手法松解联合盐酸乙哌立松片口服治疗腰背肌筋膜炎的临床研究

发布时间：2019-04-12 16:21

【摘要】：目的:探讨手法松解联合盐酸乙哌立松片口服治疗腰背肌筋膜炎的临床疗效。方法:将60例腰背肌筋膜炎患者随机分为观察组和对照组,每组30例。观察组采用手法松解联合盐酸乙哌立松片口服治疗,对照组采用芬必得布洛芬缓释胶囊加盐酸乙哌立松片口服治疗。治疗前后分别采用视觉模拟评分量表(visual analogue scale,VAS)和Oswestry功能障碍指数(Oswestry disability index,ODI)对患者腰背部疼痛和腰椎功能进行评估。治疗结束后即根据ODI改善率评价疗效,并随访观察2组患者临床复发情况,记录复发时间。结果:治疗前2组患者VAS评分和ODI评分组间比较,差异均无统计学意义[(7.3±0.9)分,(7.2±1.1)分;t=0.381,P=0.352;(40.4±4.7)分,(39.9±3.5)分;t=0.499,P=0.309]。治疗结束后2组患者VAS评分和ODI评分均较治疗前降低[(7.3±0.9)分,(1.5±0.6)分;t=28.987,P=0.000;(7.2±1.1)分,(1.9±0.8)分;t=21.399,P=0.000;(40.4±4.7)分,(11.6±2.9)分;t=28.665,P=0.000;(39.9±3.5)分,(13.9±2.9)分;t=31.456,P=0.000];且观察组VAS评分和ODI评分均低于对照组[(1.5±0.6)分,(1.9±0.8)分;t=2.633,P=0.005;(11.6±2.9)分,(13.9±2.9)分;t=-3.107,P=0.001]。根据ODI改善率评价疗效,观察组优8例、良22例;对照组优1例、良27例、可2例;观察组疗效优于对照组(Z=-2.793,P=0.005)。60例患者均获随访,随访时间12~36个月,中位数22个月。60例患者均出现复发;治疗结束至症状复发的时间观察组(17.1±7.5)个月,对照组(12.2±6.5)个月;观察组复发较对照组晚(t=2.764,P=0.004)。结论:手法松解联合盐酸乙哌立松片口服治疗腰背肌筋膜炎,可有效缓解疼痛、改善腰椎功能,疗效优于芬必得布洛芬缓释胶囊加盐酸乙哌立松片口服,且更有利于延缓复发。
[Abstract]:Objective: to investigate the clinical effect of manipulation relaxation combined with epiperisone hydrochloride tablets in the treatment of lumbar back fasciitis. Methods: sixty patients with lumbar dorsum fasciitis were randomly divided into observation group and control group with 30 cases in each group. The control group was treated with Fenbid ibuprofen sustained-release capsule and epiperisone hydrochloride tablets orally. The patients' lumbar back pain and lumbar function were evaluated by visual analogue scale (visual analogue scale,VAS) and Oswestry dysfunction index (Oswestry disability index,ODI) before and after treatment. After the treatment, the curative effect was evaluated according to the improvement rate of ODI, and the clinical recurrence of the two groups was observed and the recurrence time was recorded. Results: there was no significant difference in VAS score and ODI score between the two groups before treatment [(7.3 卤0.9), (7.2 卤1.1); t = 0.381, P = 0.352; (40.4 卤4.7), (39.9 卤3.5); T = 0.499, P = 0.309]. After treatment, the scores of VAS and ODI in the two groups decreased [(7.3 卤0.9), (1.5 卤0.6); (28.987, P < 0.001); (7.2 卤1.1), (1.9 卤0.8); (21.399, P < 0.001); (40.4 卤4.7,11.6 卤2.9,28.665, P < 0.001; 39.9 卤3.5,13.9 卤2.9; t = 31.456, P = 0.000); The scores of VAS and ODI in the observation group were lower than those in the control group [(1. 5 卤0. 6), (1. 9 卤0. 8); t = 2.63, P < 0. 05; (11.6 卤2. 9), (13.9 卤2. 9); t = 3. 107, P < 0. 001]. According to the improvement rate of ODI, 8 cases were excellent in the observation group, 22 cases were good in the observation group, 1 case was excellent in the control group, 27 cases were good and 2 cases were fair. The curative effect of the observation group was better than that of the control group (Z = 2.793, P < 0.005). 60 patients were followed up for 12 months for 36 months with a median of 22 months. The time from the end of treatment to the recurrence of symptoms was (17.1 卤7.5) months in the observation group and (12.2 卤6.5) months in the control group, and the recurrence time in the observation group was later than that in the control group (t = 2.764, P = 0.004). Conclusion: manual relaxation combined with epiperisone hydrochloride tablets can effectively relieve pain and improve lumbar spine function, which is better than Fenbid ibuprofen sustained-release capsule and epiperisone hydrochloride tablets oral, and is more beneficial to delay recurrence.
【作者单位】：中国中医科学院望京医院;
【分类号】：R686.3

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