以宗整脊治疗腰椎管狭窄症生存质量的中期随访

发布时间：2018-07-18 16:04

【摘要】：目的：研宄以宗整脊综合疗法对腰椎管狭窄症(LSS, lumbar stenosis)患者中期生存质量(QOL)的影响,通过比较对患者生存质量各维度的改善值情况。探索以生存质量评价标准治疗腰椎管狭窄症的合理方案,并为临床工作提供新依据。方法：本研究采取回顾性研究,查阅2010年1月-2015年6月在广东省中医院骨科住院治疗的退行性腰椎管狭窄症患者共189例,符合纳入标准的并愿意配合课题工作的有98例,按照治疗方案改为骨盆牵引组及整脊治疗组。以生活质量36问卷(The short-term 36, SF-36量表)为测评量表,分别对上述患者进行治疗前后的评分,进行数据统计,从生理职能(Role-Physical, RP)、生理机能(Physical Functioning, PF)、总体健康状况(General Health, GH)、躯体疼痛(Bodily Pain, BP)、社会功能(Social Functioning, SF)、精力(Vitality, VT)、精神健康(Mental Health, MH)、情感职能(Role-Emotional, RE)这8个维度评价两种治疗方法干预后患者的生存质量情况以及改善情况。结果：1.治疗后进行组内比较,以宗整脊治疗组的8个维度得分均高于骨盆牵引组得分,其中在生理机能、生理职能、躯体疼痛、社会职能、精神健康、精力这6个维度的评分有统计学差异。2.在对病程的生存质量评分分析中,病程小于4年组内,整脊组的躯体疼痛的生存质量评分高于骨盆牵引组,并且有统计学差异；另外在病程大于4年组内,整脊组的总体健康生存质量评分高于骨盆牵引组,存在着统计学差异。3.不同性别在整脊及骨盆牵引治疗患者中的各维度之间的生存质量评分并没有统计学差异。4.年龄小于65岁分组内,整脊组的躯体疼痛、社会职能情况、精神健康情况这三个维度评分高于骨盆牵引组,且存在统计学差异。在大于65岁的患者分组内,整脊组的生理机能、躯体疼痛两个维度得分高于骨盆牵引组,并且均有统计学差异。5.随访时间小于1.5年的分组内,整脊组患者的总体健康情况生存质量评分高于骨盆牵引组,骨盆牵引组的社会职能情况生存质量评分高于整脊组,并且上述两组数据存在组内统计学差异。结论：1.患者在经以宗整脊治疗后而在生理机能、生理职能、躯体疼痛、社会职能、精神健康、精力这6个维度的评分较前提高,并且有统计学差异。以宗整脊治疗对改善生理情况,缓解躯体疼痛,改善精神健康、精力以及改善社会职能有一定的帮助。在临床工作应该根据患者具体情况选择合理的治疗方案。2.性别对于进行骨盆牵引治疗及整脊治疗后患者的生存质量评分不存在影响。3.随访时间小于1.5年的整脊组患者的总体健康情况生存质量评分较骨盆牵引组患者高,可能进行整脊治疗对患者的总体健康有一定帮助；而整脊治疗组的社会职能生存质量得分较骨盆组低,可以建议患者加强与周围亲友交流及沟通。4.两个年龄分组中整脊组患者在躯体疼痛这个维度评分高于骨盆牵引组,整脊治疗可能在缓解疼痛较为有效。在小于65岁的年龄分组中整脊治疗组的社会职能情况、精神健康情况的生存质量得分高于骨盆牵引组,可能是整脊治疗后患者症状缓解有助于其社会交际及精神健康情况。在大于65岁的患者分组内,整脊组的生理机能维度得分高于骨盆牵引组,可能整脊治疗有助于改善生理机能。5.病程小于4年的整脊治疗患者的躯体疼痛生存质量评分相对骨盆牵引组较高,应该说整脊治疗有助于缓解疼痛。另外,大于4年的整脊患者在总体健康维度得分高于骨盆牵引组,整脊治疗可以对缓解躯体疼痛,同时也影响患者健康情况。6.以宗整脊疗法治疗腰椎管狭窄症是一种疗效确切,安全可靠及副作用少的治疗方法,值得临床推广。
[Abstract]:Objective: To explore the effect of LSS (lumbar stenosis) on the mid-term quality of life (QOL) in patients with lumbar spinal stenosis (QOL), and to explore the rational plan for the treatment of lumbar spinal stenosis by comparing the quality of life of the patients with the quality of life. In this study, a retrospective study was conducted to examine 189 patients with degenerative lumbar spinal stenosis hospitalized in Department of orthopedics, Guangdong Province Traditional Chinese Medical Hospital, January 2010, -2015, and 98 cases in accordance with the standard and willing to cooperate with the subject work. The treatment scheme was changed into pelvic traction group and whole spine treatment group. The quality of life 36 questionnaire (The short-TE) was used. The RM 36, the SF-36 scale) was the assessment scale, and the scores of the patients before and after the treatment were calculated, from the physiological function (Role-Physical, RP), the physiological function (Physical Functioning, PF), the overall health status (General Health, GH), body pain (Bodily Pain), social function, energy. VT), the 8 dimensions of mental health (Mental Health, MH) and emotional function (Role-Emotional, RE) were used to evaluate the quality of life and improvement of the two treatments after intervention. Results: after 1. treatments, the scores of the 8 dimensions in the Zong chiropractic group were higher than those in the pelvic traction group. The scores of the 6 dimensions of function, somatic pain, social function, mental health, and energy were statistically different..2. was less than 4 years in the quality of life score analysis of the course of disease. The quality of life of the body pain in the whole spine group was higher than that in the pelvic traction group, and there were differences in the overall planning. In addition, the whole