脊柱梳理疗法治疗92例脊柱退行性疾病患者的疗效及安全性分析

目的研究脊柱梳理疗法治疗脊柱退行性疾病患者的疗效和安全性。方法选取2015年6月~2015年12月解放军总医院康复医学中心收治的脊柱退行性疾病患者92例,均接受脊柱梳理疗法治疗,治疗前采用ODI、NPQ量表筛选和评估患者症状,治疗后采用本中心自行设计的脊柱梳理临床疗效评价量表评估症状改善情况和不良反应情况,心电监护动态监测不良事件,疗效用缓解率统计,安全性以不良反应的发生率表示,配对t检验分析治疗前和治疗中、治疗后的生命体征变化。结果患者肩颈不适、颈部疼痛、腰部僵硬、腰背疼痛、下肢疼痛、脊柱侧弯、脊椎生理弯曲消失等症状的缓解率分别为88.4%、84.2%、90.6%、84.0%、76.9%、38.9%和92.3%。治疗过程中无心血管意外发生,最主要不良反应是一过性肢体麻木,发生率为39.1%;胃区不适、恶心、头晕、心悸、颈部不适或症状加重、腰部不适或症状加重、局部皮肤磨损等一过性不良反应的发生率分别为13.0%、3.3%、4.3%、2.3%、28.3%、20.7%和14.1%;仅3.3%的患者诉有持续性胃区不适,1.1%的患者诉有持续性头晕,其余症状均在1周之内好转。大部分不良反应发生于接受腰椎及胸椎下段模式和康复梳理模式治疗的患者。心电监护动态监测治疗前、脊柱梳理床不同倒置角度和摆动频率下治疗中及治疗后生命体征变化,心率、收缩压及脉压差在治疗过程中出现一过性升高,血氧饱和度出现一过性下降,呼吸和舒张压无显著改变;治疗后20 min各项生命体征均恢复至治疗前水平。结论脊柱梳理治疗是保守治疗退行性脊柱疾病安全、有效的方法。

A study in efficacy and safety of spinal carding therapy for 92 patients with spinal degenerative disease

Objective To analysis the efficacy and safety of the spinal carding therapy treating 92 patients with spinal degenerative diseases (SDD) for the first time. Methods Clinical data for 92 patients with SDD admitted to rehabilitation department of the PLA General Hospital and accepted spinal carding bed treatment from June 2015 to December 2015 were enrolled. ODI and NPQ scale were used for assessment of symptoms before the self-designed clinical efficacy evaluation scale of the spinal carding bed was used to assess the improvement of symptoms and adverse in response,dynamic monitoring were applied to recording the cardiac adverse events. Efficacy were analyzed with remission rate,safety were described in rate of adverse reaction,paired-t test was used to analyse the change of vital signs before,during and after the treatment,P < 0.05 was considered statistically significant. Results Remission rate of neck/shoulder discomfort,neck pain,stiff waist,stiff/back pain,lower limb pain,spinal scoliosis,spinal physiological curvature vanishes was 88.4%,84.2%,90.6%,84.0%,76.9%,38.9% and 92.3%,respectively. No cardiovascular accident occurred in the course of treatment. The main adverse reaction is a numbness of the extremities (39.1%),the adverse reaction rate of a numbness of stomach discomfort,nausea,dizziness,palpitation,neck discomfor,waist pain,local skin abrasion were 13.0%,3.3% and 4.3%,2.3%,28.3%,20.7% and 14.1%,only 3.3% complained of persistent gastric discomfort,1.1% complained of persistent dizziness,and all the other symptoms relieved within a week. Most of the adverse reactions occurred in patients treated with Mode 5-6 of the spinal carding bed. Vital signs of the patients before the treatment,during the spinal carding bed treatment with different inverted angle and swing frequency,and post-treatment were monitored by the the dynamic monitoring,heart rate,systolic blood pressure and pulse pressure had transient elevations,and oxygen saturation had a transient decline with statistical significance, no obvious changes were observed in breathing and diastolic blood pressure,and all of the vital signs recovered to pretreatment levels in 20 minutes after the treatment. Conclusion The spinal carding therapy is a safe and effective conservative treatment of degenerative spinal diseases.