杨伟慧 叶亚云

[摘要] 目的 分析腰部核心肌力训练对改善腰椎间盘突出症（LDH）患者的腰椎功能及生活质量的影响。 方法 选取2017年1月～2018年6月在我院康复科门诊就诊的LDH患者84例，分为两组。两组均予腰椎间歇式牵引疗法，观察组在对照组基础上协助患者进行腰部核心肌力训练，两组患者均干预8周。观察两组干预前和干预8周后腰背部疼痛症状、腰椎功能及生活质量变化。 结果 干预8周后，两组VAS评分、JOA评分和ODI评分均较干预前明显下降（P<0.05或P<0.01），且干预后观察组下降值较对照组改善更明显（P<0.05）;两组Spitze生活质量评分均较干预前显著上升（P<0.05或P<0.01），且干预后观察组上升幅度较对照组更显著（P<0.05）。 结论 腰部核心肌力训练用于LDH患者的效果較确切，能显著减轻腰背部疼痛，改善腰椎功能，并能提高患者的生活质量。

[关键词] 腰椎间盘突出症;腰部核心肌力训练;腰背部疼痛;腰椎功能;生活质量

[中图分类号] R687.3          [文献标识码] B          [文章编号] 1673-9701（2019）19-0111-03

[Abstract] Objective To discuss the analysis on core strength of waist training to improve lumbar function and living quality of patients with lumbar disk hernia（LDH）. Methods 84 cases of patients with LDH， who were given the medical treatment in Department of Rehabilitation in the hospital during the period from January 2017 to June 2018， were selected and divided into two groups. The patients in two groups were given lumbar intermittent traction therapy， and the patients in observation group were additionally given core strength of waist training on the basis of the same treatment in control group， for 8 weeks for patients in both groups. The changes of the symptom of lower back pain， lumbar function and living quality of patients in two groups before and 8 weeks after intervention were observed. Results After 8 weeks intervention， the VAS， JOA and ODI scores of patients in two groups were declined more obviously than before（P<0.05 or P<0.01）， and the declining rates of patients in observation group were much higher than those in control group after intervention（P<0.05）. The Spitze living quality scores of patients in two groups were rose more obviously than before（P<0.05 or P<0.01）， and the rising rate of patients in observation group was much higher than that in control group after intervention（P<0.05）. Conclusion The core strength of waist training has reliable curative effect on patients with LDH， which can obviously release the lower back pain， improve the lumbar function and enhance the living quality.

[Key words] Lumbar disk hernia（LDH）; Core strength of waist training; Lower back pain; Lumbar function; Living quality

腰椎间盘突出症（lumbar disc herniation，LDH）是康复科门诊较常见疾病，好发于青壮年，是引起腰腿痛的常见原因，给患者日常生活带来较大的困扰及痛苦[1，2]。对LDH的治疗多采用针灸推拿、物理治疗、药物治疗和传统腰椎牵引等非手术治疗，虽有一定的效果，但对腰背部核心肌肉的形态结构改善不明显，不能增加腰椎的稳定性，总体效果欠佳[3-5]。研究已证实脊柱稳定性主要依靠腰背核心肌肉的维持，因此，腰部核心肌力在脊柱相关疾病的发生及发展中起重要作用，通过腰部核心肌力锻炼可用于脊柱相关疾病的治疗与康复[6，7]。本研究分析腰部核心肌力训练改善LDH患者的康复效果，现报道如下。

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