刺络拔罐联合麦肯基疗法改善下背痛患者腰部屈伸活动

目的:探讨应用刺络拔罐联合麦肯基疗法治疗下背痛(lower back pain,LBP)对患者腰部屈伸活动的改善效果。方法:选取96例LBP患者,采取简单随机数字表法将其随机分成观察组和对照组,每组各48例。对照组实施麦肯基疗法治疗,观察组在此基础上联合刺络拔罐疗法治疗,连续治疗2个疗程后评估两组疗效。治疗前后运用视觉模拟评分法(visual analogue scale,VAS)评估两组患者疼痛程度,采用日本骨科学会腰椎疾患治疗成绩评分标准(Japanese orthopaedic association JOA)评定患者腰椎功能状态,使用Oswestry功能障碍指数(Oswestry disability index,ODI)评价患者机体功能状况;并测定两组腰部多裂肌表面肌电参数[时域指标均方根(root mean square,RMS)、频域指标中位频率(median frequency,MF)]值及测量腰部不同方向的屈伸活动度。同时记录两组不良反应。结果:观察组有效率为95.8%(46/48),显著高于对照组的81.3%(39/48)(P<0.05)。两组治疗后VAS评分、ODI评分均显著低于治疗前(P<0.05),而JOA评分显著升高(P<0.05)。且治疗后,观察组VAS、JOA、ODI评分改善效果较对照组同期均更显著(P<0.05)。与治疗前比较,两组治疗后腰部多裂肌RMS值均显著上升(P<0.05),MF值则显著降低(P<0.05);且治疗后观察组腰部多裂肌RMS值显著高于对照组同期(P<0.05),而MF值显著更低(P<0.05)。与治疗前相比,两组治疗后腰部屈伸(包括前屈、后伸及左右侧屈)活动度均显著增加(P<0.05)。但观察组腰部屈伸活动度增大更显著(P<0.05)。两组均未见严重不良事件。结论:刺络拔罐联合麦肯基疗法治疗LBP的整体疗效确切,能明显减轻患者疼痛,改善腰椎功能及机体功能状态,增加腰部屈伸活动度,其作用机制可能与该联合疗法显著改善患者腰部核心肌群的肌肉功能状态有关。

Puncture Cupping Plus McKenzie Therapy in Improving Lumbar Flexion and Extension Function of Patients Suffering Lower Back Pain

Objective:To explore the effect of puncture cupping combined with cupping combined with McKenzie therapy on patients'waist flexion and extension,who suffer from lower back pain(LBP).Methods:96 patients with LBP were selected and randomly divided into observation group and control group by simple random number table method,with 48 cases in each group.The control group was treated with McKenzie therapy,and the observation group was combined with acupuncture and cupping therapy on this basis,and the efficacy of the two groups was evaluated after 2 consecutive courses of treatment.The visual analogue scale(VAS)was used to evaluate the pain of the two groups of patients before and after treatment,and the Japanese Orthopaedic Association JOA was used to evaluate the lumbar spine functional status.disability index(ODI)to evaluate the functional status of the patient's body;and to measure the surface electromyographic parameters[root mean square(RMS)of time domain index,median frequency(MF)of frequency domain index]Value and measure the flexion and extension of the waist in different directions.Adverse reactions were recorded in both groups.Results:The effective rate in the observation group was 95.8%(46/48),which was significantly higher than the control group's 81.3%(39/48)(P<0.05).The pain VAS score and ODI score of the two groups after treatment were significantly lower than before treatment(P<0.05),while the JOA score was significantly increased(P<0.05).And after treatment,the improvement of VAS,JOA,and ODI scores in the observation group was more significant than that in the control group over the same period(P<0.05).Compared with that before treatment,the RMS value of lumbar multifidus muscle increased significantly after treatment in both groups(P<0.05),and the MF value decreased significantly(P<0.05);and the RMS value of lumbar multifidus muscle in observation group was significantly higher than that in the two groups after treatment.The control group was in the same period(P<0.05),while the MF value was significantly lower(P<0.05).Compared with before treatment,the lumbar flexion and extension(including forward flexion,posterior extension,and left and right lateral flexion)activities of the two groups were significantly increased after treatment(P<0.05);but the lumbar flexion and extension activity of the observation group was significantly increased(P<0.05).No serious adverse events were seen in either group.Conclusion:The overall effect of Puncture Cupping plus McKenzie therapy on LBP is significant.It can significantly reduce patients'pain,improve lumbar spine function and body function status,increase waist flexion and extension activity,and its mechanism of action may be significantly improved with this combination therapy.The muscle function of the muscle group is related.