CAJ | 학술논문

目的：观察五禽戏配合核心肌力训练治疗非特异性腰痛（nonspecific low back pain，NLBP）的临床疗效。方法：将符合要求的80例 NLBP 患者随机分为核心肌群组（26例）、五禽戏组（26例）和联合治疗组（28例）。核心肌群组进行核心肌力训练，五禽戏组练习五禽戏，联合治疗组同时进行核心肌力训练和五禽戏练习。核心肌力训练和五禽戏练习均由专业治疗师进行指导，共锻炼3个月。比较3组治疗前及治疗3个月后的腰痛视觉模拟量表（visual analogoue scale，VAS）评分、Oswestry 功能障碍指数（Oswestry disability index，ODI）、脊柱屈伸活动度及腹背肌耐力，同时观察治疗结束后3个月内的腰痛复发率。结果：治疗前3组患者的腰痛 VAS 评分、ODI、脊柱屈伸活动度、腹肌耐力、背肌耐力比较，组间差异均无统计学意义[（5．78±1．42）分，（5．80±1．44）分，（5．75±1．30）分，F ＝0．773，P ＝0．444；（24．06±7．98）％，（23．55±7．73）％，（24．28±8．16）％，F ＝0．659，P ＝0．374；（1．67±1．25）cm，（1．60±1．07）cm，（1．71±1．14）cm，F ＝0．773，P ＝0．293；（27．10±10．46）s，（27．28±9．34）s，（26．59±10．23）s，F ＝0．541，P ＝0．592；（34．99±10．69）s，（36．08±11．44）s，（34．74±10．35）s，F ＝0．552，P ＝0．584]；治疗3个月后3组患者的腰痛 VAS 评分、ODI、脊柱屈伸活动度、腹肌耐力、背肌耐力比较，组间差异均有统计学意义[（2．39±1．16）分，（1．99±1．27）分，（1．28±1．13）分，F ＝11．728，P ＝0．003；（11．42±5．10）％，（10．02±5．26）％，（7．25±4．37）％，F ＝12．028，P ＝0．002；（3．63±1．53）cm，（3．86±1．39）cm，（4．18±1．43）cm，F ＝7．631，P ＝0．007；（42．65±13．86）s，（48．85±12．59）s，（53．79±16．81）s，F ＝17．645，P ＝0．000；（49．21±16．48）s，（52．82±16．70）s，（58．10±16．98）s，F ＝5．496，P ＝0．017]。治疗3个月后，联合治疗组的腰痛 VAS 评分和 ODI 均低于核心肌群组和五禽戏组（P ＝0．000，P ＝0．004；P ＝0．000，P ＝0．003），五禽戏组均低于核心肌群组（P ＝0．027；P ＝0．035）；联合治疗组的脊柱屈伸活动度、腹肌耐力及背肌耐力均大于核心肌群组和五禽戏组（P ＝0．004， P ＝0．008；P ＝0．000，P ＝0．004；P ＝0．000，P ＝0．032），五禽戏组均大于核心肌群组（P ＝0．042；P ＝0．003；P ＝0．041）。治疗结束后3个月内，核心肌群组5例复发、五禽戏组4例复发、联合治疗组2例复发，3组患者的腰痛复发率比较，差异无统计学意义（χ2＝1．800，P ＝1．433）。结论：五禽戏配合核心肌力训练可有效缓解 NLBP 患者的腰痛症状、增强腹背肌耐力、恢复脊柱活动度，从而改善腰部功能，而且复发率较低，值得临床推广应用。目的：觀察五禽戲配閤覈心肌力訓練治療非特異性腰痛（nonspecific low back pain，NLBP）的臨床療效。方法：將符閤要求的80例 NLBP 患者隨機分為覈心肌群組（26例）、五禽戲組（26例）和聯閤治療組（28例）。覈心肌群組進行覈心肌力訓練，五禽戲組練習五禽戲，聯閤治療組同時進行覈心肌力訓練和五禽戲練習。覈心肌力訓練和五禽戲練習均由專業治療師進行指導，共鍛煉3箇月。比較3組治療前及治療3箇月後的腰痛視覺模擬量錶（visual analogoue scale，VAS）評分、Oswestry 功能障礙指數（Oswestry disability index，ODI）、脊柱屈伸活動度及腹揹肌耐力，同時觀察治療結束後3箇月內的腰痛複髮率。結果：治療前3組患者的腰痛 VAS 評分、ODI、脊柱屈伸活動度、腹肌耐力、揹肌耐力比較，組間差異均無統計學意義[（5．78±1．42）分，（5．80±1．44）分，（5．75±1．30）分，F ＝0．773，P ＝0．444；（24．06±7．98）％，（23．55±7．73）％，（24．28±8．16）％，F ＝0．659，P ＝0．374；（1．67±1．25）cm，（1．60±1．07）cm，（1．71±1．14）cm，F ＝0．773，P ＝0．293；（27．10±10．46）s，（27．28±9．34）s，（26．59±10．23）s，F ＝0．541，P ＝0．592；（34．99±10．69）s，（36．08±11．44）s，（34．74±10．35）s，F ＝0．552，P ＝0．584]；治療3箇月後3組患者的腰痛 VAS 評分、ODI、脊柱屈伸活動度、腹肌耐力、揹肌耐力比較，組間差異均有統計學意義[（2．39±1．16）分，（1．99±1．27）分，（1．28±1．13）分，F ＝11．728，P ＝0．003；（11．42±5．10）％，（10．02±5．26）％，（7．25±4．37）％，F ＝12．028，P ＝0．002；（3．63±1．53）cm，（3．86±1．39）cm，（4．18±1．43）cm，F ＝7．631，P ＝0．007；（42．65±13．86）s，（48．85±12．59）s，（53．79±16．81）s，F ＝17．645，P ＝0．000；（49．21±16．48）s，（52．82±16．70）s，（58．10±16．98）s，F ＝5．496，P ＝0．017]。治療3箇月後，聯閤治療組的腰痛 VAS 評分和 ODI 均低于覈心肌群組和五禽戲組（P ＝0．000，P ＝0．004；P ＝0．000，P ＝0．003），五禽戲組均低于覈心肌群組（P ＝0．027；P ＝0．035）；聯閤治療組的脊柱屈伸活動度、腹肌耐力及揹肌耐力均大于覈心肌群組和五禽戲組（P ＝0．004， P ＝0．008；P ＝0．000，P ＝0．004；P ＝0．000，P ＝0．032），五禽戲組均大于覈心肌群組（P ＝0．042；P ＝0．003；P ＝0．041）。治療結束後3箇月內，覈心肌群組5例複髮、五禽戲組4例複髮、聯閤治療組2例複髮，3組患者的腰痛複髮率比較，差異無統計學意義（χ2＝1．800，P ＝1．433）。結論：五禽戲配閤覈心肌力訓練可有效緩解 NLBP 患者的腰痛癥狀、增彊腹揹肌耐力、恢複脊柱活動度，從而改善腰部功能，而且複髮率較低，值得臨床推廣應用。
