走罐对非特异性下腰痛疗效的观察

目的:评价走罐治疗非特异性下腰痛(NLBP)的疗效。方法:将符合诊断标准的70例NLBP门诊患者随机分成走罐、药物治疗两组。走罐组37例,采用隔日1次走罐治疗,6次为1疗程;药物组33例,采用右旋布洛芬0.15g口服,每日3次,若腰痛连续2日消失即停药,最长疗程为12d。使用VAS疼痛视觉模拟量尺和SF-36健康状况调查问卷评估疗效。结果:治疗前(后)VAS指数及SF-36得分,走罐组分别为6.11±2.08(1.29±1.62)及33.79±8.75(63.12±12.89);药物组分别为5.86±1.99(3.57±2.96)及34.51±9.43(53.81±13.33)。治疗前、后VAS指数差值及SF-36得分差值,走罐组分别为4.83±2.58、29.33±13.24;药物组分别为2.29±1.92、19.30±12.14。治疗前、后比较,两组VAS指数及SF-36得分差别均有统计学意义(P<0.01);两组间VAS指数及SF-36得分治疗前、后的差值差别有显著性意义(P<0.01)。结论:走罐疗法和右旋布洛芬均能明显改善NLBP,但走罐的疗效优于右旋布洛芬。     

局部振动疗法对慢性非特异性腰痛的疗效研究

目的:观察局部振动疗法对慢性非特异性腰痛患者的干预疗效。方法:81例慢性非特异性腰痛患者随机分为观察组40例和对照组41例。对照组患者接受中药熏蒸疗法和超短波治疗,观察组在对照组的基础上增加局部振动治疗。分别于治疗前后利用视觉模拟评分(VAS)评估2组患者的疼痛,利用Oswestry功能障碍指数(ODI)及指地距离(FFD)评估2组患者的功能情况。结果:治疗2周后,2组VAS及ODI评分均较治疗前明显下降(P0.01,0.05),且观察组低于对照组(均P0.01);2组FFD评分治疗前后及组间比较差异均无统计学意义。结论:局部振动疗法可以缓解慢性非特异性腰痛患者疼痛,减轻因腰痛引起的功能障碍,安全性高,患者依从性好,是一种值得推荐的康复治疗方案。     

四位一体推拿疗法治疗慢性非特异性腰痛的近期疗效观察

目的 比较四位一体推拿疗法与传统推拿疗法治疗慢性非特异性腰痛的近期疗效。方法 慢性非特异性腰痛患者60例,采用随机数字表法分为四位一体推拿疗法组和传统推拿组各30例,分别采用传统推拿和四位一体推拿,每周治疗2次,每次40 min,连续治疗4周。比较两组患者治疗前和治疗结束后1个月的腰部疼痛视觉模拟量表(VAS)评分、Roland腰椎功能障碍评分和Oswestry功能障碍指数(ODI)评分。结果 治疗后1月,两组患者VAS评分、Roland评分、ODI评分均低于治疗前,且四位一体推拿疗法组评分低于单纯推拿组,好转率优于单纯推拿组,差异有统计学意义(P<0.05)。结论 采用四位一体推拿疗法和传统推拿法治疗慢性非特异性腰痛均能使腰部疼痛得到缓解,改善腰部活动功能,四位一体推拿疗法近期临床疗效更佳。     

推拿加腰背肌训练对非特异性下腰痛的疗效及其机制

目的探讨推拿加腰背肌训练治疗非特异性下腰痛的作用机理。方法200例非特异性下腰痛（NLBP）患者分为4组：空白组、训练组、推拿组、推拿加训练组，各50例。在治疗开始和治疗4周后，对4组患者进行肌酸激酶（CK）、乳酸脱氢酶（LDH）、超氧化物歧化酶（SOD）活性、丙二醛（MDA）含量的测定及目测类比定级法（VAS）评定。结果4组患者的CK、LDH、SOD和MDA含量以及VAS指数均有不同程度的改善。组间比较，推拿加训练组的CK、LDH、SOD和MDA含量以及VAS指数均明显优于其他3组（均P〈0．01）。结论中医推拿技术结合主动功能训练治疗NLBP具有明显的康复疗效。     

非特异性下腰痛的保守治疗现状

<正>非特异性下腰痛(nonspecific low back pain,NLBP)是原发于腰部、不伴有神经根受累或腰部器质性病变的慢性腰痛[1],其临床特点为患者疼痛和功能障碍明显[2]。根据欧盟委员会COST B13工作组颁布的下腰痛预防指南,NLBP被定义为无可识别的明确病理学改变(如感染、肿瘤、骨质疏松、强直性脊柱炎、骨折、马尾综合征等)的下腰痛(Low back pain,LBP)[3]。NLBP的现代临床诊断属于腰肌劳损、腰肌筋膜炎、急性腰扭伤、腰     

