CAJ | 학술논문

目的：探讨不同类型Modic 改变的慢性非特异性腰痛（CNLBP）的传统推拿手法治疗的近期疗效。方法：前瞻性分析推拿治疗CNLBP患者82例，根据MRI中Modic改变分4组：A组Modic 0型43例；B组Modic I型13例，C组ModicⅡ型20例，D组Modic Ⅲ型6例。所有患者均采用统一的推拿治疗。同时采集患者一般资料、治疗前后汉化Oswestry功能障碍指数（ODI），并采用IBM SPSS20.0进行统计分析。结果：4组间患者性别、年龄、腰痛时间、治疗前ODI等差异无统计学意义。与同组治疗前比较，治疗后4组ODI明显减小（P<0.01）。A和B之间、C和D之间ODI评分差异无统计学意义，其余组间差异均有统计学意义（P<0.05）。结论：CNLBP Modic改变是影响临床疗效的原因之一。无Modic改变和Modic I型CNLBP比ModicⅡ、Ⅲ型患者的推拿近期疗效好，提出ModicⅡ、Ⅲ型患者需要考虑叠加其他疗法。
목적：탐토불동류형Modic 개변적만성비특이성요통（CNLBP）적전통추나수법치료적근기료효。방법：전첨성분석추나치료CNLBP환자82례，근거MRI중Modic개변분4조：A조Modic 0형43례；B조Modic I형13례，C조ModicⅡ형20례，D조Modic Ⅲ형6례。소유환자균채용통일적추나치료。동시채집환자일반자료、치료전후한화Oswestry공능장애지수（ODI），병채용IBM SPSS20.0진행통계분석。결과：4조간환자성별、년령、요통시간、치료전ODI등차이무통계학의의。여동조치료전비교，치료후4조ODI명현감소（P<0.01）。A화B지간、C화D지간ODI평분차이무통계학의의，기여조간차이균유통계학의의（P<0.05）。결론：CNLBP Modic개변시영향림상료효적원인지일。무Modic개변화Modic I형CNLBP비ModicⅡ、Ⅲ형환자적추나근기료효호，제출ModicⅡ、Ⅲ형환자수요고필첩가기타요법。
This study was aimed to investigate short-term efficacy treated with traditional manipulation for patients with chronic non-specific low back pain (CNLBP) based on the classification of Modic changes. Eighty-two cases with CNLBP treated with traditional manipulation were analyzed prospectively. Cases were divided into 4 groups based on the classification of Modic changes in MRI. Forty-three cases in group A were Modic type 0; 13 cases in group B were Modic type Ⅰ; 20 in group C were Modic type II, and 6 cases in group D were Modic type Ⅲ. All patients were treated with traditional manipulation uniformly. Meanwhile, general data and Chinese Oswestry disabili-ty index (ODI) before and after treatment were collected. IBM SPSS 20.0 was used in the statistical analysis. The re-sults showed that there were no statistical differences on the gender, age, time of pain, and pretreatment ODI among 4 groups. Compared to the pretreatment of the same group, the ODI was obviously decreased in four groups (P <0.01). There were no statistical differences on ODI between A and B, C and D. There were statistical differences a-mong other groups (P< 0.05). It was concluded that Modic change was one of the causes which influence the effica-cy of CNLBP patients. Efficacy was better in Modic types 0 and Ⅰ than Modic type II and Ⅲ. It was suggested other treatment methods should be considered to use for patients of Modic type IIand Ⅲ.