목적：관찰오금희배합핵심기력훈련치료비특이성요통（nonspecific low back pain，NLBP）적림상료효。방법：장부합요구적80례 NLBP 환자수궤분위핵심기군조（26례）、오금희조（26례）화연합치료조（28례）。핵심기군조진행핵심기력훈련，오금희조연습오금희，연합치료조동시진행핵심기력훈련화오금희연습。핵심기력훈련화오금희연습균유전업치료사진행지도，공단련3개월。비교3조치료전급치료3개월후적요통시각모의량표（visual analogoue scale，VAS）평분、Oswestry 공능장애지수（Oswestry disability index，ODI）、척주굴신활동도급복배기내력，동시관찰치료결속후3개월내적요통복발솔。결과：치료전3조환자적요통 VAS 평분、ODI、척주굴신활동도、복기내력、배기내력비교，조간차이균무통계학의의[（5．78±1．42）분，（5．80±1．44）분，（5．75±1．30）분，F ＝0．773，P ＝0．444；（24．06±7．98）％，（23．55±7．73）％，（24．28±8．16）％，F ＝0．659，P ＝0．374；（1．67±1．25）cm，（1．60±1．07）cm，（1．71±1．14）cm，F ＝0．773，P ＝0．293；（27．10±10．46）s，（27．28±9．34）s，（26．59±10．23）s，F ＝0．541，P ＝0．592；（34．99±10．69）s，（36．08±11．44）s，（34．74±10．35）s，F ＝0．552，P ＝0．584]；치료3개월후3조환자적요통 VAS 평분、ODI、척주굴신활동도、복기내력、배기내력비교，조간차이균유통계학의의[（2．39±1．16）분，（1．99±1．27）분，（1．28±1．13）분，F ＝11．728，P ＝0．003；（11．42±5．10）％，（10．02±5．26）％，（7．25±4．37）％，F ＝12．028，P ＝0．002；（3．63±1．53）cm，（3．86±1．39）cm，（4．18±1．43）cm，F ＝7．631，P ＝0．007；（42．65±13．86）s，（48．85±12．59）s，（53．79±16．81）s，F ＝17．645，P ＝0．000；（49．21±16．48）s，（52．82±16．70）s，（58．10±16．98）s，F ＝5．496，P ＝0．017]。치료3개월후，연합치료조적요통 VAS 평분화 ODI 균저우핵심기군조화오금희조（P ＝0．000，P ＝0．004；P ＝0．000，P ＝0．003），오금희조균저우핵심기군조（P ＝0．027；P ＝0．035）；연합치료조적척주굴신활동도、복기내력급배기내력균대우핵심기군조화오금희조（P ＝0．004， P ＝0．008；P ＝0．000，P ＝0．004；P ＝0．000，P ＝0．032），오금희조균대우핵심기군조（P ＝0．042；P ＝0．003；P ＝0．041）。치료결속후3개월내，핵심기군조5례복발、오금희조4례복발、연합치료조2례복발，3조환자적요통복발솔비교，차이무통계학의의（χ2＝1．800，P ＝1．433）。결론：오금희배합핵심기력훈련가유효완해 NLBP 환자적요통증상、증강복배기내력、회복척주활동도，종이개선요부공능，이차복발솔교저，치득림상추엄응용。
Objective:To observe the curative effect of five mimic -animal boxing combined with core muscular strength exercise on nonspecific low back pain(NLBP).Methods:Eighty patients with NLBP enrolled in the study were randomly divided into core muscle group(26 cases),five mimic -animal boxing group(26 cases)and combination therapy group(28 cases).The patients were treated with core muscular strength exercise(core muscle group),five mimic -animal boxing(five mimic -animal boxing group)and core muscular strength exercise combined with five mimic -animal boxing practice(combination therapy group).The core muscular strength exercise and five mimic -animal boxing were performed with guidance from professional therapists for totally 3 months.The low back pain visual analo-goue scale(VAS)scores,Oswestry disability index(ODI),spinal