A multicenter randomized controlled study for treatment of middle⁃aged and old⁃aged lumbar disc herniation by Shi⁃style spine balance manipulation combined with bone and muscle guidance

Xing DING; Jinhai XU; Wen MO; Guodong WANG; Zhengyi TONG; Jie YE; Shengbao WANG; Chunlan FAN; Kang LIU; Xiaoxia HUANG; Qi SHI

doi:10.16305/j.1007-1334.2022.2109075

您当前的位置：

首页 >

文章列表页 >

A multicenter randomized controlled study for treatment of middle⁃aged and old⁃aged lumbar disc herniation by Shi⁃style spine balance manipulation combined with bone and muscle guidance

更新时间：2022-07-09

- A multicenter randomized controlled study for treatment of middle⁃aged and old⁃aged lumbar disc herniation by Shi⁃style spine balance manipulation combined with bone and muscle guidance
- Shanghai Journal of Traditional Chinese Medicine Vol. 56, Issue 4, Pages: 50-55(2022)
- 作者机构：
  
  1.上海中医药大学附属龙华医院骨伤科（上海 200032）
  2.上海中医药大学脊柱病研究所（上海 200032）
  3.上海市浦东新区上钢社区卫生服务中心（上海 201315）
  4.上海市浦东新区南码头社区卫生服务中心（上海　　201204）
  5.上海市浦东新区中医医院骨伤科（上海 200299）
- 作者简介：
- 基金信息：
- DOI：10.16305/j.1007-1334.2022.2109075
  CLC：
扫描看全文
丁兴,许金海,莫文等.施氏脊柱平衡手法结合筋骨导引术治疗中老年腰椎间盘突出症的多中心随机对照临床研究[J].上海中医药杂志,2022,56(04):50-55.

DING Xing,XU Jinhai,MO Wen,et al.A multicenter randomized controlled study for treatment of middle⁃aged and old⁃aged lumbar disc herniation by Shi⁃style spine balance manipulation combined with bone and muscle guidance[J].Shanghai Journal of Traditional Chinese Medicine,2022,56(04):50-55.
丁兴,许金海,莫文等.施氏脊柱平衡手法结合筋骨导引术治疗中老年腰椎间盘突出症的多中心随机对照临床研究[J].上海中医药杂志,2022,56(04):50-55. DOI： 10.16305/j.1007-1334.2022.2109075.

DING Xing,XU Jinhai,MO Wen,et al.A multicenter randomized controlled study for treatment of middle⁃aged and old⁃aged lumbar disc herniation by Shi⁃style spine balance manipulation combined with bone and muscle guidance[J].Shanghai Journal of Traditional Chinese Medicine,2022,56(04):50-55. DOI： 10.16305/j.1007-1334.2022.2109075.

摘要

目的,2,观察施氏脊柱平衡手法结合筋骨导引术治疗中老年腰椎间盘突出症的临床疗效。,方法,2,将4个分中心的144例中老年腰椎间盘突出症患者随机分为试验组和对照组，每组72例，试验组予施氏脊柱平衡手法结合筋骨导引术，对照组予骨盆牵引结合腰背肌康复训练；施氏脊柱平衡手法、骨盆牵引疗程为4周，筋骨导引术、腰背肌康复训练疗程为6个月。比较治疗前及治疗2周、4周、3个月、6个月时疼痛视觉模拟评分（VAS）、日本骨科学会（JOA）评分、Oswestry功能障碍指数（ODI），以及治疗前、治疗6个月时脊柱骨盆矢状位参数的变化情况。,结果,2,①试验过程中，试验组剔除1例，对照组剔除2例，最终完成试验者试验组71例，对照组70例。②试验组、对照组总有效率分别为91.55%、88.57%，试验组临床疗效优于对照组（,P,<,0.05）。③随着治疗时间的延长，两组VAS评分逐渐降低（,F,时间,=307.785，,P,<,0.001），治疗2周、4周、3个月、6个月时组间比较，试验组VAS评分低于对照组（,P,<,0.05）。④随着治疗时间的延长，两组JOA评分逐渐升高（,F,时间,=316.774，,P,<,0.001）；治疗3个月、6个月时组间比较，试验组JOA评分高于对照组（,P,<,0.05）。⑤随着治疗时间的延长，两组ODI值逐渐降低（,F,时间,=1328.008，,P,<,0.001）；治疗2周、4周时组间比较，试验组ODI值低于对照组（,P,<,0.05）。⑥治疗后，两组脊柱骨盆矢状位参数均未见明显改变（,P,>,0.05），组间比较，上述参数差异亦无统计学意义（,P,>,0.05）。,结论,2,施氏脊柱平衡手法结合筋骨导引术治疗中老年腰椎间盘突出症疗效满意，能显著缓解疼痛症状，提升躯体功能，改善患者的生活质量，其疗效不劣于骨盆牵引结合腰背肌康复训练。

