基于肌筋膜链理论手法治疗退变性腰椎失稳的疗效观察

目的:探讨基于肌筋膜链理论推拿手法治疗退变性腰椎失稳的临床疗效。方法:对2018年1月至2019年12月收治的57例退变性腰椎失稳患者进行回顾性分析,均采用推拿手法治疗。其中基于肌筋膜链理论手法治疗组(肌筋膜链组)29例,男14例,女15例;年龄40～69(51.76±5.07)岁;病程(3.4±1.6)年。基于中医经络理论手法治疗组(中医经络组)28例,男12例,女16例;年龄42～70(52.48±4.31)岁;病程(3.3±1.7)年。分别于治疗前和治疗结束后、治疗结束后1和3个月采用视觉模拟疼痛评分(visual analogue scale,VAS)评价腰痛程度,并采用日本骨科协会(Japanese Orthopaedic Association,JOA)下腰痛评分及改良的Oswe stry功能障碍指数(Oswestry Disability Index,ODI)评价腰椎功能改善情况,腰部肌肉肌张力变化评价临床疗效。结果:两组治疗后VAS评分、JOA评分、改良ODI评分及腰部肌肉肌张力均较治疗前明显改善(P0.05)。肌筋膜链组治疗前及治疗结束后的VAS评分、JOA评分、改良ODI评分及腰部肌肉肌张力与中医经络组比较差异无统计学意义(P0.05)。但肌筋膜链组治疗结束后1和3个月VAS评分、JOA评分、改良ODI评分及腰部肌肉肌张力较中医经络组改善更为明显(P0.05)。结论:基于肌筋膜链理论手法治疗退变性腰椎失稳可有效缓解腰痛症状,改善腰椎功能,值得临床推广。

Clinical effect of manipulation therapy for the treatment of degenerative lumbar instability based on myofascial chain theory

Objective: To explore clinical effects of manipulation therapy in treating degenerative lumbar instability based on myofascial chain theory.Methods: Fifty-seven patients with degenerative lumbar spine instability were analyzed retrospectively from January 2018 to December 2019,and treated with massage manipulation therapy. Among them,29 patients were treated with massage manipulation therapy based on the myofascial chain theory(myofascial chain group),including 14 males and 15 females,aged from 40 to 69 years old with an average of (51.76±5.07) years old,the courses of disease was (3.4±1.6) years. Twenty-eight patients were treated with massage manipulation therapy based on TCM meridian theory (TCM meridian group),including 12 males and 16 females,aged from 42 to 70 years old with an average of(52.48±4.31) years old,the courses of disease was(3.3±1.7) years. Before treatment,after treatment,1 and 3 months after treatment,visual analogue scale (VAS) was used to evaluate pain degree of lumbar,Japanese Orthopaedic Association(JOA) and modified Oswestry Disability Index(ODI) were used to assess improvement of lumbar function,and changes of lumbar muscle tension were used to evaluate clinical effect.Results: VAS score,JOA score,modified ODI score and lumbar muscle tension after treatment were significantly improved than those of before treatment between two groups(P<0.05). There were no statistical difference in VAS score,JOA score,modified ODI score and lumbar muscle tension between two groups before treatment and after treatment immediately(P>0.05). However,VAS score,JOA score,modified ODI score and lumbar muscle tension at one and three months after treatment in myofascial chain group were significantly better than that of TCM meridian group (P<0.05).Conclusion: Manipulation therapyon in treating degenerative lumbar instability based on myofascial chain theory could effectively relieve low back pain symptom and improve lumbar function. It is worthy of promoting.