腰椎间盘突出症射频消融术后核心肌力训练联合艾灸治疗的临床疗效分析

发布时间：2018-01-26 23:53

  本文关键词： 腰椎间盘突出症 核心肌群稳定性 艾灸 运动训练　出处：《南京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:观察腰椎间盘突出症患者射频消融术后核心肌力训练联合艾灸治疗的临床疗效。方法:将60例已进行单针单节射频消融术治疗的腰椎间盘突出症患者随机分为常规治疗组(C组,n=20)、核心肌力训练组(E组,n=22)和核心肌力训练联合艾灸治疗组(EM组,n=21)。C组:给予常规术后治疗;E组:给予常规术后治疗和核心肌力训练治疗;EM组:给予常规术后治疗、核心肌力训练和局部艾灸治疗。分别于治疗开始前第1天(1st day,1d)、1周(1st week,1w)和12周(12th week,12w)训练结束后评价患者疼痛程度(VAS)、Oswestry功能障碍指数(ODI)水平、腰背肌伸肌肌力、蜷腹肌力。结果:治疗前,各组VAS、ODI和腰背伸肌肌力、蜷腹肌力水平无明显差异(P0.05)。①与1d相比,各组在1w时的VAS均降低(P0.05),12w时VAS显著降低(P0.01);与C组相比,在1w、12w时E组VAS低于C组且差异有统计学意义(P0.05),EM组VAS低于C组且差异显著(P0.01);与E组相比,EM组在1w、12w时VAS更低,差异有统计学意义(P0.05)。②与1d相比,各组在1w和12w时的ODI均降低(P0.05),12w时降低且差异显著(P0.01);与C组相比,E组在1w时ODI较低,但差异无统计学意义(P0.05),在12w时更低,差异有统计学意义(P0.05);与C组相比,EM组在1w时ODI更低,差异有统计学意义(P0.05),12w时ODI更低,差异显著(P0.01);与E组相比,1w时EM组ODI更低,但两组结果无显著差异(P0.05),在12w时EM组ODI低于E组且差异有统计学意义(P0.05)。③与1d相比,各组在1w时的挺腹时间均提高,差异有统计学意义(P0.05),在12w时E组、EM组挺腹时间明显提高,与治疗前差异显著(P0.01);E、EM组与C组相比,在1w时挺腹时间长于C组,差异有统计学意义(P0.05),在12w时E组、EM组挺腹时间更长,差异显著(P0.01);E组与EM组相比较,1w、12w时EM组挺腹时间更长,但两组结果无显著差异(P0.05)。④与1d相比,各组在1w时的蜷腹时间均提高,差异有统计学意义(P0.05),在12w时E组、EM组显著提高(P0.01);E组、EM组与C组相比,在1w时蜷腹时间均长于C组,差异有统计学意义(P0.05),在12w时E组、EM组蜷腹时间显著长于C组(P0.01);E组与EM组相比较,1w、12w时EM组蜷腹时间更长,但两组结果无显著差异(P0.05)。结论:①单独核心肌力训练或者核心肌力训练联合艾灸治疗均可以促进腰椎间盘突出症患者射频消融术后疼痛缓解;②核心肌力训练联合艾灸治疗促进腰椎间盘突出症患者射频消融术后疼痛缓解,效果优于单独进行核心肌力训练治疗;③单独核心肌力训练或者核心肌力训练联合艾灸治疗均可以促进腰椎间盘突出症患者射频消融术后运动功能恢复;④核心肌力训练联合艾灸治疗与单独核心肌力训练相比,12周时对运动功能恢复的促进有明显效果,但1周时效果并不优于单独进行核心肌力训练。
[Abstract]:Objective: to observe the clinical effect of core muscle strength training combined with moxibustion in patients with lumbar disc herniation after radiofrequency ablation. Sixty patients with lumbar disc herniation who had been treated with single needle radiofrequency ablation were randomly divided into routine treatment group (. Group C. The core muscle strength training group (group E) and the moxibustion group (group B) were given routine postoperative treatment. Group E: routine postoperative treatment and core muscle strength training; Group EM was treated with routine postoperative treatment, core muscle strength training and local moxibustion treatment. The first day of treatment was 1 day before the beginning of treatment. The pain degree and the Oswestry dysfunction index (ODI) were evaluated after 12 weeks and 12 weeks of training. Results: before treatment, there was no significant difference in the muscle strength of VASO ODI and extensor lumbar dorsalis muscle, and the level of cuddle abdominus muscle strength in each group (P0.05.1 vs 1 d). The VAS of each group was significantly lower than that of P0. 05 and P0. 01 at 12 weeks. Compared with group C, the VAS of group E was lower than that of group C at 12 weeks, and the difference was statistically significant. The VAS of group E was lower than that of group C (P 0.05) and the difference was significant (P 0.01). Compared with E group, the VAS of EM group was lower than that of E group at 12 weeks after 1 week, and the difference was statistically significant (P 0.05) compared with that of 1 day. The ODI of each group decreased at 1 and 12 weeks, and the difference was significant (P 0.01). Compared with group C, the ODI of group E was lower at 1 week, but the difference was not statistically significant (P 0.05), but it was lower at 12 weeks (P 0.05). Compared with group C, the ODI of EM group was lower than that of group C at 1 week, and the ODI was lower at 12 weeks after P0.05, and the difference was significant (P 0.01). The ODI of EM group was lower than that of E group at 1 week, but there was no significant difference between the two groups (P 0.05). At 12 weeks, the ODI of EM group was lower than that of E group, and the difference was statistically significant (P 0.05). At 12 weeks, the time of occipitostomy in group E was significantly higher than that before treatment (P 0.01). Compared with group C, the time of occipitostomy in group E was longer than that in group C at 1 week, the difference was statistically significant (P 0.05), and that in group E was longer than that in group E at 12 weeks, and the difference was significant (P 0.01). Compared with EM group, group E was longer than EM group at 12 weeks, but there was no significant difference between the two groups (P 0.05.4). Compared with group 1, the time of curling up abdomen in each group was increased at 1 week. The difference was statistically significant (P 0.05). At 12 weeks, E group was significantly higher than that of EM group (P 0.01). Compared with group C, group E had a longer time of curling up abdomen at 1 week than group C, the difference was statistically significant (P 0.05), and at 12 weeks, group E was significantly longer than that of group C. The curling time of EM group was significantly longer than that of group C (P 0.01). Compared with EM group, group E had longer time of curling up abdomen than EM group at 12 weeks after 1 week. However, there was no significant difference between the two groups (P 0.05). Conclusion either the core muscle strength training alone or the core muscle strength training combined with moxibustion therapy can promote pain relief after radiofrequency ablation in patients with lumbar disc herniation. 2the effect of core muscle strength training combined with moxibustion in promoting pain relief after radiofrequency ablation in patients with lumbar intervertebral disc herniation was better than that of core muscle strength training alone; (3) single core muscle strength training or core muscle strength training combined with moxibustion therapy can promote the recovery of motor function after radiofrequency ablation in patients with lumbar disc herniation. (4) the effect of core muscle strength training combined with moxibustion treatment on the recovery of motor function at 12 weeks was significantly higher than that of single core muscle strength training, but the effect at 1 week was not better than that of core muscle strength training alone.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R681.53;R493

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