推拿配合艾灸治疗慢性腰肌劳损临床效果观察

目的:对推拿配合艾灸治疗慢性腰肌劳损临床效果进行观察.方法:将我院2015年4月至2016年4月间收治的慢性腰肌劳损患者86例作为研究对象,随机分为研究组43例及对照组43例,对照组采取推拿治疗,研究组在此基础上联合艾灸治疗,对比两组患者治疗效果.结果:研究组总有效率为95.35％,对照组总有效率为81.39％,研究组总有效率要高于对照组,两组比较差异具有统计学意义(P<0.05).结论:推拿配合艾灸治疗慢性腰肌劳损临床效果较优,可有效改善患者症状,值得推广.     

中医治疗在军事训练伤腰肌劳损中的应用

军事训练伤是军事训练不可避免的问题,其损害官兵身体健康,导致非战斗减员,削弱部队战斗力。慢性腰肌劳损是军事训练中的常见病,是影响参训人员训练质量的重要因素。本文分析了军训伤所致腰肌劳损的流行病学特点,提出治疗重点在于早期保健预防。中医药治疗成本少,花费低,操作简便易行,器械轻小易携,对军训伤有良好疗效,适于在基层推广。对于提高参训人员健康状态,维护部队战斗力方面有重要作用。     

自拟腰痛灵洗剂治疗腰肌劳损疗效观察

自2006年2月-2008年3月以来,对骨伤科门诊收治的久治无效的腰肌劳损病人采用外用中药洗剂治疗,效果满意,现报告如下。     

基于肌肉力学性能探讨推拿治疗慢性腰肌劳损作用机制

全身均保持着适度的肌张力和肌力使肌肉功能最有效的发挥,以维持身体姿势及正常运动。腰部作为人体躯干部活动中枢,相应肌群在长期受到重复应力后逐渐出现肌张力异常升高、肌力下降,这种慢性积累性损伤又无足够时间恢复,最终引起慢性腰肌劳损。结合文献研究,本文从肌肉力学性能角度对推拿治疗慢性腰肌劳损的作用机制进行探讨,为慢性腰肌劳损的防治提供新的思路。     

肌肉刺激疗法治疗慢性腰肌劳损

慢性腰肌劳损是临床常见病、多发病,主要病变在腰部肌肉、筋膜、韧带等软组织。本病多发于成年体力劳动者,遇阴雨天气或劳动、久坐之后酸痛明显加重,适当休息或治疗后可缓解。但本病病程缠绵,常反复发作。2006年3月-2008年10月,笔者将140例慢性腰肌劳损病例随机分为肌肉刺激疗法组与针灸组进行比较,发现肌肉刺激疗法疗效较好。现报告如下。     

手法治疗配合双柏散外敷对军人慢性腰肌劳损疗效观察

目的探讨推拿手法配合双柏散外敷对军人慢性腰肌劳损的临床疗效。方法将我部2009—2012年收治的50例慢性腰肌劳损的军人分为观察组与对照组,各25例,两组患者均行手法推拿治疗,观察组患者加用双柏散外敷治疗,治疗前后应用视觉模拟评分法(VAS)对两组患者的疼痛情况进行评价,比较两组患者的治疗效果。结果对照组患者临床总有效率低于观察组,两组患者比较差异有统计学意义(P<0.05);观察组患者VAS评分改善优于对照组,两组患者比较差异有统计学意义(P<0.05)。结论推拿手法配合双柏散外敷对军人慢性腰肌劳损能显著改善患者症状,双柏散在抗炎、镇痛等方面有不同程度的疗效,值得在临床推广。     

