中国骨伤2025，Vol.38Issue(8)：779-785,7.DOI:10.12200/j.issn.1003-0034.20240883
骨伤手法联合导引功法治疗慢性期腰椎间盘突出症
Treatment of chronic lumbar disc herniation by bone injury manipulation combined with guided exercise
摘要
Abstract
Objective To explore the clinical efficacy of orthopedic manipulation combined with daoyin exercises in the treatment of chronic lumbar disc herniation under the guidance of the theory of"equal emphasis on muscles and bones".Methods A total of 60 patients with single-segment,unilateral chronic lumbar disc herniation from January 2023 to January 2024 were randomly divided into the traditional physical therapy group and the manipulation treatment group,with 30 cases in each group.Among them,3 cases were lost to follow-up in the traditional physical therapy group and 2 cases in the manipula-tion treatment group.There were 27 cases in the traditional physical therapy group,including 15 males and 12 females,aged 25 to 65 years old with an average of(51.96±14.42)years;the course of disease ranged from 3 to 15 months with an average of(9.89±3.32)months;11 cases were on the left side and 16 cases on the right side;15 cases were at the L4,5 segment and 12 cases at the L5S1 segment.They were treated with lumbar traction,medium-frequency electrical stimulation and ultrasonic ther-apy.There were 28 cases in the manipulation treatment group,including 14 males and 14 females,aged 24 to 68 years old with an average of(49.82±14.85)years old;the course of disease ranged from 3 to 14 months with an average of(9.61±3.05)months;15 cases were on the left side and 13 cases on the right side;17 cases were at the L4,5 segment and 11 cases at the L5S1 segment.They were treated with orthopedic manipulation combined with daoyin exercises.The visual analogue scale(VAS),Oswestry disability index(ODI)and bilateral erector spinae muscle tone were compared between the two groups before treat-ment,after 2 weeks and 4 weeks of treatment.Results The two groups of patients were followed up and evaluated before treat-ment,2 weeks and 4 weeks after treatment.The VAS of the manipulation treatment group and the traditional physical therapy group decreased from(5.46±0.99)and(5.41±1.05)points before treatment to(1.75±0.79)and(2.29±0.82)points after 4 weeks of treatment,respectively.Both groups were significantly improved after treatment compared with before treatment,and the differences were statistically significant(P＜0.05);and the manipulation treatment group was better than the traditional physical therapy group at 4 weeks of treatment,with a statistically significant difference(P＜0.05).The ODI of the manipulation treatment group and the traditional physical therapy group before treatment was(20.25±2.72)and(18.96±2.52)points,re-spectively,which decreased to(15.46±1.88)and(16.56±2.01)points after 2 weeks of treatment,and to(11.54±1.23)and(12.85±1.72)points after 4 weeks of treatment.Both groups were significantly improved after treatment compared with before treatment,and the differences were statistically significant(P＜0.05),and the ODI in the manipulation treatment group was bet-ter than that in the traditional physical therapy group after treatment(P＜0.05).There was no significant statistical difference in the displacement of erector spinae muscle tone between the healthy side and the affected side in both the manipulation treat-ment group and the traditional physical therapy group before treatment(P＞0.05).After 2 weeks of treatment,the displacement values of erector spinae muscle tone on the healthy side in the manipulation treatment group and the traditional physical thera-py group were(6.68±0.81)mm and(6.45±0.65)mm,respectively,and those on the affected side were(5.87±0.82)mm and(5.61±0.84)mm,respectively.After 4 weeks of treatment,the displacement values of erector spinae muscle tone on the healthy side in the manipulation treatment group and the traditional physical therapy group were(7.51±0.75)mm and(7.04±0.63)mm,respectively,and those on the affected side were(6.87±0.78)mm and(6.33±0.82)mm,respectively.The displacement values of erector spinae muscle tone on both the healthy and affected sides in both groups were significantly higher than those before treatment,and the differences were statistically significant(P＜0.05);the displacement of erector spinae muscle tone in the manipulation treatment group after 4 weeks of treatment was better than that in the traditional physical therapy group,with a statistically significant difference(P＜0.05).Conclusion Orthopedic manipulation combined with daoyin exercises can effec-tively improve the symptoms and lumbar function of patients with chronic lumbar disc herniation,and has more advantages in improving the tone of the erector spinae muscle.关键词
腰椎/椎间盘突出/慢性期/正骨手法/导引功法Key words
Lumbar vertebrae/Intervertebral disc herniation/Chronic phase/Bone setting manipulation/Guid-ing exercise分类
医药卫生引用本文复制引用
邱峰,周爱珍,过琳,王磊,张贤..骨伤手法联合导引功法治疗慢性期腰椎间盘突出症[J].中国骨伤,2025,38(8):779-785,7.基金项目
无锡市科技发展资金项目(编号:Y2022009) （编号:Y2022009）
无锡市中医药管理局科技项目(编号:ZYKJ202123) （编号:ZYKJ202123）
无锡市青年托举人才行动(编号:TJXD-2025-221)Wuxi Science and Technology Development Fund Project(No.Y2022009) （编号:TJXD-2025-221）