电针结合核心肌群训练治疗非特异性下腰痛的疗效观察

目的:探讨电针结合核心肌群训练治疗非特异性下腰痛的临床疗效。方法:选取符合诊断标准的非特异性下腰痛患者60例,随机把患者分为观察组和对照组各30例,2组均进行电针治疗,观察组加用核心肌群训练,共治疗2周。在治疗前、治疗第2周结束时及治疗结束后3个月随访时分别使用疼痛视觉类比评分法(VAS)评估疼痛强度,使用改良日本骨科协会(JOA)腰痛疗效问卷评分观察腰痛改善情况。结果:治疗2周后,2组患者改良JOA腰痛疗效评分及VAS评分均较治疗前有显著改善(P0.05),且观察组更优于对照组(P0.05);治疗3个月后随访,观察组的复发率明显低于对照组(10.0%、30.0%,P0.05)。结论:电针治疗结合腰部核心肌群训练治疗非特异性下腰痛2周的临床疗效优于单纯电针治疗,不易复发。     

非特异性下腰痛的临床与康复

下腰痛(low back pain，LBP)是指下腰、腰骶、骶髂、臀部或腿部一组疼痛的主观感觉，伴有腿部疼痛、麻木和无力就称为坐骨神经痛。大约有60％—80％，的成年人在生活中有过LBP的经历，是仅次于上呼吸道疾患而就诊的第二位常见的临床症状，是45岁以下人群最常见的致残原因。对于疼痛没有客观的测量，只能通过主观的自我描述(如疼痛的刻     

干扰电结合肌肉能量技术治疗非特异性下腰痛的疗效

目的：观察干扰电结合肌肉能量技术治疗非特异性下腰痛的临床疗效。方法：40例非特异性下腰痛患者随机分为观察组和对照组各20例,对照组给予常规针灸、推拿及中药熏药治疗,观察组在此基础上应用干扰电结合肌肉能量技术治疗。治疗前后采用视觉模拟评分（VAS）、JOA下腰痛评分系统评定疗效。结果：治疗21d后,2组患者VAS评分均较治疗前明显下降（P〈0.05）,且观察组更低于对照组（P〈0.05）;2组JOA评分均较治疗前明显提高（P〈0.05）,且观察组更高于对照组（P〈0.05）。治疗后观察组临床满意率明显高于对照组（85.0%、65.0%,P〈0.05）。结论：干扰电结合肌肉能量技术技术能有效缓解下腰背疼痛,具有较好的临床效果。     

社区非特异性下腰痛患者健康教育方法与效果

目的探讨非特异性下腰痛患者健康教育的传播形式及效果。方法将206例非特异性下腰痛患者分为观察组和对照组各103例,观察组采用手机短信的形式进行健康教育,对照组采用常规健康教育。干预前后分别采用知识评估问卷、遵医行为评估问卷、Zung氏焦虑自评量表、抑郁自评量表进行问卷调查。结果干预后,观察组焦虑评分、抑郁评分、复发率均低于对照组(P<0.01或P<0.05);知识知晓率、遵医率高于对照组(P<0.01)。结论实施手机短信形式的健康教育对社区非特异性下腰痛患者健康教育效果明显优于传统健康教育。     

Balance Control Comparison between Subjects with and without Non-specific Low Back Pain*

Objective: To compare the balance ability between normal people and non-specific low back pain (nsLBP) patients and explore the relationship between balance ability and muscle function in nsLBP patients. Method: Ten nsLBP patients as nsLBP group and 10 age and gender-matched healthy control subjects as control group were investigated. Posturography on balance platform and surface electromyography(sEMG) were performed to assess all the subjects′ function of equilibrium and muscle activities of erector spinea(ES), multifidus(MF), abdominal external oblique (EO), hamstring (HS) and maximal gluteus (MG) bilaterally. Result: The nsLBP subjects had greater sway on anterior-posterior direction (Y-speed and Y-extension, P=0.05) on feet-together posture and bigger main axis (P=0.023) on nature standing with eyes closed when compared with controls. The iEMG ratios of right MG in nature standing (eyes closed)/ nature standing (eyes open) and feet-together (eyes open)/nature standing (eyes open) in control group were significant higher than that in nsLBP group (P=0.03 and P=0.013). Conclusion: Balance evaluation combined with sEMG measurement on trank and lower limb muscles provided some quantitative information about functional deficits such as postural control and muscle activities in nsLBP patients. Ｔhis relationship should be emphasized in prevention and rehabilitation of nsLBP.     

