69 years old with an average of (51.76±5.07) years old, the courses of disease was (3.4±1.6) years. Twenty-eight patients were treated with massage manipulation therapy based on TCM meridian theory (TCM meridian group), including 12 males and 16 females, aged from 42 to 70 years old with an average of(52.48±4.31) years old, the courses of disease was (3.3±1.7) years. Before treatment, after treatment, 1 and 3 months after treatment, visual analogue scale (VAS) was used to evaluate pain degree of lumbar, Japanese Orthopaedic Association (JOA) and modified Oswestry Disability Index (ODI) were used to assess improvement of lumbar function, and changes of lumbar muscle tension were used to evaluate clinical effect.
VAS score, JOA score, modified ODI score and lumbar muscle tension after treatment were significantly improved than those of before treatment between two groups (<0.05) . There were no statistical difference in VAS score, JOA score, modified ODI score and lumbar muscle tension between two groups before treatment and after treatment immediately(> 0.05). However, VAS score, JOA score, modified ODI score and lumbar muscle tension at one and three months after treatment in myofascial chain group weresignificantly better than that of TCM meridian group (<0.05).
Manipulation therapyon in treating degenerative lumbar instability based on myofascial chain theory could effectively relieve low back pain symptom and improve lumbar function. It is worthy of promoting.
基于肌筋膜链理论探讨推拿手法治疗退行性腰椎不稳的临床疗效。
回顾性分析2018年1月至2019年12月收治的57例退行性腰椎不稳患者，均采用推拿手法治疗。其中，29例采用基于肌筋膜链理论的推拿手法治疗（肌筋膜链组），男14例，女15例，年龄40～69岁，平均（51.76±5.07）岁，病程（3.4±1.6）年。28例采用基于中医经络理论的推拿手法治疗（中医经络组），男12例，女16例，年龄42～70岁，平均（52.48±4.31）岁，病程（3.3±1.7）年。治疗前、治疗后、治疗后1个月及3个月采用视觉模拟评分法（VAS）评估腰部疼痛程度，采用日本骨科学会（JOA）评分及改良Oswestry功能障碍指数（ODI）评估腰椎功能改善情况，通过腰部肌肉张力变化评估临床疗效。
两组治疗后VAS评分、JOA评分、改良ODI评分及腰部肌肉张力均较治疗前显著改善（<0.05）。两组治疗前及治疗后即刻VAS评分、JOA评分、改良ODI评分及腰部肌肉张力比较，差异无统计学意义（>0.05）。但肌筋膜链组治疗后1个月及3个月的VAS评分、JOA评分、改良ODI评分及腰部肌肉张力均显著优于中医经络组（<0.05）。
基于肌筋膜链理论的推拿手法治疗退行性腰椎不稳能有效缓解腰痛症状，改善腰椎功能，值得推广。
