CAJ | 학술논문

目的：观察坐位定点旋转整复法治疗腰椎间盘突出症的临床疗效。方法：将符合要求的60例腰椎间盘突出症患者随机分为2组，每组30例，分别采用坐位定点旋转整复法和腰椎斜扳法治疗，共治疗2个疗程。采用视觉模拟评分法（visual analogue score，VAS）和日本骨科学会（Japanese orthopaedic association，JOA）下腰痛评分系统评价腰椎疼痛及功能恢复情况，并采用《中医病证诊断疗效标准》中腰椎间盘突出症疗效标准评价疗效。结果：治疗前2组患者的腰痛 VAS 评分比较，差异无统计学意义[（6．12±1．39）分，（6．86±1．12）分，t ＝0．166，P ＝0．871]；治疗后2组患者的腰痛 VAS 评分均降低[（2．47±1．58）分，（4．26±2．21）分]，旋转整复组降低幅度更明显[（4．90±1．31）分，（1．93±0．18）分，t ＝2．626，P ＝0．010]。治疗前2组患者的 JOA 评分比较，差异无统计学意义[（16．24±5．34）分，（15．67±6．19）分，t ＝0．760，P ＝0．087]；治疗后2组患者的 JOA 评分均增加[（24．25±4．05）分，（19．38±5．85）分]，旋转整复组增加更明显[（8．92±4．05）分，（5．12±4．91）分，t ＝4．706，P ＝0．032]。旋转整复组治愈16例、好转12例、未愈2例，斜扳组治愈11例、好转13例、未愈6例，旋转整复组的疗效优于斜扳组[旋转整复组95％CI 为（0．09，0．84），R ＝0．28；斜扳组95％CI 为（0．24，0．70），R ＝0．41]。结论：坐位定点旋转整复法治疗腰椎间盘突出症，操作简单，可以有效减轻患者腰痛症状，促进腰椎功能恢复，改善患者生活质量。
목적：관찰좌위정점선전정복법치료요추간반돌출증적림상료효。방법：장부합요구적60례요추간반돌출증환자수궤분위2조，매조30례，분별채용좌위정점선전정복법화요추사반법치료，공치료2개료정。채용시각모의평분법（visual analogue score，VAS）화일본골과학회（Japanese orthopaedic association，JOA）하요통평분계통평개요추동통급공능회복정황，병채용《중의병증진단료효표준》중요추간반돌출증료효표준평개료효。결과：치료전2조환자적요통 VAS 평분비교，차이무통계학의의[（6．12±1．39）분，（6．86±1．12）분，t ＝0．166，P ＝0．871]；치료후2조환자적요통 VAS 평분균강저[（2．47±1．58）분，（4．26±2．21）분]，선전정복조강저폭도경명현[（4．90±1．31）분，（1．93±0．18）분，t ＝2．626，P ＝0．010]。치료전2조환자적 JOA 평분비교，차이무통계학의의[（16．24±5．34）분，（15．67±6．19）분，t ＝0．760，P ＝0．087]；치료후2조환자적 JOA 평분균증가[（24．25±4．05）분，（19．38±5．85）분]，선전정복조증가경명현[（8．92±4．05）분，（5．12±4．91）분，t ＝4．706，P ＝0．032]。선전정복조치유16례、호전12례、미유2례，사반조치유11례、호전13례、미유6례，선전정복조적료효우우사반조[선전정복조95％CI 위（0．09，0．84），R ＝0．28；사반조95％CI 위（0．24，0．70），R ＝0．41]。결론：좌위정점선전정복법치료요추간반돌출증，조작간단，가이유효감경환자요통증상，촉진요추공능회복，개선환자생활질량。
Objective:To observe the clinical curative effects of fixed-point rotational reduction in sitting position in the treatment of lumbar disc herniation(LDH).Methods:Sixty patients with LDH enrolled in the study were randomly divided into 2 groups,30 cases in each group.The patients were treated with fixed-point rotational reduction in sitting position(group A)and lumbar oblique pulling(group B) respectively for consecutive two course of treatment.The lumbar pain and lumbar function recovery were evaluated by using the visual ana-logue scale(VAS)and Japanese orthopaedic association(JOA)low back pain scoring systerm,furthermore,the curative effects were evalua-ted according to therapeutic effect evaluation standard of LDH which was extracted from Standard for diagnosis and therapeutic effectiveness evaluation of traditional Chinese medicine syndromes.Results:There was no statistical difference in low back pain VAS scores between the 2 groups before the treatment(6.12 +/-1.39 vs 6.86 +/-1.12 points,t =0.166,P =0.871).The low back pain VAS scores decreased in both of the 2 groups after the treatment(2.47 +/-1.58 vs 4.26 +/-2.21 points)and there was a bigger decrease in group A(4.90 +/-1.31 vs 1.93 +/-0.18 points,t =2.626,P =0.010).There was no statistical difference in JOA scores between the 2 groups before the treatment(16.24 +/-5.34 vs 15.67 +/-6.19 points,t =0.760,P =0.087).The JOA scores increased in both of the 2 groups after the treatment(24.25 +/-4.05 vs 19.38 +/-5.85 points)and there was a bigger increase in group A(8.92 +/-4.05 vs 5.12 +/-4.91 points, t =4.706,P =0.032).Sixteen patients obtained an excellent result,12 good and 2 poor in group A;while 11 patients obtained an excellent result,13 good and 6 poor in group B.The group A surpassed the group B in the total curative effect(Group A:95%CI(0.09,0.84),R =0.28;Group B:95%CI(0.24,0.70),R =0.41).Conclusion:Fixed-point rotational reduction in sitting position,which is easy operated, can effectively relieve low back pain and promote the lumbar function recovery,so it can improve the quality of live of patients with LDH.