spine group was more than 4 years, and the whole spine group The overall health quality score was higher than that in the pelvic traction group. There was a statistical difference in.3.. There was no statistical difference in the quality of life scores between the different sexes in the whole spine and pelvic traction patients. The.4. age was less than 65 years old, and the body pain, social function, and mental health were the three dimensions of the whole spine group. The score of degree score was higher than that in pelvic traction group, and there was a statistical difference. In the group of patients older than 65 years old, the score of physiological function and body pain in the whole spine group was higher than that in the pelvic traction group, and there were statistically significant differences in the.5. follow-up time of less than 1.5 years. The overall health quality score of the patients with whole spinal cord group was higher than that of the pelvis. In the traction group, the score of the social function of the pelvic traction group was higher than that of the whole group, and there was a statistical difference between the two groups. Conclusion: the scores of the 1. patients were improved in physiological function, physiological function, somatic pain, social function, mental health, energy and energy, and the scores of the 6 dimensions were higher than before. Statistical differences. The treatment of Zong chiropractic has some help to improve physical condition, relieve somatic pain, improve mental health, energy, and improve social function. In clinical work, a reasonable treatment scheme should be selected according to the specific condition of the patient,.2. sex for the quality of life of the patients after pelvic traction treatment and whole spinal therapy. The overall health quality score of the patients with.3. follow-up less than 1.5 years was higher than those in the pelvic traction group. It may be helpful for the overall health of the patients, while the social function score of the whole spine treatment group was lower than that in the pelvic group, and it was suggested that the patients should be strengthened with the surrounding relatives and friends. In the two age groups of the two age groups, the whole spine group was higher than the pelvic traction group. The whole ridge therapy may be more effective in alleviating pain. The social function of the whole spine group in the age group of less than 65 years of age was higher than the pelvic traction group. In patients older than 65 years of age, the score of the physiological function dimension of the whole spine group is higher than that of the pelvic traction group. It may be helpful to improve the somatic pain quality score of the patients with physiological function.5. for less than 4 years. There is a higher traction group. It should be said that spinal cord therapy helps relieve pain. In addition, the overall health dimension of the patients who are more than 4 years is higher than the pelvic traction group. The whole ridge therapy can relieve somatic pain and also affect the health of the patients. The treatment of lumbar spinal stenosis is an effective, safe, reliable and auxiliary treatment for the treatment of lumbar spinal stenosis by.6.. Less effective treatment is worthy of clinical promotion.
【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】：2016
【分类号】：R244.1

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