摘要目的观察推拿联合功能训练治疗康复期腰椎间盘突出症的效果。方法选择我院2016年6月～2017年6月收治的70例符合入组标准的康复期腰椎间盘突出症患者作为研究对象，按随机数字表法分为观察组35例和对照组35例。对照组患者仅采用功能锻炼进行干预，观察组在对照组基础上再给予推拿手法治疗，均干预12周。治疗前、治疗12周后进行视觉疼痛模拟评分（VAS）、下腰痛评分（JOA）评判疼痛改善情况，采用Oswestry功能障碍指数（ODI）评估腰椎功能，采用脊柱测试评价训练系统评价前屈最大肌力，进行步行能力及临床效果评定。结果观察组和对照组治疗后的 VAS 评分分别为（1.06±0.48）、（2.32±0.65）分，JOA 评分分别为（27.88±2.46）、（24.90±2.42）分，ODI指数分别为（32.08±16.06）%、（45.15±15.83）%，前屈最大肌力分别为（300.86±54.35）、（270.42±58.52），两组的上述指标比较，差异均有统计学意义（均P＜0.05）。观察组和对照组治疗后的能力均明显优于治疗前（P＜0.05），观察组治疗后的步行能力明显优于对照组（P＜0.05）。观察组和对照组的总有效率分别为97.14%、74.29%，两组比较，差异有统计学意义（χ2=8.525，P＜0.05）。结论在功能训练治疗康复期腰椎间盘突出症的基础上再给予推拿手法治疗能有效改善患者的症状体征、前屈肌群功能及下肢运动功能，提高临床治疗效果。
Abstract：ObjectiveTo observe the effect ofmassage combined with functional training in treatment of patients with lumber disc herniation(LDH)at recovery stage.MethodsA total of 70 patientswith LDH at recovery stagemeeting the inclusion criteria from June 2016 to June 2017 treated in ourhospitalwere selected as the research object,all patientswere divided into 35 cases of observation group and 35 cases of control group according to random number tablemethod.The control group was treated with functional training,while the observation group were given massage therapy on the basis of the control group,both group had been treated for 12 weeks.Before treatment and after 12 weeks treatment,the VAS and JOA scorewere assessed to evaluate the improvementof pain,the ODIwas assessed to evaluate the lumbar function,the flexion maximum muscle strength were detected by spinal test evaluation training system,the walking ability were assessed and the effectwere evaluated.ResultsVAS score of the observation group and the control group after treatment was(1.06±0.48),(2.32±0.65)points,JOA scorewas(27.88±2.46),(24.90±2.42)points,ODIwas(32.08±16.06)%,(45.15±15.83)%,the flexionmaximum muscle strength was(300.86±54.35),(270.42±58.52)respectively,and the differenceswere statistically significant(P＜0.05).Thewalking ability of the observation group and the controlgroup after treatmentwere significantly better than those before treatment(P＜0.05),and the walking ability of the observation group after treatmentwas significantly better than thatof the control group(P＜0.05).The totaleffective ratesof the observation group and the controlgroup was 97.14%and 74.29%respectively,and the difference between the two groupswas statistically significant(χ2=8.525,P＜0.05).ConclusionMassage given on the basis of functional training treating lumber disc herniation at recovery stage can effectively improve the symptoms and signs,flexormuscle function and lower limb motor function of patients,so as to improve the clinical therapeutic effect.
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