杠杆定位手法治疗腰椎间盘突出症疗效及对Cobb角影响

目的:观察杠杆定位手法治疗腰椎间盘突出症疗效及对Cobb角的影响。方法:2017年12月至2018年11月纳入67例腰椎间盘突出症患者进行研究,将67例患者用随机数字表法分为治疗组和对照组。治疗组34例,其中男20例,女14例,年龄(36.09±8.26)岁,病程(13.79±15.50)个月,采用杠杆定位手法治疗。对照组33例,其中男18例,女15例,年龄(36.48±7.81)岁,病程(12.82±15.68)个月,采用腰椎斜扳法治疗。两组每周均治疗3次,隔1 d治疗1次,6次为1个疗程,治疗2个疗程后,通过影像学资料比较两组患者治疗前后Cobb角的变化;参照临床评定标准对症状体征进行评分;参照国家中医药管理局颁布的腰椎间盘突出症《中医病证诊断疗效标准》对总体疗效进行评价。结果:两组各有1例脱落患者。治疗组和对照组治疗前症状体征评分分别是18.56±4.81,18.61±3.72,治疗后分别为9.41±5.19,13.55±3.68,治疗后治疗组症状体征评分明显低于对照组(P<0.05),总体疗效有效率治疗组和对照组分别为97.06%、75.76%,治疗组优于对照组(P<0.05),治疗后两组患者的Cobb角均有变小(P<0.05)。治疗组和对照组治疗前Cobb角分别为(17.95±4.45)°,(18.14±3.59)°,治疗后分别为(18.14±3.59)°,(15.49±1.75)°,治疗组Cobb角变化优于对照组(P<0.05)。结论:杠杆定位手法与腰椎斜扳法两种方法对腰椎间盘突出症治疗均有疗效,但杠杆定位手法治疗腰椎间盘突出症患者的疗效更为显著,对Cobb角的影响更为明显,值得推广。

Clinical effect of lever positioning manipulation for lumbar disc herniation and its influence on Cobb angle

Objective: To observe the clinical effect of lever positioning manipulation for the treatment of lumbar disc herniation and its effect on Cobb angle.Methods: From December 2017 to November 2018,67 patients with lumbar disc herniation were included in the study. The patients were randomly divided into treatment group and control group by digital table method. There were 34 cases in the treatment group,including 20 males and 14 females,with an average age of(36.09±8.26) years old and a course of(13.79±15.50) months. Treatment group was treated with lever positioning manipulation. There were 33 cases in the control group,including 18 males and 15 females,with an average age of(36.48±7.81) years old and a course of (12.82±15.68) months. Control group was treated with lumbar slanting manipulation. Two groups were treated 3 times a week,once every other day,6 times for a course of treatment,after 2 courses of treatment,the changes of Cobb angle before and after treatment were compared between two groups by imaging. The symptoms and signs were scored with reference to clinical evaluation standard;overall efficacy was evaluated with reference to "Diagnostic Efficacy Criteria of Traditional Chinese Medicine Syndrome" issued by the State Administration of Traditional Chinese Medicine for lumbar disc herniation.Results: One patient in each group dropped out. The symptom and sign scores of treatment group and control group before treatment were 18.56±4.81,18.61±3.72,while after treatment were 9.41±5.19,13.55±3.68;treatment group was significantly lower than control group after treatment (P<0.05). The rate of overall efficacy of treatment group and control group were 97.06% and 75.76%,respectively,and treatment group was superior to control group(P<0.05). Post-treatment Cobb angle of both groups of patients became smaller(P<0.05). The Cobb angle of treatment group and control group were(17.95±4.45)°,(18.14±3.59)° before treatment,while after treatment were (18.14±3.59)°,(15.49±1.75)°,change of Cobb angle in treatment group was better than in control group(P<0.05).Conclusion: Both the lever positioning manipulation and the lumbar slanting manipulation methods are effective for the treatment of lumbar disc herniation,but clinical effect of lever positioning method on lumbar disc herniation is more significant,and the effect on Cobb angle is more obvious. It is worthy of promotion.