董偓 李建南 陈东 李韶辉

【摘要】 目的：探討腰椎间盘突出症采用整脊手法治疗的效果。方法：选择2019年2月-2020年2月本院收治的腰椎间盘突出症患者80例为研究对象。按照随机数字表法将患者分为观察组和对照组，每组40例。对照组采用椎旁神经阻滞治疗，观察组给予整脊手法治疗。比较两组治疗前后的血清IgG、IgM、IgA含量、VAS评分、JOA评分、ODI指数、异常感觉症状积分、腰椎功能、生活质量评分及血清炎症因子水平。结果：治疗前，两组血清IgG、IgM、IgA含量、VAS评分、ODI指数、JOA评分、生活质量评分、血清炎症因子水平比较，差异均无统计学意义（P>0.05）。治疗后，观察组血清IgG、IgM、IgA含量均高于对照组，差异均有统计学意义（P<0.05）。治疗后，观察组VAS评分、ODI指数均低于对照组，JOA评分、生活质量评分均高于对照组，差异均有统计学意义（P<0.05）。治疗后，观察组血清炎症因子水平均低于对照组，差异均有统计学意义（P<0.05）。结论：采用整脊手法治疗腰椎间盘突出症效果较好，可有效减轻疼痛程度，缓解炎症反应，提高生活质量。

【关键词】 腰椎间盘突出症 整脊手法 腰椎功能 生活质量 血清炎症因子

Clinical Effect Analysis of Lumbar Disc Herniation Treated by Chiropractic Manipulation/DONG Wo， LI Jiannan， CHEN Dong， LI Shaohui. //Medical Innovation of China， 2021， 18（12）： 0-052

[Abstract] Objective： To investigate the effect of chiropractic manipulation in the treatment of lumbar disc herniation. Method： A total of patients with lumbar disc herniation admitted to our hospital from February 2019 to February 2020 were selected as the research objects. According to random number table method， the patients were divided into observation group and control group， 40 cases in each group. The control group was treated with paravertebral nerve block， and the observation group was treated with chiropractic manipulation. Serum IgG， IgM， IgA content， VAS score， JOA score， ODI index， score of abnormal sensory symptoms， lumbar function， quality of life score and serum inflammatory factors were compared between two groups before and after treatment. Result： Before treatment， there were no significant differences in serum IgG， IgM， IgA contents， VAS score， ODI index， JOA score， quality of life score and serum inflammatory cytokine levels between two groups （P>0.05）. After treatment， the contents of IgG， IgM and IgA in serum of the observation group were higher than those of the control group， the differences were statistically significant （P<0.05）. After treatment， VAS score and ODI index in the observation group were lower than those in the control group， while JOA score and quality of life score were higher than those in the control group， the differences were statistically significant （P<0.05）. After treatment， the levels of serum inflammatory cytokines in the observation group were lower than those in the control group， the differences were statistically significant （P<0.05）. Conclusion： The treatment of lumbar disc herniation with chiropractic manipulation has a good effect， which can effectively reduce pain， relieve inflammation and improve the quality of life.

[Key words] Lumbar disc herniation Chiropractic manipulation Lumbar function Quality of life Serum inflammatory factors

First-authors address： Huizhou First Peoples Hospital， Huizhou 516000， China

doi：10.3969/j.issn.1674-4985.2021.12.011

腰椎间盘突出症是骨科常见病，主要由外伤或者腰椎间盘病变引起，患者腰椎间盘纤维环、髓核与软骨板各部分，尤其是髓核出现不同程度退行性改变之后，在外力作用下会导致椎间盘纤维环破裂，髓核组织自破裂处脱出或者突出于椎管内或者后方，刺激或压迫相邻的脊神经根，进而引起腰部疼痛、双下肢或者一侧下肢疼痛、麻木等症状[1]。中医认为腰椎间盘突出症属于“痹症”范畴，其发生主要与筋脉失养及肝肾亏虚有关，在遭受风寒湿邪的侵袭之后导致筋骨经络闭阻，进而导致发病，治疗应该坚持温肾助阳、温经活血及除湿散寒的原则，通过整脊手法进行康复治疗可对错位的脊椎进行矫正，还可降低腰椎的僵硬度，进而有效减轻疼痛[2-3]。本次……