1.上海中医药大学附属龙华医院,上海市徐汇区宛平南路725号,200032
2.上海中医药大学附属岳阳中西医结合医院
3.上海中医药大学附属曙光医院
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收稿:2025-01-18,
修回:2025-06-10,
纸质出版:2025-08-17
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刘士逸,陈跃来,周楠等.腰椎振荡调整手法治疗腰椎间盘突出症的随机对照试验[J].中医杂志,2025,66(16):1672-1678.
LIU Shiyi,CHEN Yuelai,ZHOU Nan,et al.Lumbar Oscillatory Manipulation for Lumbar Disc Herniation:A Randomized Controlled Trial[J].Journal of Traditional Chinese Medicine,2025,66(16):1672-1678.
刘士逸,陈跃来,周楠等.腰椎振荡调整手法治疗腰椎间盘突出症的随机对照试验[J].中医杂志,2025,66(16):1672-1678. DOI: 10.13288/j.11-2166/r.2025.16.009.
LIU Shiyi,CHEN Yuelai,ZHOU Nan,et al.Lumbar Oscillatory Manipulation for Lumbar Disc Herniation:A Randomized Controlled Trial[J].Journal of Traditional Chinese Medicine,2025,66(16):1672-1678. DOI: 10.13288/j.11-2166/r.2025.16.009.
目的
2
观察腰椎振荡调整手法治疗腰椎间盘突出症患者的临床疗效和安全性。
方法
2
将90例腰椎间盘突出症患者随机分为治疗组和对照组各45例。治疗组予腰椎振荡调整手法,对照组予传统腰椎斜板法,每周治疗2次,共4周。比较两组患者治疗前及治疗2、4周后Oswestry功能障碍指数(ODI)评分、腰椎活动度、腰部竖脊肌肌肉左右两侧硬度差值的绝对值;比较治疗前及治疗4周后双侧多裂肌的剪切波弹性模量值及肌腹厚度;比较临床疗效,进行安全性评价。
结果
2
与本组治疗前比较,两组治疗2、4周后ODI评分和腰部竖脊肌肌肉左右两侧硬度差值的绝对值降低,腰椎前屈、后伸、左侧屈、右侧屈的各个方向活动度增加;两组治疗4周后第4腰椎节段双侧多裂肌的剪切波弹性模量值降低、肌腹厚度增加(
P
<0.05)。与对照组同时间比较,治疗组治疗2周后ODI评分降低,治疗4周后第4腰椎节段双侧多裂肌的剪切波弹性模量值降低、肌腹厚度增加(
P
<0.05)。治疗组总有效率为90.48%(38/42),对照组为71.43%(30/42),治疗组临床疗效优于对照组(
P
<0.05)。两组在研究过程中均未发生不良事件。
结论
2
腰椎振荡调整手法在缓解腰椎间盘突出症症状、改善腰椎功能方面优于传统腰椎斜扳法,可能与其改善多裂肌弹性有关。
Objective
2
To observe clinical effectiveness and safety of lumbar oscillatory manipulation in the treatment of patients with lumbar disc herniation.
Methods
2
This study recruited 90 lumbar disc herniation patients who were randomly divided into 45 cases each in the treatment group and the control group. The treatment group was given lumbar oscillatory manipulation, while the control group was given traditional lumbar obliquely pulling manipulation, and both groups were treated twice a week for 4 weeks. The Oswestry dysfunction index (ODI) score, lumbar spine mobility, and the absolute values of difference in hardness between the left and right sides of the lumbar erector spinae muscle were compared between groups of patients before treatment and after 2 and 4 weeks of treatment; the shear wave elastic modulus of multifidus muscle and abdominal muscle thickness were compared between groups before treatment and after 4 weeks of treatment; the clinical effectiveness of the treatment was compared, and the safety evaluation was carried out.
Results
2
Compared with the group before treatment, the ODI scores and the the absolute values of difference in hardness between the left and right sides of the lumbar erector spinae muscle decreased after 2 and 4 weeks treatment in both groups, and the mobility of the lumbar vertebrae in all directions of anterior flexion, posterior extension, left lateral flexion, and right lateral flexion increased; the shear wave elastic modulus of bilateral multifidus muscles of the fourth lumbar vertebral segments decreased, and the thickness of abdominal muscle increased after 4 weeks of treatment in both groups (
P
<0.05). Compared with the control group, the ODI score of the treatment group decreased after 2 weeks of treatment, and the shear wave elastic modulus value of bilateral multifidus muscle of the fourth lumbar vertebral segment decreased and the thickness of abdominal muscle increased after 4 weeks of treatment (
P
<0.05). The total effective rate was 90.48% (38/42) in the treatment group and 71.43% (30/42) in the control group, and the clinical effectiveness of the treatment group was better than that of the control group (
P
<0.05). No adverse events occurred in both groups during the study.
Conclusion
2
Lumbar oscillatory manipulation is superior to traditional lumbar obliquely pulling manipulation in relieving symptoms of lumbar disc herniation and improving lumbar spine function, which may be related to its improvement in the elasticity of the multifidus muscle.
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