远红外线治疗仪联合热敷护理在维持性血液透析患者中的应用

目的 探讨远红外线治疗仪联合热敷护理在维持性血液透析(MHD)患者中的应用价值。方法 选取2019年2月至2021年2月于南通市中医院血液净化中心行MHD的68例患者,以随机数字表法分为两组,每组34例。对照组予以单纯热敷护理,观察组在对照组基础上联合远红外线治疗仪干预,均持续干预3个月,比较两组穿刺疼痛程度、局部血流状况及内瘘并发症发生情况。结果 干预后,观察组穿刺疼痛程度轻于对照组,头静脉血流速度大于对照组,头静脉管壁厚度小于对照组,内瘘并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论 远红外线治疗仪联合热敷护理可有效减轻MHD患者的穿刺疼痛感,改善局部血流,降低内瘘并发症的发生风险。     

慢性腰肌劳损

本文介绍慢性腰肌劳损的病因病理、临床表现、诊断、鉴别诊断及中西医治疗方法。     

新型鹞式腰带对慢性腰肌劳损的临床疗效观察

目的观察鹞式新型腰带对慢性腰肌劳损的临床疗效。方法入选患者60人,随机分成2组,每组30人,实验组应用鹞式新型腰带治疗,对照组应用传统的长方形腰带治疗,治疗3个月及1年后观察比较两组患者的治疗效果。结果治疗3个月后,两组有效率均为96.67%;治疗组1年后治疗有效率为96.67%,显著高于对照组的46.67%,差异有统计学意义(P<0.05)。结论鹞式新型腰带对慢性腰肌劳损有良好的治疗作用,值得临床推广应用。     

温针灸治疗慢性腰肌劳损99例临床效果观察

目的探讨在进行慢性腰肌劳损治疗措施上采取温针灸治疗措施能够取得的治疗疗效。方法以我中心中医针灸室2012年3月---2013年2月收治的99名患有慢性腰肌劳损的病人作为研究对象,随机抽取他们当中的49名病人组成治疗组,其余50名病人组成对照组。治疗组采取温针灸治疗措施进行治疗,对照组采取常规治疗措施进行治疗。观察和对比两组治疗结束后的疗效。结果治疗结束后,治疗组总有效率达到100％,对照组有效率仅为82％,两组对比差异明显（P＜0．05）,有统计学意义。结论在对慢性腰肌劳损的治疗上,采取温针灸治疗措施进行治疗能够取得更好的治疗效果,在治疗过程中不会给病人造成很大的痛苦,治疗成本低,治疗结束后病情不易复发,这种治疗方法值得临床推广应用。     

智能控温远红外热敷治疗仪的研制

目的研制一种智能控温远红外热敷治疗仪,用于人体四肢关节及颈肩腰等部位进行恒温热敷治疗。方法采用微电脑技术和模糊控制方法对治疗温度和治疗时间进行自动控制,加热元件采用碳纤维加热器,负载电压采用36V安全电压。结果研制出的样机使用方便、安全可靠、加热速度快,被测点的控温精度可达±1℃。结论远红外船热器的穿透作甩使得中药成分更容易被病痛部位所吸收,从而增强了治疗效果。     

表面肌电图对腰肌劳损病人竖脊肌功能的评价

目的:采用表面肌电图研究腰肌劳损病人竖脊肌在不同运动角速度、屈曲角度时肌肉的功能状况,竖脊肌MPF、MPFslope以及RMS值的变化和影响因数.方法:有下腰痛病史的患者10例.患者固定在Cybex 6000等速仪上,表面肌电图在双侧L3L4、L5S1水平竖脊肌采样.(1)选择等长运动模式;(2)选择等速运动仪等速运动模式.结果:(1)等长运动L3L4水平右侧竖脊肌的MPF值与用力程度(n%MVC)显著性相关;(2)等长运动所测部位RMS值受用力程度的影响;(3)角速度90、60、30、12度/秒时,MPF、MPF slope与运动角速度不相关,与L3L4水平竖脊肌的RMS值不相关,但是与L5S1水平竖脊肌的RMS值正相关,运动速度越快,RMS值越大.结论:(1)表面肌电图的参数MPF和RMS受用力程度、屈曲角度的影响不同;(2)急性下腰痛者在等长运动早期中竖脊肌的MPF值较正常时上升,而RMS下降;(3)竖脊肌的功能变化与下腰痛密切相关.     

