手法及中药辅助治疗腰椎间盘突出症慢性阶段的病例对照研究

目的：观察以手法配合中药和以牵引配合西药两种治疗手段对腰椎间盘突出症（LDH）慢性阶段的治疗效果，对比两者疗效。方法：采用多中心、中央区组的研究方法，对2008年11月28日至2010年5月7日收治的200例LDH患者进行临床研究，其中治疗组100例，男45例，女55例；平均年龄（43．43±9．18）岁；应用“手法加中药导入加口暇汤药”治疗，疗程3周。对照组100例，脱落5例，男38例，女57例；平均年龄（42．29±9．78）岁，应用“牵引加理疗加口服西药”治疗，疗程3周。应用VAS、M—JOA、LMS及分级疗效评定进行组间及治疗前后观察指标比较和疗效评价。结果：治疗前后比较：治疗组治疗后较治疗前VAS及M—JOA改善，治疗前后LMS差异无统计学意义；对照组治疗后铰治疗前VAS及M—JOA改善，治疗前后LMS差异无统计学意义。组间比较：治疗后治疗组VAS及M—JOA的改善优于对照组，两组间LMS差异无统计学意义。疗效评价：治疗组优41例，良34例，可13例，差12例；对照组优35例，良16例，可19例，差25例，治疗组疗效优于对照组。结论：两种治疗方法均能改善LDH患者的VAS及M—JOA，且治疗组的改善情况好于时照组，两种治疗方法对下肢肌力的改善均不明显。

Case-control study on manipulation combined with Chinese herbs for the treatment of lumbar disc herniation within chronic stage

Objective: To observe and compare the therapeutic effects of two methods to lumbar disc herniation treated by manipulation combined with Chinese herbs and traction with Western medicine. Methods: A multi-center with a central district unit was used to study the patients with lumbar disc herniation from November 28th, 2008 to May 7th, 2010. All the patients were divided into treatment group and control group. The treatment group had 100 cases, including 45 males and 55 females, averaged(43. 43±9. 18) years. The treatment group was treated by manipulation combined with Chinese herbs;Control group had 100 cases (5 cases were fall off), including 38 males and 57 females, averaged(42. 29±9. 78) years. The control group was treated by traction with Western medicine. The course of treatment was 3 weeks. VAS, M-JOA, LMS(lower limb muscle strength) and classification efficacy was used to evaluate outcome and therapeutic effects before and after treatment. Results: VAS and M-JOA were improved after the treatment both in treatment group and control group; there was no significant difference in LMS before and after treatment in both groups. VAS and M-JOA in treatment group was superior to those of control group after treatment. There was no significant difference in LMS. According to classification efficacy, 41 cases got excellent result, 34 good, 13 fair and 12 poor in treatment group; in control group, 35 cases obtained excellent results, 16 good, 19 fair and 25 poor. The effect of treatment group was better than that of control group. Conclusion: Both of two methods can improve the score of VAS, M-JOA, and treatment group is better than that of control group. While for the improvement of LMS, both of two methods have no obvious effects.