平脊疗法治疗青少年型腰椎间盘突出症的效果及对脊柱-骨盆矢状位参数的影响

Effect of flat chiropractic therapy on adolescent lumbar disc herniation and its influence on spinal and pelvic sagittal position parameters

摘要:

摘要：目的 探讨平脊疗法治疗青少年型腰椎间盘突出症（ALDH）的效果及对脊柱-骨盆矢状位参数的影响。方法 选取医院2020年2月~2022年3月就诊的ALDH患者104例，采用随机数字表法将其分成研究组（n=52）与对照组（n=52）。研究组采用平脊疗法中优值牵引、中药熏洗、手法松解（脊柱整体手法、弹压手法以及三维旋转复位手法）治疗，对照组采用优值牵引、中药熏洗、常规手法治疗。15d为1个疗程，2组均治疗3个疗程。对比2组疼痛情况、功能障碍情况、生活质量、脊柱-骨盆矢状位参数及临床疗效。结果 治疗后，2组腰臀部、下肢视觉模拟评分法（VAS）评分均降低（P＜0.05），且研究组更低（P＜0.05）。治疗后，2组Oswestry功能障碍指数（ODI）评分均降低（P＜0.05），且研究组更低（P＜0.05）。治疗后，2组健康调查简表（SF-36）评分均升高（P＜0.05），且研究组更高（P＜0.05）。治疗后，2组T1骨盆角（TPA）、骨盆倾斜角（PT）均降低（P＜0.05），且研究组更低（P＜0.05）；2组治疗前后骨盆入射角（PI）对比无明显差异（P＞0.05）；2组治疗后的骶骨倾斜角（SS）、腰椎前凸角（LL）、胸椎后凸角（TK）均升高（P＜0.05），且研究组更高（P＜0.05）。两组疗效等级分布差异有统计学意义（P＜0.05）。研究组总优良率（90.38%）高于对照组（75.00%）（P＜0.05）。两组均未观察到明显不良反应或并发症。结论 平脊疗法治疗ALDH患者疗效确切，可改善患者生活质量与功能障碍程度，减轻下肢、腰臀部疼痛，改善功能障碍程度与生活质量，增大SS、LL、TK，降低TPA、PT。

Abstract:

Abstract: Objective To investigate the effect of flat chiropractic therapy on adolescent lumbar disc herniation (ALDH) and its effect on spinal and pelvic sagittal position parameters. Methods A total of 104 ALDH patients treated in hospitals from February 2020 to March 2022 were selected and divided into study group (n=52) and control group (n=52) by random number table method. The study group was treated with optimal traction, traditional Chinese medicine fumigation, manual release (spine whole manipulation, compression manipulation and three-dimensional rotational reduction manipulation), while the control group was treated with optimal traction, traditional Chinese medicine fumigation and conventional manipulation. 15d was a course of treatment, and both groups were treated for 3 courses. Pain, dysfunction, quality of life, spinal and pelvic sagittal parameters and clinical efficacy were compared between the two groups. Results After treatment, the visual analogue scale (VAS) scores of waist, buttocks and lower limbs in 2 groups were decreased (P<0.05), and the study group was lower (P<0.05). After treatment, the Oswestry Disability Index (ODI) score was lower in both groups (P<0.05), and lower in the study group (P < 0.05). After treatment, item short form-36(SF-36) scores were increased in both groups (P<0.05), and higher in the study group (P<0.05). After treatment, thoracic pelvic angle(TPA) and pelvic tilt (PT) were decreased in 2 groups (P < 0.05), and lower in study group (P <0.05). There was no significant difference in pelvic incidence(PI) between the two groups before and after treatment (P>0.05). Sacral slope(SS), lumbar lordosis (LL) and thoracic kyphosis (TK) were increased in 2 groups after treatment(P<0.05), and higher in study group (P<0.05). There was significance in the distribution of efficacy grade between the two groups (P<0.05). The total excellent and good rate of the study group (90.38%) was higher than control group (75.00%) (P<0.05). No significant adverse reactions or complications were observed in both groups.Conclusion Plain chiropractic therapy is effective in the treatment of ALDH patients, which can improve the quality of life and the degree of dysfunction of patients, reduce the pain of lower limbs, waist and hip, improve the degree of dysfunction and the quality of life, increase SS, LL and TK, and reduce TPA and PT. Key words: Chiropractic therapy; Adolescent lumbar disc herniation; Clinical effect; Quality of life; Spinal - pelvic sagittal position parameters