基于肌筋膜链理论运用推拿手法联合温针灸治疗血瘀型腰椎间盘突出症临床研究
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R274.9

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上海市慢性筋骨病临床医学研究中心项目(20MC1920600)


Clinical Study on Tuina Manipulation Combined with Warming-Needle Moxibustion in Treating Lumbar Disc Herniation of Blood Stasis Type Based on Myofascial Chain Theory
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    摘要:

    目的:观察基于肌筋膜链理论运用推拿手法联合温针灸治疗血瘀型腰椎间盘突出症(LDH) 的临 床疗效。方法:选取2021年5月—2023年5月在海南省肿瘤医院治疗的82例血瘀型LDH患者,采用随机数字 表法分为对照组与研究组,每组41例。对照组予常规疗法治疗,研究组在对照组基础上基于肌筋膜链理论运 用推拿手法联合温针灸治疗,2组均治疗8周。比较2组临床疗效、步行能力(6 min步行距离、10 m步行时 间)、视觉模拟评分法(VAS) 评分、日本骨科协会评估治疗分数(JOA评分)、腰椎相关指标(腰椎矢状位 Cobb角、椎间隙高度)、腰背肌力学效应指标[伸直过程平均表面肌电值(AEMG)、屈曲过程AEMG]。结果: 治疗8周后,总有效率研究组90.24%(37/41),高于对照组70.73%(29/41)(P<0.05)。2组6 min步行距离均 较治疗前延长(P<0.05),研究组6 min步行距离长于对照组(P<0.05)。2组10 m步行时间均较治疗前缩 短(P<0.05),研究组10 m步行时间短于对照组(P<0.05)。2组VAS评分均较治疗前降低(P<0.05),研究 组VAS 评分低于对照组(P<0.05)。2 组JOA 评分均较治疗前升高(P<0.05),研究组JOA 评分高于对照 组(P<0.05)。2组腰椎矢状位Cobb角、椎间隙高度均较治疗前增大(P<0.05),研究组腰椎矢状位Cobb角、 椎间隙高度均大于对照组(P<0.05)。2 组伸直过程AEMG 均较治疗前增大(P<0.05),研究组伸直过程 AEMG大于对照组(P<0.05)。2组屈曲过程AEMG均较治疗前减小(P<0.05),研究组屈曲过程AEMG小于 对照组(P<0.05)。结论:基于肌筋膜链理论运用推拿手法联合温针灸治疗血瘀型LDH疗效肯定,能改善步 行能力和腰椎功能,减轻疼痛。

    Abstract:

    Abstract:Objective:To observe the clinical effect of tuina manipulation and warming-needle moxibustion in the treatment of lumbar disc herniation (LDH) of blood stasis type based on the myofascial chain theory. Methods:A total of 82 LDH patients of blood stasis type treated at Hainan Cancer Hospital from May 2021 to May 2023 were selected and divided into the control group and the study group according to random number table method,with 41 patients in each group. The control group was treated with conventional therapy,and the study group was additionally treated with tuina manipulation and warming-needle moxibustion according to the myofascial chain theory on the basis of the control group. Both groups were treated for eight weeks. Clinical effects, walking ability (6-minute walking distance and 10-meter walking time),scores of Visual Analogue Scale (VAS) and Japanese Orthopedic Association (JOA),lumbar spinerelated indicators (lumbar sagittal Cobb angle and intervertebral height),and biomechanical indicators of lumbar spine muscle [average surface electromyography (AEMG) during extension and flexion] were compared between the two groups. Results: After eight weeks of treatment, the total effective rate in the study group was 90.24% (37/41), which was higher than that of 70.73 (29/41) in the control group (P<0.05). The 6-minute walking distance in the two groups was longer than that before treatment (P<0.05),and the study group had a longer 6-minute walking distance than the control group (P<0.05). The 10-meter walking time in the two groups was shorter than that before treatment( P<0.05),and the study group had a shorter 10-minute walking time than the control group( P<0.05). The VAS scores in the two groups were decreased when compared with those before treatment (P<0.05), and the VAS scores in the study group were lower than those in the control group (P<0.05). Both groups showed an increase in JOA scores compared to that before treatment (P<0.05),with the study group having a higher JOA score than the control group (P<0.05). The sagittal Cobb angle and intervertebral height in the two groups were increased when compared with those before treatment (P<0.05),and the sagittal Cobb angle and intervertebral height in the study group were larger than those in the control group (P<0.05). The AEMG during the extension process was increased in the two groups when compared with that before treatment (P<0.05),and the AEMG during the extension process in the study group was greater than that in the control group (P<0.05). The AEMG during the flexion process in the two groups was decreased when compared with that before treatment (P<0.05),and the AEMG during the flexion process in the study group was smaller than that in the control group (P<0.05). Conclusion: Based on the theory of myofascial chains, tuina manipulation and warming-needle moxibustion has a positive effect on LDH of blood stasis type, which can improve walking ability and lumbar function,and relieve pain.

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宁嘉威,林雨晨,单继刚,陈雷.基于肌筋膜链理论运用推拿手法联合温针灸治疗血瘀型腰椎间盘突出症临床研究[J].新中医,2025,57(2):108-113

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  • 在线发布日期: 2025-02-05
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