Back Extensor Muscle Endurance Test Scores in Coal Miners in Australia

Study Design: A cross-sectional analytic study was conducted. Objectives: To collect normative data on back extensor endurance holding times and evaluate the discriminative validity of the Biering–Sorensen test in a group of coal miners in Australia. Summary of Background Data: Low back pain is a common complaint among those working in the Australian coal mining industry. One test that may be predictive of first-time episodes of low back pain is the Biering–Sorensen test of back extensor endurance strength. While this test has been evaluated in overseas sedentary populations, normative data and the discriminative ability of the test have not been evaluated with coal miners. Methods: Eighty-eight coal miners completed a questionnaire for known risk factors for low back pain, performed the Biering–Sorensen test, and undertook a test of aerobic fitness. Data analysis was performed to describe the groups and to determine whether any significant difference existed between those with a past history of low back pain and those without. Results: Significantly lower than expected holding times were found in this group of coal miners (mean 113 s). This result was significantly lower than demonstrated in previous studies (mean 138 s, t ₈₇ = 6.32, p < 0.001). When holding times for those with a past history of low back pain were compared with times for those with no history of low back pain, the difference was not statistically significant (t ₈₆ = 1.56, p = 0.12), nor was there a significant difference in fitness between those with a past history of low back pain and those without (t ₈₆ = 0.47, p = 0.64). Discussion/Conclusions: Coal miners in Australia have lower than normal Biering– Sorensen holding times. This lower back holding time does not differ between coal miners with a past history of low back pain and those without.     

The Reduction of Chronic, Nonspecific Low Back Pain Through the Control of Early Morning Lumbar Flexion: 3-Year Follow-Up

Three years ago, an 18-month randomized controlled trial of chronic, nonspecific low back pain investigated the effectiveness of instructing subjects to restrict bending activities in the early morning, when the fluid content in the disc is increased. Pain days (as recorded by daily diaries) were reduced 23% in the treatment group, compared to a 2% reduction in the control (sham treatment) group. The purpose of the current follow-up study was to determine whether the results of that trial were maintained during the 3 years following completion of the trial. A questionnaire was mailed to the 60 subjects who completed the original trial. Fifty subjects completed the questionnaire for a response rate of 83%. Thirty-one subjects (62%) continued to restrict bending activities in the early morning, and experienced a further reduction of 10.1 pain days per month (51%) since the completion of the experiment. However, some of the subjects who did not continue to comply also improved. Several possible explanations for the improvement of noncompliant subjects are offered.     

Application of outcomes research in occupational low back pain: The Maine Lumbar Spine Study

Outcomes research represents an expansion of traditional clinical research to include issues of cost and quality of care in usual clinical practice, emphasizing outcomes that matter most to patients. In low back disorders, outcomes research has focused on the lack of reliable information to support much of clinical practice and has demonstrated marked variability in the treatment of these common problems. The Maine Lumbar Spine Study represents an example of an outcomes research study to investigate the treatment of patients with sciatica in usual clinical practice. Because low back symptoms are a frequent cause of occupational disability. Workers' Compensation patients were explicitly oversampled. Baseline features were significantly different in those patients who were receiving Workers' Compensation versus those who were not. Efforts to compare outcomes by disability status need to control for these differences. Whereas most Workers' Compensation patients were still receiving disability compensation regardless of treatment at 6 months, patients who were treated surgically were more likely to have come off disability and returned to work than nonsurgically treated patients. Long-term follow-up is necessary to determine whether these differences persist. © 1996 Wiley-Liss, Inc.     

Prevalence of psychopathology in acute and chronic low back pain patients

This study assessed the differential prevalence rates of psychopathology in chronic and acute low back pain patients. Psychopathology was assessed with the Structured Clinical Interview for the DSM-III-R (SCID). The results showed that chronic low back pain patients (n=90), had much higher rates of psychopathology than did patients in the acute back pain group (n=90), and much higher than general population base rates. In particular, chronic low back pain patients had high rates of major depression, substance abuse, and personality disorders. Moreover, the chronic low back patients also had high rates of premorbid psychopathology. It was concluded that psychopathology is a major concomitant of chronic low pack pain, and that treating the psychological problems, along with the physical aspects of the chronic low back pain may increase the patient's chance of a successful therapeutic outcome.     

