[1]宋宇锋,王安利,武政.主动运动疗法治疗腰椎间盘突出症的疗效及安全性研究[J].中华老年骨科与康复电子杂志,2016,(04):228-233.[doi:10.3877/cma.j.issn.2096-0263.2016.04.007]
　Song Yufeng,Wang Anli,et al.The efficiency and safety of active exercise in the treatment of lumbar disc herniation[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(04):228-233.[doi:10.3877/cma.j.issn.2096-0263.2016.04.007]
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主动运动疗法治疗腰椎间盘突出症的疗效及安全性研究()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2016年04期
页码:
228-233
栏目:
康复医学
出版日期:
2016-11-05

文章信息/Info

Title:
The efficiency and safety of active exercise in the treatment of lumbar disc herniation
作者:
宋宇锋 1; 2; 王安利 1; 武政 2
100084 北京体育大学运动康复系 1；030001 太原，山西医科大学第二医院康复医学科 2
Author(s):
Song Yufeng1;  2;  Wang Anli1;  Wu Zheng2
关键词:
运动疗法;  腰椎;  康复
Keywords:
1Department of Rehabilitation and Sports;  Beijing Sport University1;  Beijing 100084;  China ;  2Department of Rehabilitation;  The Second Hospital of Shanxi Medical University2;  Taiyuan 030001;  China
DOI:
10.3877/cma.j.issn.2096-0263.2016.04.007
文献标志码:
A
摘要:
目的 研究主动运动疗法治疗膨出型及疝出型腰椎间盘突出症（Fardon分型）的疗效及安全性。方法 前瞻性收集 2015年 2月至 5月山西医科大学第二医院收治的符合纳入及排除标准的腰椎间盘突出患者 40例，按照 Fardon分型分为膨出组（n=20）和疝出组（n=20）。对所有患者行主动运动疗法，分别于治疗前、治疗后 1周、4周、8周随访并比较两组患者疼痛视觉模拟评分（VAS）、日本骨科学会评分（JOA）、等速肌力评定（单位体重峰力矩、屈/伸肌峰力矩比值）及末次改良 Macnab评定。结果 40例患者均获得随访，随访时间为（8.04±0.07）周。均无不良事件发生，重复测量设计资料的方差分析显示：膨出组与疝出组在VAS、JOA评分方面，组间差异无统计学意义，随着时间延长，两组患者的 VAS评分均逐渐降低，JOA评分逐渐升高，差异有统计学意义（F=127.051，F=92.571，P＜0.05）；膨出组在各时间点的单位体重峰力矩均高于疝出组，随着时间延长，两组患者的单位体重峰力矩均逐渐升高（P＜0.05），治疗前膨出组屈/伸峰力矩比值低于疝出组，治疗后 8周膨出组高于疝出组（P＜0.05）。1周后两组的屈/伸峰力矩比值均降至正常范围（P＜0.05），之后各个时间点屈/伸峰力矩比值保持相对稳定。末次随访时，膨出组患者的改良 Macnab评定优良率（80%）低于疝出组（85%），差异有统计学意义（c2=11.000，P＜0.05）。结论 主动运动疗法对膨出型及疝出型腰椎间盘突出症（Fardon分型）的大部分患者有较好效果，在治疗早期腰背部伸肌力量、屈伸肌平衡性及症状改善方面，疝出组效果优于膨出组。
Abstract:
Objective To study the efficiency and safety of active exercise in the treatment of lumbar disc herniation (LDH) (Fardon type: bulged and protruded type). Methods Forty eligilble LDH patients treated in the Scond Hospital of Shanxi Medical Universty were included in the prospective study from February to May 2015. All patients were classified into two groups according to the Fardon type, bulged group (n=20) and protruded group (n=20), all patients received active exercises treatment. Visual analogue scale (VAS), Japanese orthopaedic association (JOA), isokinetic muscle testing [peak torque/body weight (PT/BW) and Flexor/Extensor peak torque ratios (F/E)] were assessed before and 1 week, 4 weeks, 8 weeks after treatment, and at the last follow-up, modified Macnab classification was assessed. Results All 40 patients received an average of 8.04 ± 0.07 weeks followed- up with no adverse event. RMANOVA analysis showed no significant difference about VAS and JOA scores between two groups, but the VAS scores were gradually decreased and the JOA scores were gradually increased in each group, with statistical significance (F=127.051, F=92.571, P<0.05). The PT/BW of bulged group was higher than that of protruded group, as the time went on, PT/BW markedly enhanced (P<0.05). PT/BW in bulged group was lower than that in protruded group before treatment. However, it was significant higher than that in protruded group after 8 weeks treatment (P<0.05). F/E value in two groups dropped to nearly normal after 1 week treatment (P<0.05), and maintained the relative stabilization after that (P< 0.05). At the last follow-up, the modified Macnab classification in bulged group (80%) was lower than that in protruded group (85% ), with statistical significance (c2=11.000, P<0.05). Conclusions Active exercise treatment can achieve better effectiveness in most lumbar disc herniation patients (both protruded and bulged types). The improvement of the lumbar extensor strength, lumbar stability and back symptom in protruded group were better than that in bulged group in early treatment.

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备注/Memo

备注/Memo:
基金项目：山西省留学基金（2013-115）
更新日期/Last Update: 2017-04-01