抱膝滚腰锻炼防治腰椎退行性骨关节病的 病例对照研究

目的：探讨抱膝滚腰锻炼对腰椎退行性骨关节病患者腰痛与腰椎功能的影响。方法：自2006年8月至2008年1月，150侧腰椎退行性骨关节病患者随机分为3组：对照组、抱膝滚腰锻炼组与结合组（每组50例）。3组女／男构成比分别为16／34、13／37和15／35；平均年龄分别为（58．8±10．2）岁，（60．1±8．2）岁与（59．9±11．4）岁；平均病程分别为（16．3±14．9）个月，（17．1±15.3）个月与（19．8±17．2）个月。3组分别采用美洛昔康片口服、抱膝滚腰锻炼以及上两种方法结合进行治疗，观察3组患者在治疗3周后的疗效、疼痛视觉模拟评分与腰痛指数的变化。随访6—24个月，观察患者每月腰痛指数的变化。结果：治疗3用后，3组疗效比较：对照组和抱膝滚腰组相比，差异无统计学意义（P〉0．05）；结合组与对照组、抱膝滚腰锻炼组相比，差异有统计学意义（均P〈0．01）。3组治疗后的VAS评分与ODI指数与治疗前相比，差异均有统计学意义（均P〈0．01）；治疗后结合组的VAS疼痛评分与ODI指数与其他两组相比，差异有统计学意义（均P〈0．01）。随访期间，后两组患者平均每月的腰痛指数与对照组相比差异有统计学意义（均P〈0．01）。结论：抱膝滚腰锻炼操作简单、无花费，是腰椎退行性骨关节病疗效比较好的防治方法。

Case-control study on embracing knee and rolling lumbar training for preventing and treating degenerative osteoarthritis of lumbar spine

Objective: To study therapeutic effects of embracing knee and rolling lumbar(EKRL) training on the pain and the function of lumbar of patients with degenerative osteoarthritis of lumbar spine. Methods: From 2006.8 to 2008.1,150 patients with degenerative osteoarthritis of lumbar spine were randomly divided into the control group,EKRL training group and the combined group. In the control group (n=50),there were 16 females and 34 males,the average age was(58.8±10.2)years and the average course of diseases was(16.3±14.9)months. In the EKRL training group(n=50=50),there were 13 females and 37 males, the average age was(60.1±8.2)years and the average course of disease was(17.1±15.3)months. In the combined group(n=50=50),there were 15 females and 35 males,the average ages was(59.9±11.4)years and the average course of diseases was(19.8±17.2)months. The patients in three groups were treated with Meloxicam tablets,EKRL training and two above methods combination respectively. After 3 weeks treatment, the curative effect,the visual analogous scores and the ODI indexes were observed. All the patients were followed up and the duration ranged from 6 to 24 months;the changes of average ODI indexes were observed monthly. Results: After 3 weeks treatment,the therapeutic effects in three groups had obvious difference after Ridit analyses:there were significant differences between the combined group and other two groups(P=50<0.01),but no obvious differences existed in other two groups. Compared with before treatment,the visual analogue scale scores and the ODI indexes in three groups reduced significantly(P<0.01). After treatment, the visual analogue scale scores and the ODI indexes of the combined group had significant differences compared with those of other two groups(P<0.01),but the ODI indexes of other two groups had no obvious differencses. After 6 to 24 months following-up,the monthly changes of average ODI indexes of EKRL training and combined groups had obvious differences compared with that of the control group(P<0.01). Conclusion: EKRL training is a simple,no expense and effective methods for preventing and treating degenerative osteoarthritis of lumbar spine.