flexion -extension range and dorsal abdominal muscle endurance were compared between the 3 groups before treatment and after 3 -month treatment respectively,and the recurrence rate of NLBP were also ob-served after 3 -month treatment.Results:There was no statistical difference in low back pain VAS score,ODI,spinal flexion -extension range,abdominal muscle endurance and dorsal muscle endurance between the 3 groups before the treatment(5.78 +/-1.42,5.80 +/-1.44,5.75 +/-1.30 points,F =0.773,P =0.444;24.06 +/-7.98%,23.55 +/-7.73%,24.28 +/-8.16%,F =0.659,P =0.374;1.67 +/-1.25,1.60 +/-1.07,1.71 +/-1.14 cm,F =0.773,P =0.293;27.10 +/-10.46,27.28 +/-9.34,26.59 +/-10.23 sec,F =0.541,P =0.592;34.99 +/-10.69,36.08 +/-11.44,34.74 +/-10.35 sec,F =0.552,P =0.584).There was statistical difference in low back pain VAS score,ODI,spine flexion -extension range,abdominal muscle endurance and dorsal muscle endurance between the 3 groups after 3 -month treatment(2.39 +/-1.16,1.99 +/-1.27,1.28 +/-1.13 points,F =11.728,P =0.003;11.42 +/-5.10%, 10.02 +/-5.26%,7.25 +/-4.37%,F =12.028,P =0.002,3.63 +/-1.53,3.86 +/-1.39,4.18 +/-1.43 cm,F =7.631,P =0.007;42.65 +/-13.86,48.85 +/-12.59,53.79 +/-16.81 sec,F =17.645,P =0.000;49.21 +/-16.48,52.82 +/-16.70,58.10 +/-16.98 sec,F =5.496,P =0.017).After 3 -week treatment,the low back pain VAS scores and ODI were lower in combination therapy group compared to core muscle group and five mimic -animal boxing group(P =0.000,P =0.004;P =0.000,P =0.003)and were lower in five mimic -animal boxing group compared to core muscle group(P =0.027;P =0.035).The spinal flexion -extension range,abdominal mus-cle endurance and dorsal muscle endurance were greater in combination therapy group compared to core muscle group and five mimic -ani-mal boxing group(P =0.004,P =0.008;P =0.000,P =0.004;P =0.000,P =0.032),and were greater in five mimic -animal boxing group compared to core muscle group(P =0.042;P =0.003;P =0.041).Recrudescent NLBP were found in core muscle group(5),five mimic -animal boxing group(4)and combination therapy group(2)within 3 months after the end of the treatment,and there was no statisti-cal difference in the recurrence rate of NLBP between the 3 groups(χ2 =1.800,P =1.433).Conclusion:The combination therapy of five mimic -animal boxing and core muscular strength exercise can effectively relief the low back pain and enhance the dorsal abdominal muscle endurance and recover the spinal flexion -extension range with low recurrence rate.Therefore,it can improve the lower back function in pa-tients with NLBP and it is worthy of popularizing in clinic.