Abstract

Objective,2,To observe the clinical efficacy of Shi-style spine balance manipulation （SBM） combined with muscle and bone guidance （MBG） in the treatment of lumbar disc herniation （LDH） of the middle-aged and elderly patients.,Methods,2,Totally 144 middle-aged and elderly patients with lumbar disc herniation from four sub-centers were randomly divided into a treatment group （,n,=72） and a control group （,n,=72）. The treatment group was given Shi-style spine balance manipulation combined with muscle and bone guidance， and the control group was given pelvic mechanical traction combined with rehabilitation training of lumbar and back muscles. The treatment of Shi-style spine balance manipulation and pelvic traction lasted 4 weeks， while the muscle and bone guidance as well as the rehabilitation training of lumbar and back muscles lasted 6 months. The visual analogue scale （VAS） scores， Japanese Orthopaedic Association （JOA） scores， Oswestry Disability Index （ODI）， and the changes of spinal-pelvic sagittal parameters were compared before treatment and at 2， 4， 12， 24 weeks of treatment， respectively.,Results,2,①During the trial， one case was excluded from the test group and two cases were excluded from the control group. Finally， 71 cases completed the trial in the treatment group and 70 cases in the control group. ②The total effective rate was 91.55% in the treatment group and 88.57% in the control group. The clinical efficacy of the treatment group was better than that of the control group （,P,<,0.05）. ③With the progress of treatment， the VAS scores gradually decreased in both groups （,F,=307.785，,P,<,0.001）， and the VAS scores of patients in the treatment group were significantly lower than those in the control group at 2， 4， 12， 24 weeks of treatment （,P,<,0.05）. ④With the progress of treatment， the JOA scores gradually increased in both groups （,F,=316.774，,P,<,0.001）， and the JOA scores in the treatment group were higher than those in the control group at 3 and 6 months of treatment （,P,<,0.05）. ⑤With the progress of treatment， the ODI values of the two groups gradually decreased （,F,=1328.008，,P,<,0.001）， and the ODI values in the treatment group were lower than those in the control group at 2 and 4 weeks of treatment （,P,<,0.05）. ⑥After treatment， there was no significant difference in the spinal-pelvic sagittal parameters in both groups （,P,>,0.05）， and the difference in the spinal-pelvic sagittal parameters between the two groups was not statistically significant （,P,>,0.05）.,Conclusion,2,Shi-style spine balance manipulation combined with muscle and bone guidance has achieved a satisfactory result in the treatment of lumbar disc herniation in the middle-aged and elderly people， which can significantly relieve pain， enhance somatic function and improve patients’ quality of life. Its clinical efficacy is not inferior to that of pelvic mechanical traction combined with rehabilitation training of lumbar and back muscles.

关键词

腰椎间盘突出症施杞手法导引术多中心临床试验中医药疗法

Keywords

lumbar disc herniationShi Qimanipulationguidancemulticenter clinical trialtraditional Chinese medicine therapy

references

卜海富，马武秀，孔荣，等. 安徽省腰椎间盘突出症分级诊疗指南（2015年版）［J］. 安徽医学，2016， 37（1）： 14-20.

鲁玉来，孙永华. 最新腰腿痛诊断治疗学［M］. 北京：人民军医出版社，2007： 208-232．

盛放. 腰椎间盘突出症发病的危险因素研究［J］. 中国初级卫生保健，2012， 26（10）： 119-120.

程艳彬，房敏，王广东，等. 以“筋骨失衡，以筋为先”探讨脊柱退化性疾病的推拿治疗［J］. 中华中医药杂志，2015， 30（10）： 3470-3473.

吕立江，陆森伟，王晓东，等. 杠杆定位手法对正常腰椎影响的生物力学实时测试［J］. 中华中医药学刊，2015， 33（1）： 15-17.

