龙氏正骨手法治疗腰椎滑脱症的临床研究

发布时间：2018-01-19 01:21

本文关键词： 龙氏手法牵抖冲压法腰椎滑脱症正骨　出处：《广州中医药大学》2015年硕士论文　论文类型：学位论文

【摘要】：腰椎滑脱症主要是由于双侧峡部不连,椎弓崩裂,椎体间慢性错位,引起慢性腰痛腿痛症状,称为腰椎滑脱症,本症多发于中年以上女性,男女比1：5,以腰4、5滑脱最多见。随着现代人生活方式的改变,腰椎滑脱症患者越来越多,并日趋年轻化,严重影响了人们日常生活和工作,故加强对腰椎滑脱症的临床研究,得出一种有效的治疗方法,具有非常重要的临床意义。目的：通过规范化的研究、临床观察及客观数据对比龙氏正骨手法与腰椎牵引法对腰椎滑脱症的治疗效果,为龙氏正骨手法治疗腰椎滑脱症提供科学的应用数据。明确龙氏正骨手法的治疗特点,探讨龙氏正骨手法的操作规范,推广及应用,为临床治疗腰椎滑脱症提供新的方法。方法：将60例腰椎滑脱症患者随机分为两组,每组30人。治疗组采用龙氏正骨手法治疗,对照组则用腰椎牵引法治疗,比较两组治疗1个疗程(每周治疗5次,2周为1个疗程)和治疗后3个月(远期)的临床疗效。60名患者在治疗前和完成1个疗程后及治疗后3个月均采用改良日本骨科学会下腰痛评分表(JOA)、疼痛视觉模拟评分表(VAS)评分及中医疾病诊断疗效标准评价分级,最后用统计学的方法检验,以全面分析评价其临床疗效是否具有统计学意义。结果：(1)符合纳入标准的60例患者,实际完成病例60例。经1个疗程的治疗后,治疗组30例中,治愈17例,显效8例,有效3例,无效2例,总有效率93.33%；对照组30例中,治愈10例,显效6例,有效7例,无效7例,总有效率76.67%。经统计学的卡方检验,龙氏正骨手法治疗组治疗疗效明显。(2)在临床症状的改善方面与疼痛改善方面,两种方法治疗腰椎滑脱症,治疗前、后组内JOA评分与VAS评分比较,差异均具有统计学意义(P0.01),龙氏正骨手法的远期疗效优于腰椎牵引法。(3)治疗结束后3个月随访时,两组临床症状改善方面,VAS和JOA评分比较,经统计学比较(P0.05),说明龙氏正骨手法的远期疗效优于腰椎牵引法。结论：本研究是从科学、客观、严谨的临床数据去评价龙氏正骨手法的临床疗效,研究结果更加可信。龙氏正骨手法治疗腰椎滑脱症是有显著疗效的,是目前治疗腰椎滑脱症较好方法之一。因此,龙氏正骨手法治疗腰椎滑脱症在临床上值得推广。
[Abstract]:Lumbar spondylolisthesis is mainly due to bilateral isthmus, spondylolysis, chronic dislocation between the vertebral body, causing chronic low back pain and leg pain symptoms, known as lumbar spondylolisthesis, this disease is more than middle-aged women, male to female ratio of 1: 5. With the change of modern life style, more and more patients with lumbar spondylolisthesis become younger and younger, which seriously affects people's daily life and work. Therefore, to strengthen the clinical study of lumbar spondylolisthesis, to obtain an effective treatment method, has a very important clinical significance. Clinical observation and objective data were used to compare the therapeutic effect of Longs bony manipulation and lumbar traction in the treatment of lumbar spondylolisthesis. To provide scientific data for the treatment of lumbar spondylolisthesis with Longshi bone-orthopaedic manipulation. Methods: 60 cases of lumbar spondylolisthesis were randomly divided into two groups, 30 in each group. The control group was treated with lumbar traction, and the two groups were treated with one course of treatment (5 times a week). Clinical efficacy of 2 weeks as a course of treatment and 3 months (long term) after treatment. 60 patients were treated with the modified Japanese Orthopaedic Society low back pain scale before and after 1 course of treatment and 3 months after the treatment (2 weeks as a course of treatment) and 3 months after treatment (2 weeks as a course of treatment) and 3 months after treatment (. JOAA. Visual analogue scale of pain (VASS) and criteria for the diagnosis of TCM diseases were used to evaluate the efficacy of VASs. Finally, statistical methods were used to test them. Results there were 60 patients who met the inclusion criteria and 60 patients who actually completed the treatment. After one course of treatment, 30 cases in the treatment group. 17 cases were cured, 8 cases were obviously effective, 3 cases were effective, 2 cases were ineffective. The total effective rate was 93.33%. In the control group, 10 cases were cured, 6 cases were markedly effective, 7 cases were effective and 7 cases were ineffective. The total effective rate was 76.677.The result of chi-square test was statistically significant. Longshi bone manipulation treatment group in the treatment of clinical symptoms and pain improvement, two methods to treat lumbar spondylolisthesis, before treatment, after the group JOA score and VAS score comparison. The difference was statistically significant (P 0.01). The long term curative effect of Longshi bone manipulation was better than that of lumbar traction. 3 months after the treatment, the clinical symptoms of the two groups were improved. VAS and JOA scores were compared statistically (P 0.05), indicating that the long term effect of long bone manipulation was better than that of lumbar traction. Conclusion: this study is scientific and objective. Rigorous clinical data to evaluate the clinical efficacy of Longshi bone manipulation, the results of the study is more credible. Longshi bony manipulation treatment of lumbar spondylolisthesis is a significant effect. It is one of the better methods to treat lumbar spondylolisthesis. Therefore, the treatment of lumbar spondylolisthesis by long's bony manipulation is worth popularizing.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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