非特异性下腰痛护理干预的效果和费用分析

目的评价非特异性下腰痛患者综合护理干预的临床效果和费用。方法将260例非特异性下腰痛患者随机分为研究组和对照组各130例,对研究组进行综合护理干预（心理干预及渐进性锻炼方法）,对照组采取常规护理。采用Zung氏焦虑自评量表（Zung self-anxiety scale,SAS）、抑郁自量表（self-depression scale,SDS）、视觉模拟评分法（visual analog scale,VAS）及生活质量评估表,分别在干预前、干预1年后对两组患者进行评估,并对干预1年时两组患者与下腰痛相关的医疗服务情况及其费用进行分析。结果两组患者干预前SAS和SDS评分与国内常模比较有显著差异（P＜0．01）;干预后,两组患者间SAS和SDS评分、疼痛情况、生活质量及费用比较均有显著差异（P＜0．05或P＜0．01）。结论对患者进行心理干预及渐进性腰背肌、腹肌锻炼结合常规护理的综合干预方法可提高患者的生活质量,降低医疗费用。     

悬吊运动训练对慢性非特异性腰痛的疗效观察

目的观察悬吊运动训练技术治疗社区慢性非特异性腰痛的效果。方法 35例成人慢性非特异性腰痛患者分成治疗组(n=18)和对照组(n=17),分别采用电疗+悬吊运动训练和单纯电疗治疗4周。使用疼痛数字评分(NRS)、Oswestry腰痛功能障碍问卷,分别在治疗开始前、治疗4周后进行评估。结果治疗后与对照组比较,治疗组NRS、Oswestry腰痛功能障碍问卷评分改善(P<0.05)。结论悬吊运动训练可以有效减轻社区慢性非特异性腰痛患者的疼痛及功能障碍。     

非特异性下腰痛患者不同桥式运动时腰肌表面肌电信号的变化

目的了解非特异性下腰痛患者在行不同桥式运动时腰肌表面肌电活动的变化。方法选取正常对照与非特异性下腰痛患者各18 例,记录两组受试者行桥式运动、单足支撑桥式运动时的腰肌表面肌电信号均方根值。结果对照组行不同桥式运动时,双侧竖脊肌、多裂肌表面肌电配对比较均无显著性差异(P>0.05);各时段组间同侧同名肌肉表面肌电比较无显著性差异(P>0.05)。患者组行桥式运动时,双侧腰肌表面肌电配对比较无显著性差异(P>0.05);行单足支撑桥式运动时,支撑足侧竖脊肌肌电值较对侧大(P<0.05),前、中、后时段腰肌肌电值无显著性差异(P>0.05)。结论非特异性下腰痛患者行非对称性桥式运动时,双侧竖脊肌收缩力不平衡。     

Differences in Comorbidities on Low Back Pain and Low Back Related Leg Pain

Objective: Investigate the influence of external factors such as depression and BMI among subjects with primary severe low back pain (LBP) and low back related leg pain (LBLP). Background: The report of disability in patients with LBP may be significantly influenced by confounding and moderating variables. No similar studies have examined the influence of these factors on LBLP. Methods: This study included 1,448 consecutive subjects referred to a tertiary spine clinic. Unconditional binary logistic regression was used to determine the influence of comorbidities on the relationship between self‐reported back and leg pain. A change in estimate formula was used to quantify this relationship. Results: Among those subjects with primary LBP the unadjusted odds ratio was 8.58 (95% CI 4.87, 15.10) and when adjusting for BMI, depression and smoking was 5.94 (95% CI 3.04, 11.60) resulting in a 36.7% change due to confounding by these comorbidities. Among those with primary LBLP, the unadjusted odds ratio was 4.49 (95% CI 2.78, 7.27) and when adjusting for BMI and depression was 4.60 (95% CI 2.58, 8.19) resulting in a 1.7% change due to confounding by these comorbidities. Conclusion: The disability statuses of the patients with primary LBP in this study were more significantly affected by comorbidities of BMI, depression and smoking than patients with report of LBLP. However, these comorbidities contribute little to the relationship of primary low back related leg pain and Oswestry scores ≥ 40.     

Ability of Early Response to Predict Discharge Outcomes With Physical Therapy for Chronic Low Back Pain

Objective: To determine how well early responses to physical therapy for chronic low back pain predict outcomes at discharge. Methods: A prospective single cohort study of chronic low back pain patients seen at a university spine physical therapy clinic. Self‐reported pain severity on a 100‐mm visual analog scale was measured before each physical therapy visit. The predictive variables were the change in pain score at the second, third, and fourth visits. The first outcome variable was discharge change in pain severity for a correlation analysis. The second outcome variable was a dichotomous variable of whether the subjects had achieved at least a 30% reduction in pain severity at discharge for a discriminant analysis. Results: Spearman’s rank order correlation coefficient showed that early responses at the second (r = 0.324, P = 0.02) third (r = 0.342, P = 0.01), and fourth visits (r = 0.615, P < 0.001) were all significantly correlated with discharge change in pain. The discriminant analysis showed that early responses from the second to fourth visits were able to correctly predict 80.4% of the discharge outcomes (P < 0.001). Conclusions: Early responses with physical therapy help predict discharge outcomes for chronic low back pain.