康复学报2025，Vol.35Issue(2)：176-182,189,8.DOI:10.3724/SP.J.1329.2025.02010
基于专家调查的推拿联合易筋经干预腰椎间盘突出症临床方案
Treatment Protocol of Lumbar Disc Herniation with Tuina Combined with Yijinjing Based on Expert Survey
摘要
Abstract
Objective To construct a clinical protocol for the intervention of lumbar disc herniation(LDH)with Tuina com-bined with Yijinjing based on expert questionnaire survey.Methods An expert consultation questionnaire was developed based on literature research.The Delphi method was used to conduct two rounds of expert consultations on the clinical protocol for the inter-vention of LDH with Tuina combined with Yijinjing.The participation and authority of experts were analyzed through indicators such as questionnaire response rate and expert authority coefficient(Cr).The concentration of expert opinions on the indicator sys-tem was analyzed through the mean(M),standard deviation(S),and full-mark ratio(K)of the items.The coefficient of variation(CV)and Kendall's harmony coefficient(Kendall's W)were used to evaluate the variation degree of expert scores and the coordina-tion and consistency of evaluation opinions.The clinical protocol was constructed using a comprehensive decision-making mecha-nism:(1)indicators that simultaneously satisfy the conditions of M<4 points,K<0.8,and CV>0.25 were deleted;(2)integrating expert opinions for item removal.Finally,a clinical protocol combining Tuina and Yijinjing for the intervention of LDH was formed.Results Expert consultation data showed a 100%questionnaire response rate in both rounds;the expert authority coefficients were 0.73 and 0.82,respectively.The final M values of the items after two rounds ranged from 4.42 to 4.87,with K values ranging from 0.54 to 0.88 and CV values ranging from 0.07 to 0.16.Kendall's W increased from 0.331 and 0.567 in the first round to 0.504 and 0.695 in the second round.The clinical protocol for the intervention of LDH with Tuina combined with Yijinjing requires the physi-cian to maintain mental focus during Tuina and perform holistic treatment on the waist,hips,and buttocks;Yijinjing should focus on practicing five core movements,including holding the heavens with palms,pulling nine cow tails backwards,pulling nine horse knives like a ghost,grasping with the dragon's claw,and pouncing like a tiger.Practice should be performed at least once a day,10-15 minutes a time for four weeks.Practice should integrate breath regulation,mental focus,and mindfulness.Conclusion The clinical protocol for the intervention of LDH with Tuina combined with Yijinjing provides a reference for clinical standardized treatment of LDH.关键词
腰椎间盘突出症/推拿/易筋经/临床方案/德尔菲法Key words
lumbar disc herniation/Tuina/Yijinjing/clinical protocol/Delphi method引用本文复制引用
郭蕾,王程,周鑫,田育魁,摆雪,朱清广,房敏,刘俊昌..基于专家调查的推拿联合易筋经干预腰椎间盘突出症临床方案[J].康复学报,2025,35(2):176-182,189,8.基金项目
新疆维吾尔自治区"天山英才"培养计划科技创新团队计划项目(2022TSYCTD0008) （2022TSYCTD0008）
新疆维吾尔自治区重点研发项目(2022B03011-3) （2022B03011-3）
新疆医科大学研究生创新创业项目(CXCY2024003) （CXCY2024003）
国家中医药管理局高水平中医药重点学科建设项目(ZYYZDXK-2023061) （ZYYZDXK-2023061）