范志勇，吴山，李振宝，等. 基于筋骨力学平衡探讨提拉旋转斜扳治疗急性腰椎间盘突出症的相关临床思考［J］. 中国中医急症，2016， 25（4）： 642-643.

GUAN X， KUAI S， ZHOU W， et al. Continuous lumbar spine rhythms during level walking， stair climbing and trunk flexion in people with and without lumbar disc herniation［J］. Gait Posture， 2018， 63： 296-301.

STEIN D J. Massage acupuncture， moxibustion， and other forms of complementary and alternative medicine in inflammatory bowel disease［J］ . Gastroenterol Clin North Am， 2017， 46（4）： 875-880.

KARABULUT A B， KAFKAS M E， KAFKAS A S， et al. The effect of regular exercise and massage on oxidant and antioxidant parameters［J］. Indian J Physiol Pharmacol， 2013， 57（4）： 378-383.

刘涛，张昊. 魏氏导引锻炼在腰椎间盘突出症治疗中的应用［J］. 世界中医药，2013， 8（2）： 161-163.

矫俊东，邢杰，闫雪. 中医导引干预腰椎间盘突出症的临床应用概况［J］. 吉林中医药，2021， 41（1）： 123-126.

陈新用，梁裕，曹鹏，等. 手术与非手术治疗腰椎间盘突出症远期疗效的比较评价［J］. 中国矫形外科杂志，2012， 20（7）： 606-609.

国家中医药管理局. 中医病证诊断疗效标准［M］. 南京：南京大学出版社，1994： 201-202.

中华医学会疼痛学分会脊柱源性疼痛学组. 腰椎间盘突出症诊疗中国疼痛专家共识［J］. 中国疼痛医学杂志，2020， 26（1）： 2-6.

FAIRBANK J C， PYNSENT P B. The Oswestry disability index［J］. Spine （Phila Pa 1976）， 2000， 25（22）： 2940-2952.

INOUE S， KATAOKA H， TAJIMA N， et al. Assessment of treatment for low back pain［J］. J Jpn Orthop Assoc， 1986（60）： 391-394.

秦大平，张晓刚，聂文忠，等. 不同运动状态下模拟人体腰椎结构特征变化的有限元分析［J］. 医用生物力学，2017， 32（4）： 355-362.

RUSTENBURG C M E， FARAJ S S A， KET J C F， et al. Prognostic factors in the progression of intervertebral disc degeneration： Which patient should be targeted with regenerative therapies？［J］. JOR Spine， 2019， 2（3）： e1063.

王拥军，梁倩倩，唐德志，等. 施杞防治慢性筋骨病学术思想与研究［J］. 上海中医药杂志，2017， 51（4）： 1-5.

王睿，庄艺，高山，等. 三维正脊法配合经筋穴位针刺治疗退行性腰椎滑脱症的临床观察［J］. 中国中医药科技，2016， 23（3）： 309-310，312.

符慧明，陆志夫，朱华亮，等. 中医针灸结合正骨推拿治疗单纯性腰椎椎间盘突出症的临床观察［J］. 辽宁中医杂志，2017， 44（9）： 1951-1953.

张荣，张向东，赵明宇. 平乐正骨筋滞骨错理论在退行性腰椎滑脱症诊治中的应用［J］. 中医正骨，2019， 31（4）： 61-63.

Views

334

下载量

CSCD

CNKI被引量

Alert me when the article has been cited

提交

Tools

Publicity Resources

Clinical practice and reflection on TCM conservative treatment of prolapsed/sequestrated lumbar disc herniation to promote resorption

Multicenter randomized controlled clinical study on treatment of lumbar disc herniation with traditional Chinese herbal medicine syndrome differentiation combined with sacral canal block

Effects of Chaihu Shugan Powder on AMPK/SIRT3 signaling pathway in rats with functional dyspepsia

A randomized， double‑blind， placebo‑controlled clinical trial on the external application of Taohong Siwu Decoction to improve the arteriovenous fistula patency during hemodialysis

Based on theory of “all cold with contraction belong to the kidney” to explore the treatment of myelosuppression after chemotherapy for gastric cancer from kidney

Related Author

No data

Related Institution

Suzhou Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine

Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine

Shanghai Qingpu District Hospital of Traditional Chinese Medicine

Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine

Huangpu Branch of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine

⁰