三步推拿法治疗腰椎间盘突出症在社区农村的推广应用研究

目的论证三步推拿法治疗腰椎间盘突出症的临床疗效，同时研究其在社区医疗机构推广应用的价值。方法采用三级推广模式，选取腰椎间盘突出症患者180例（三甲医院90例、二级医院45例和基层社区卫生服务中心45例），均随机分为三步推拿组、牵引治疗组和传统手法组，分别采用相应的治疗方法，观察比较三家医院各组间的临床疗效及ODI、VAS差异。结果三组临床总有效率分别为三步推拿组85．00％、牵引治疗组60．00％和传统手法组83．33％，组间临床疗效差异具有统计学意义（P〈0．05）。三家医疗机构三步推拿组临床疗效比较，差异无统计学意义（P〉0．05）。结论三步推拿法治疗腰椎间盘突出症的临床疗效等同于传统推拿手法，且明显优于单一的牵引治疗；其具有简便易掌握的特点，适合在基层医院推广应用。

Popularization and application of Three-steps Massage Therapy for treating lumbar disc herniation in communities

Objective To further expound and prove the clinical effect of lumbar disc herniation with Three-steps Massage Therapy, and research the value of popu- larization and application in the community and rural basic medical institutions. Methods The study adopted three popularizing models. 180 cases with herniated lumbar disc were selected, 90 cases from municipal hospital,45 cases from district hospital and 45 from community health center. The trials were randomly divided into Three-steps Massage Therapy group, traction treatment group and traditional massage therapy group. Compare the clinical efficacy among the three hospitals. ODI（ Oswestry disability index） and VAS（ visual analogus scale） were used as the observation index sign for quantitative curative effects. Results The total effec- tive rates of Three-steps Massage Therapy group ,traction treatment group and traditional massage therapy group were respectively 85.00% ,60.00% and 83.33% , with obvious statistical differences between the three groups （ P 〈 0.05 ）. The ratio of cure with Three-step Massage Therapy has no statistical difference among three different hospitals （ P 〉 0.05 ）. Conclusion Three-steps Massage Therapy is quite effective for lmnbar disc herniation, and suitable for base hospitals.