松解理筋手法联合微波理疗治疗非特异性下腰痛临床研究

目的:观察松解理筋手法联合微波理疗治疗非特异性下腰痛(寒湿瘀阻证)的临床疗效及对血液流变学的影响。方法:将124例患者随机分为对照组和观察组各62例。对照组采用理疗+牵引方法治疗;观察组采用松解理筋手法+微波理治疗。两组均以6 d为1个疗程,连续治疗3个疗程。统计两组患者治疗前后日本骨科学会腰痛疗效评定量表(Japanese orthopaedic association scores,JOA)积分、疼痛程度、身体损害指数评定量表(PⅡ)和寒湿瘀阻证评分,并检测治疗前后血液流变学指标。结果:观察组JOA评分改善优良率为72.59%,对照组为54.84%,两组比较差异有统计学意义(χ2=4.226,P0.05);观察组JOA量表主观症状、运动障碍、日常功能活动受限评分和总分均显著低于对照组(P0.01);观察组腰前屈、腰后伸、腰侧屈、单腿直腿抬高、脊柱触痛、双侧主动直腿抬高、仰卧起坐评分及总分均显著低于对照组(P0.01);观察组疼痛程度评分和寒湿瘀阻证评分均显著低于对照组(P0.01);观察组全血黏度、血浆黏度、纤维蛋白原和血小板聚集率均显著低于对照组(P0.01)。结论:松解理筋手法联合微波理疗治疗寒湿瘀阻型非特异性下腰痛,能促进患者血液循环,减轻疼痛,促进功能的恢复,从而提高患者的日常生活能力。

Clinical Study on the Treatment of Nonspecific Low Back Pain with the Method of Relaxing Muscles and Tendons Method Combined with Microwave Therapy

Objective:To observe the clinical curative effect of relaxing muscles and tendons method combined with microwave therapy in the treatment of nonspecific low back pain(cold dampness stasis blocking syndrome) and its effect on blood rheology.Methods:124 patients were randomly divided into control group and observation group with 62 cases in each group.The control group was given traction physiotherapy treatment;observation group was treated with physiotherapy reinforcement treatment.6 d for 1 course of treatment,continuous treatment of 3 courses.Statistics Japanese orthopaedic association scores (JOA),the degree of pain,physical impairment index rating scale (P Ⅱ),and cold dampness stasis syndrome score of the two groups before and after treatment,and detected blood rheology index before and after treatment.Results:JOA score excellent rate in the observation group was 72.59％,the control group was 54.84％,there was significant difference between two groups (P ＜ 0.05);the observation group JOA scale of subjective symptoms,movement disorders,daily function score and activity limitation scores were significantly lower than that of the control group (P ＜ 0.01);observation group of lumbar flexion,waist after lumbar extension,lateral flexion,single leg straight leg raising,spine tenderness,bilateral active straight leg raise crunches,and the total score were significantly lower than the control group(P ＜ 0.01);the observation group pain score and cold dampness stasis syndrome scores were significantly lower than that of control group(P ＜ 0.01);the observation group of whole blood viscosity,plasma viscosity,fibrinogen and platelet aggregation rate were significantly lower than control group (P ＜ 0.01).Conclusion:The relaxing muscles and tendons technique combined with microwave therapy treatment of cold dampness and blood stasis non-specific low back pain can promote blood circulation,relieve pain of patients,promote the recovery of function,there by providing the ability of daily life of patients.