| 吴彬.针刺疗法联合腰腹手法对退变性腰椎滑脱患者腰椎功能的改善作用观察[J].浙江中西医结合杂志,2025,35(3): |
| 针刺疗法联合腰腹手法对退变性腰椎滑脱患者腰椎功能的改善作用观察 |
| Observation on the improvement of lumbar spine function in patients with degenerative lumbar spondylolisthesis by acupuncture therapy combined with lumbar and abdominal manipulation |
| 投稿时间：2024-05-07 修订日期：2025-02-05 |
| DOI： |
| 中文关键词: 针刺疗法 腰腹手法 腰椎牵引 退变性腰椎滑脱 腰椎功能 |
| 英文关键词:Acupuncture therapy Lumbar manipulation Lumbar traction Degenerative lumbar spondylolisthesis Lumbar spine function |
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| 中文摘要: |
| 目的 观察针刺疗法联合腰腹手法对退变性腰椎滑脱患者腰椎功能的改善效果。方法 研究选取时间为2021年2月～2023年12月，纳入人群均为我院中医康复科门诊收治的80例退变性腰椎滑脱患者，采用Excel表将患者随机分为两组，单组40例。牵引组给予腰椎牵引物理治疗，中医疗法组在牵引组基础上给予针刺疗法联合腰腹手法治疗。比较两组视觉模拟（VAS）评分、脊柱-骨盆参数、日本骨科协会评分法（JOA）评分、腰椎活动度、滑脱椎体水平移位距离，统计两组疗效。结果 两组治疗前对脊柱-骨盆参数进行比较，无统计学差异（P>0.05）。治疗前后比较脊柱-骨盆参数，两组骨盆入射角升高，舐骨倾斜角、腰椎前凸角降低，骨盆倾斜角、胸椎后凸角无变化（P>0.05）。中医疗法组治疗后骨盆入射角较牵引组更高，舐骨倾斜角、腰椎前凸角较牵引组更低，骨盆倾斜角、胸椎后凸角与牵引组比较，无统计学差异（P>0.05）。两组治疗前对滑脱椎体水平移位距离、腰椎活动度进行比较，无统计学差异（P>0.05）。治疗前后比较滑脱椎体水平移位距离、腰椎活动度，两组滑脱椎体水平移位距离降低，腰椎活动度升高（P<0.05）。中医疗法组治疗后滑脱椎体水平移位距离较牵引组更低，腰椎活动度较牵引组更高（P<0.05）。两组治疗前对VAS评分、JOA评分进行比较，无统计学差异（P>0.05）。治疗前后比较腰椎活动度，两组JOA评分升高，VAS评分降低（P<0.05）。中医疗法组治疗后JOA评分较牵引组更高，VAS评分较牵引组更低（P<0.05）。中医疗法组临床总有效率高于牵引组，有统计学差异（P<0.05）。结论 针刺疗法联合腰腹手法可改善退变性腰椎滑脱患者腰椎功能，改善腰椎活动度和脊柱-骨盆参数，提高疗效。 |
| 英文摘要: |
| Objective To observe the effect of acupuncture therapy combined with lumbar manipulation on the improvement of lumbar spine function in patients with degenerative lumbar spondylolisthesis.Methods The study was selected from February 2021 to December 2023, and the included population were all 80 cases of degenerative lumbar spondylolisthesis patients admitted to the outpatient clinic of the TCM Rehabilitation Department of our hospital, and the Excel table was used to randomly divide the patients into two groups, with 40 cases in a single group. The traction group was given lumbar traction physiotherapy, and the TCM group was given acupuncture therapy combined with lumbar and abdominal manipulation on the basis of the traction group. Visual analogue (VAS) scores, spine-pelvis parameters, Japanese Orthopaedic Association scoring method (JOA) scores, lumbar spine mobility, and the horizontal displacement distance of slipped vertebrae were compared between the two groups, and the efficacy of the two groups was counted.Results Comparison of spine-pelvic parameters between the two groups before treatment showed no statistical difference (P>0.05). Comparing the spine-pelvis parameters before and after treatment, the pelvic incidence angle was higher in the two groups, the lick tilt angle and lumbar anterior convexity angle were lower, and there was no change in the pelvic tilt angle and thoracic posterior convexity angle (P>0.05). The pelvic incidence angle was higher in the TCM group than the traction group after treatment, the lick bone tilt angle and lumbar anterior convexity angle were lower than the traction group, and there was no statistically significant difference between the pelvic tilt angle and thoracic posterior convexity angle compared with the traction group (P>0.05). Comparison of the horizontal displacement distance of slipped vertebrae and lumbar spine mobility between the two groups before treatment showed no statistical difference (P>0.05). Comparing the horizontal displacement distance of slipped vertebrae and lumbar spine mobility before and after treatment, the horizontal displacement distance of slipped vertebrae decreased and lumbar spine mobility increased in both groups (P<0.05). The horizontal displacement distance of the slipped vertebrae was lower and the lumbar spine mobility was higher in the TCM group than in the traction group after treatment (P<0.05). Comparison of VAS scores and JOA scores between the two groups before treatment showed no statistical difference (P>0.05). Comparing lumbar spine mobility before and after treatment, JOA score was higher and VAS score was lower in both groups (P<0.05). The JOA score was higher and the VAS score was lower in the TCM group than in the traction group after treatment (P<0.05). The total clinical effectiveness rate of the TCM group was higher than that of the traction group, with a statistical difference (P<0.05).Conclusion Acupuncture therapy combined with lumbar manipulation improves lumbar spine function, lumbar spine mobility and spino-pelvic parameters in patients with degenerative lumbar spondylolisthesis. |
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