针刀联合腰背肌核心稳定性训练治疗慢性非特异性下腰痛疗效观察

目的观察针刀联合腰背肌核心稳定性训练治疗慢性非特异性下腰痛的效果。方法将2017年10月—2018年10月北京中医药大学第三附属医院治疗的63例慢性非特异性下腰痛患者随机分为试验组和对照组。试验组32例给予针刀联合腰背肌核心稳定性训练,对照组31例给予单纯腰背肌核心稳定性训练,连续治疗3个月,分别于治疗后1个月、3个月观察2组患者VAS评分、ODI评分、JOA评分变化,评价治疗效果。结果试验组失访者1例,未按要求进行治疗者1例;对照组失访者1例。治疗前2组下腰痛VAS评分、ODI评分比较差异均无统计学意义(P均<0.05);治疗后即刻及治疗后3个月,试验组VAS评分及ODI评分均低于对照组,差异有统计学意义(P均<0.05);治疗结束后3个月,试验组总有效率为93%(28/30),显著高于对照组的73%(22/30),差异有统计学意义(P<0.05)。结论单用腰背肌核心稳定性训练与针刀联合腰背肌核心稳定性训练治疗慢性非特异性下腰痛均有效果,均能降低VAS分值、ODI评分,但联合治疗在近期症状改善及远期疗效维持方面更具优势。

Observation of the curative effect of acupotomy combined with lumbar and back muscle core stability training on chronic nonspecific low back pain

Objective It is to observe the effect of acupotomy combined with core stability training of the lumbar and back muscles in the treatment of chronic non-specific low back pain.Methods Sixty-three patients with chronic nonspecific low back pain treated in the Third Affiliated Hospital of Beijing University of Chinese Medicine from October 2017 to October 2018 were randomly divided into an experimental group and a control group.32 patients in the experiment group were treated with acupotomy combined with core stability training of the lumbar and back muscles,and 32 patients in the control group were treated with simple core stability training of the lumbar and back muscles,both groups were continuously treated for 3 months.The changes of the VAS scores,ODI scores,and JOA scores of the patients in both groups were observed after 1,3 months of treatment,and the treatment effects were evaluated.Results One case was lost and one case was not treated as required in the experiment group,one case was lost in the control group.There was no statistically significant difference in VAS score and ODI score between the two groups before treatment(P<0.05);the VAS scores and ODI scores of the experiment group in the experiment group were significantly lower than that of the control group immediately after treatment and 3 months after treatment,the differences were statistically significant(P<0.05).In 3 months after the end of treatment,the total effective rate in the experiment group was 93%(28/30),which was significantly higher than that 73%(22/30)in the control group,the difference was statistically significant(P<0.05).Conclusion Core stability training of the lumbar and back muscles and acupotomy combined with low back muscle core stability training are both effective in the treatment of chronic non-specific low back pain,both can reduce the VAS score and ODI score,but the combined treatment is more effective in the improvement of short-term symptoms and the maintenance of long-term efficacy.