三步五法治疗退行性腰椎滑脱症的临床研究

发布时间：2018-04-14 22:42

本文选题：退行性腰椎滑脱症 + 三步五法　；参考：《云南中医学院》2017年硕士论文

【摘要】：目的:通过观察三步五法和常规推拿手法治疗退行性腰椎滑脱症的临床疗效,初步探讨三步五法的疗效依据和作用机理,为临床治疗退行性腰椎滑脱症提供一种安全、有效的治疗方法。方法:采用随机对照分组方法,将符合纳入标准的65例患者随机分为2组,其中试验组33例,脱落3例;对照组32例,脱落2例。试验组采用三步五法进行推拿治疗,对照组采用常规推拿手法(参考王华兰主编《推拿治疗学》中的治疗方法)进行推拿治疗,每次治疗时间为30分钟;两组患者除行推拿治疗外均配合导引功法进行锻炼。以上治疗每日1次,2周为1个疗程,共执行1个疗程。分别观察治疗前、疗程结束后的“疼痛程度(PD)”及“JOA评分”变化,对相关数据进行统计学分析,比较两组的临床疗效。结果:1.完成本课题研究的60例患者,经1个疗程的治疗后,30例试验组中临床控制6例、显效10例、有效13例、无效1例,总有效率为96.67%;30例对照组中临床控制2例、显效6例、有效20例、无效2例,总有效率为93.33%。经秩和检验,试验组和对照组总体疗效相比,差异具有统计学意义(P0.05),说明三步五法组总体疗效优于常规推拿手法组。2.在疼痛程度的降低方面,两种手法治疗前后组内比较,差异均具有统计学意义(P0.05);疗程结束后组间比较,差异亦具有统计学意义(P0.05),说明三步五法组在降低患者疼痛程度方面优于常规推拿手法组。3.在临床症状、体征的改善方面,两种手法治疗前后组内评分比较,差异均具有统计学意义(P0.05);疗程结束后组间比较,差异亦具有统计学意义(P0.05),说明三步五法组在改善患者临床症状、体征方面优于常规推拿手法组。结论:1.经1个疗程的治疗后,三步五法组和常规推拿手法组均能降低患者疼痛程度及改善临床症状、体征;但组间比较,三步五法组均优于常规推拿手法组;2.经1个疗程的治疗后,三步五法组的总体疗效优于常规推拿手法组,三步五法值得在临床上推广运用。
[Abstract]:Objective: to observe the clinical curative effect of three step five method and conventional massage in treating degenerative lumbar spondylolisthesis, and to explore the curative effect basis and mechanism of three step five method, so as to provide a kind of safety for clinical treatment of degenerative lumbar spondylolisthesis.An effective treatment.Methods: 65 patients who met the inclusion criteria were randomly divided into two groups, including 33 cases in the experimental group and 3 cases in the control group, and 32 cases in the control group, 2 cases in the control group.The experimental group was treated with three steps and five methods, while the control group was treated with conventional massage manipulation (referring to the treatment method in Wang Hua Lan's editor of Tuina Therapy), each time was 30 minutes.In addition to massage treatment, the two groups of patients with guidance exercises.The above treatment was given once a day for 2 weeks as a course of treatment, and a course of treatment was performed.The changes of pain degree and JOA score before and after treatment were observed, and the related data were statistically analyzed to compare the clinical efficacy of the two groups.The result is 1: 1.After one course of treatment, there were 6 cases of clinical control, 10 cases of remarkable effect, 13 cases of effective and 1 case of ineffectiveness. The total effective rate was 96.67% in the control group (2 cases, 6 cases).Effective 20 cases, ineffective 2 cases, the total effective rate is 93.33.By rank sum test, compared with the control group, the overall curative effect of the trial group was significantly higher than that of the control group (P 0.05), indicating that the total curative effect of the three-step five-method group was better than that of the conventional massage manipulation group .2.In terms of pain reduction, the differences between the two groups before and after treatment were statistically significant (P 0.05), and after the end of the course of treatment, there was a significant difference between the two groups.The difference was also statistically significant (P 0.05), indicating that the three step five method group was superior to the conventional massage group in reducing the pain degree of the patients. 3.In the aspect of improvement of clinical symptoms and signs, there were significant differences in the scores between the two groups before and after the treatment, the difference was statistically significant (P 0.05), and the comparison between the two groups after the end of the course of treatment,The difference was also statistically significant (P 0.05), which indicated that the three step five method group was superior to the routine massage group in improving the clinical symptoms and signs of the patients.Conclusion 1.After one course of treatment, the three step five method group and the routine massage manipulation group can both reduce the pain degree and improve the clinical symptoms and signs, but the three step five method group is better than the routine massage manipulation group 2.After one course of treatment, the overall curative effect of the three-step five-method group was better than that of the conventional massage manipulation group, and the three-step five-method method was worth popularizing in clinical practice.
【学位授予单位】：云南中医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R244.1

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