通督正脊术治疗腰椎间盘突出症的临床研究

发布时间：2018-02-24 06:31

本文关键词： 通督正脊术腰椎牵引腰椎间盘突出症　出处：《山西省中医药研究院》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过比较通督正脊术与腰椎牵引治疗腰椎间盘突出症患者在疼痛评分(VAS)、腰腿痛疾患治疗成绩评分(JOA)、脊柱侧弯的角度COBB值方面的差异,以及评价两种疗法在治疗本病中的有效性及安全性,得出通督正脊术疗效更佳的结论,从而为保守治疗腰椎间盘突出症提供新的行之有效且安全性高的治疗方案。方法:将就诊于推拿科门诊(山西省中医院)的64例腰椎间盘突出症患者,采取完全随机的方法分为治疗组(通督正脊术)和对照组(腰椎牵引),每组32例。治疗组和对照组均隔日1次,1个疗程为10次,治疗共计1个疗程。以疼痛直观模拟量表(VAS)、腰腿痛疾患治疗成绩评分表(JOA)及影像学评价指标(COBB值)为观察指标,采用SPSS17.0统计软件对数据进行处理和分析,对比两种治疗方法的临床疗效。结果:1.VAS评分:治疗结束后,经统计分析,P0.01,组间VAS评分比较有差异,说明通督正脊术优于腰椎牵引;治疗前后两组分别组内VAS评分比较,经统计分析,P0.01,说明两种治疗方法均可减轻患者的疼痛。2.JOA评分:治疗结束后,经统计分析,P0.01,两组组间JOA分值比较有差异,说明通督正脊术疗效比腰椎牵引好;治疗前后两组分别组内JOA分值比较,经统计分析,P0.01,说明通督正脊术和腰椎牵引均可改善患者的临床症状和体征。3.COBB值评分:治疗结束后,经统计分析,P0.01,两组在改善COBB值方面有差异,且通督正脊术优于腰椎牵引;治疗前后两组分别组内COBB值比较,经统计分析,P0.01,说明通督正脊术和腰椎牵引均可改善患者棘突的偏歪程度。4.初次治疗后VAS评分:初次治疗后,经统计分析,P0.01,组间VAS评分比较有差异,说明通督正脊术即时止痛效果比腰椎牵引快;治疗前和初次治疗后两组分别组内VAS评分比较,经统计分析,P0.01,说明两种治疗方法均可以迅速缓解疼痛。5.总体疗效:通督正脊术和腰椎牵引疗效对比,治疗组总有效率为96.9%,对照组总有效率为84.4%,经统计分析,P0.05,说明两组患者的总体疗效有差异,且通督正脊术的疗效优于腰椎牵引。结论:1.通督正脊术与腰椎牵引在腰椎间盘突出症的治疗中均有明显的临床疗效,均可改善患者的疼痛程度、临床症状、体征及腰椎棘突的偏歪程度。2.通督正脊术在改善疼痛和临床症状、体征及腰椎棘突的偏歪程度方面相对于腰椎牵引更为显著。
[Abstract]:Objective: to compare the differences of pain score (VASA), score of pain score (JOAA), angle of scoliosis (COBB) in patients with lumbar disc herniation treated by Tongduzheng spinal surgery and lumbar traction. And to evaluate the efficacy and safety of the two kinds of therapies in the treatment of this disease, and draw the conclusion that the curative effect of Tongdu Zhengji surgery is better. Methods: 64 patients with lumbar disc herniation (Shanxi Provincial traditional Chinese Medicine Hospital) were treated with conservative treatment of lumbar intervertebral disc herniation, and 64 patients with lumbar intervertebral disc herniation were treated in the department of massage (Shanxi Provincial traditional Chinese Medicine Hospital). The treatment group and the control group were randomly divided into two groups: treatment group (control group) and control group (lumbar traction group, 32 cases in each group). The treatment group and control group were treated once every other day for 10 courses of treatment. The total course of treatment was 1 course. The visual analogue pain scale (VASA), the score scale for the treatment of low back and leg pain (JOAA) and the imaging evaluation index (COBB) were used to process and analyze the data by SPSS17.0 statistical software. Results 1. VAS score: after the treatment, there were differences in VAS scores between the two groups by statistical analysis (P0.01), which indicated that Tongduzheng spinal surgery was superior to lumbar traction, and the VAS scores of the two groups were compared before and after treatment. Statistical analysis showed that the two treatment methods can alleviate the pain of patients. 2. JOA score: after the end of treatment, after the statistical analysis of P0.01, the JOA scores of the two groups were different, which indicated that the curative effect of the two groups was better than that of lumbar traction. The comparison of JOA scores between the two groups before and after treatment showed that the clinical symptoms and signs of the patients could be improved after the treatment. 3. The score of COBB value: after the treatment, the patients' clinical symptoms and signs could be improved by the operation of Tongdu's spine and lumbar traction: after the treatment, the patients' clinical symptoms and signs could be improved. After statistical analysis, there were differences in improving COBB value between the two groups, and the value of COBB in the two groups before and after treatment was better than that in lumbar traction. By statistical analysis, it was shown that the degree of skewness of spinous process could be improved by the operation of straight spine of Tongdu and the traction of lumbar spine. 4. The VAS score after the first treatment: after the first treatment, the VAS score of the two groups was different after the first treatment (P 0.01), and there was a significant difference between the two groups. The results showed that the immediate analgesic effect of Tongdu Zhengji operation was faster than that of lumbar traction, and the VAS scores of the two groups were compared before and after the first treatment. By statistical analysis of P0.01, it is shown that both of the two treatments can relieve pain quickly. 5. the overall curative effect: the comparison of the curative effect of Tongduzhengji operation and lumbar traction, The total effective rate of the treatment group was 96.9 and the total effective rate of the control group was 84.4. The statistical analysis showed that there was a difference in the overall curative effect between the two groups. Conclusion both the operation and the lumbar traction have obvious clinical effect in the treatment of lumbar disc herniation, which can improve the degree of pain and clinical symptoms of the patients with lumbar intervertebral disc herniation. Physical signs and the degree of skew of lumbar spinous process .2.Tongduzheng spinal surgery is more significant than lumbar traction in improving pain and clinical symptoms, signs and the degree of skew of lumbar spinous process.
【学位授予单位】：山西省中医药研究院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.9

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