The Role of Pain-Related Anxiety Reduction in the Outcome of Multidisciplinary Treatment for Chronic Low Back Pain: Preliminary Results

The success of multidisciplinary treatments for chronic pain in helping patients suffer less and function better is well documented. However, this success has occurred despite a lack of understanding of the process of change that produces positive outcomes. The purpose of this study was to investigate the role of pain-related anxiety reduction in the outcome of treatment for chronic pain. Seventy-nine persons with chronic pain completed measures of pain, pain-related interference with activity, affective distress, general daily activity, and pain-related anxiety at admission and immediately following a 3-week multidisciplinary treatment program focusing on functional restoration. Patients significantly improved on all outcome measures. Reductions in pain-related anxiety predicted improved functioning on each measure. Additional analyses showed that change in pain-related anxiety remained a significant predictor of outcome independent of change in depression.     

The Effect of Order of Testing in Functional Performance in Persons with and Without Chronic Back Pain

Batteries of individually standardized physical and functional tests are commonly used to assess persons with chronic back pain disability. The order of testing may affect performance on later tests. One hundred and fifty patients with>3 months of back pain disability underwent a multidisciplinary Spine Team Assessment involving Physical Therapy, Occupational Therapy, Pain Psychology, and Vocational Rehabilitation Counselor assessments at a university spine clinic. Seventeen back healthy volunteers performed the physical component of the assessment. For the volunteers the order of testing was randomized to OT tests first or PT test first, with 0.5 h rest between the tests. For patients the order of testing was arbitrarily set by an alternating schedule, with 1 h psychological testing between the two components. For both the patients and volunteers, among the 14 test components, there was no significant difference (p > 0.05) in performance with order of testing. This held true for the subgroup of patients who put out good cardiac effort. Volunteers performed better than patients on all individual tests (p < 0.001). Results suggest that the order of physical testing during a Spine Team Assessment does not affect test performance either in chronic low back disabled patients or in volunteers.     

两种微创治疗方法在盘源性腰痛治疗中的应用

目的比较水冷式双极射频纤维环成形术和椎间盘内电热疗法治疗盘源性腰痛的临床效果及其并发症。方法 80例盘源性腰痛患者,随机分为A、B两组,每组40例,分别采用水冷式双极射频纤维环成形术和椎间盘内电热疗法进行治疗,观察两组患者手术前后VAS疼痛评分、Oswestry功能障碍指数评定的功能状态以及手术并发症等情况变化。结果经两种微创方法治疗后,两组患者疼痛评分均明显降低,功能状态显著改善,无严重并发症发生。结论水冷式双极射频纤维环成形术和椎间盘内电热疗法均能快速缓解患者疼痛,显著改善患者功能状态,并发症少,两者都是治疗盘源性腰痛的安全、有效的方法。     

Effects of Subacute Versus Chronic Status of Low Back Pain Patients' Response to a Functional Restoration Program

This study evaluated various functional capacity measures in two cohorts of patients participating in a functional restoration program: 1) subacute patients (defined as being admitted to the program within 1/2 year of injury), and 2) chronic patients (defined as being admitted after 1/2 year of injury). The main aim was to evaluate the differential effects of subacute versus chronic intervention functional outcomes of low back pain patients who participated in a functional restoration program. Findings clearly demonstrated that, compared to the chronic intervention group (n = 170), the subacute intervention group (n = 110) displayed greater functional performance gains in various tasks (e.g., range of motion, lifting capacity, etc.). These findings are consistent with recent suggestions in the literature that early intervention will produce greater therapeutic improvement in low back pain patients, with resultant health-care cost savings. Additional research is needed to further evaluate the utility of distinguishing among acute, subacute, and chronic patients as a means of predicting the degree of functional gains produced by intervention.