三步推拿法改善腰椎间盘突出症患者腰椎曲度的研究

目的进一步论证三步推拿法治疗腰椎间盘突出症的临床疗效,同时研究其对于腰椎生理曲度改善的程度。方法研究选取腰椎间盘突出症患者180例,随机分入三步推拿组、牵引治疗组和传统手法组,每组60例。三步推拿组采用松解、调整、整理三步治疗,每次治疗20 min;牵引治疗组采用电动机械牵引床牵引患者腰椎,每次治疗20 min;传统手法组采用松解、拔伸、按压、调整等手法,每次治疗20 min。三组均以3次为1个疗程,共治疗2个疗程。结合Oswestry功能障碍指数（ODI）评分、视觉模拟评分（VAS）观察比较三组间的临床疗效差异。选用Seze法测量值观察三步推拿法对于腰椎生理曲度改善的效果。结果三组临床总有效率分别为三步推拿组85.00%、牵引治疗组60.00%和传统手法组83.33%,差异有统计学意义（P〈0.05）。三种治疗方法对于腰椎生理曲度都有改善。组间两两比较：三步推拿组与牵引治疗组比较差异有统计学意义（P〈0.001）;三步推拿组与传统手法组比较差异无统计学意义（P〉0.05）;牵引治疗组与传统手法组比较差异有统计学意义（P〈0.001）。其中三步推拿法等同于传统手法,且两者均显著优于牵引治疗组。结论三步推拿法治疗腰椎间盘突出症的临床疗效以及其对于腰椎曲度的改善等同于传统推拿手法,且明显优于单一的牵引治疗,其具有简捷、易掌握的特点,在广大基层医院中有着更为广阔的推广使用前景。

Study on improvement degree of lumbar curvature with three-step massage therapy

Objective To demonstrate the clinical effect on lumbar disc herniation and improvement degree of lumbar curvature with three-step massage therapy. Methods 180 lumbar disc herniation patients were selected and divided into the three-step massage therapy group, traction group and traditional massage therapy group by a random table, with 60 cases in each group. Three-step massage therapy group was treated by releasing, reduction and rubbing for 20 minutes. Traction group was treated by the electric mechanical traction bed for 20 minutes. Traditional massage therapy group was treated by releasing, pulling, pressing, reduction and etc for 20 minutes. All 3 groups took 3 times as a course, all were treated for two courses. The differentiation of clinical effect by visual analogue scale （VAS）, Oswestry disability index （ODI） and improvement degree of lumbar curvature by Seze were observed. Results The effective rates were 85.00% （three-step massage therapy group）, 60.00% （traction group） and 83.33% （traditional massage therapy group） respectively, the differences were statistically significant （P 〈 0.05）. Each method improved lumbar curvature. Comparison between any two groups： there was a significant difference between three-step massage therapy group and traction group （P 〈 0.001）, there was no significant difference between three-step massage therapy group and traditional massage therapy group （P 〉 0.05）, there was a significant difference between traction group and traditional massage therapy group （P 〈 0.001）. Three-step massage therapy group was similar to traditional massage therapy group and both of them were better than traction group. Conclusion Both clinical effect and improvement degree of lumbar curvature by three-step massage therapy are equated with traditional massage therapy, and superior to traction. Considering that three-step massage therapy is simple and easy to use, it has broad prospects in primary hospitals.