牵引配合手法及中药治疗腰椎间盘突出症.docVIP

牵引配合手法及中药治疗腰椎间盘突出症[摘要] 目的:观察牵引配合手法及中药治疗腰椎间盘突出症的疗效。方法:采用中药补肝肾、活血化瘀配合正复按摩手法治疗腰椎间盘突出症191例,10 d为一疗程。结果:临床治愈70例,显效82例,一般23例,无效16例,有效率为91.6%。结论:牵引配合手法及中药治疗腰椎间盘突出症疗效确切,具有一定的临床推广价值。 [关键词] 独活寄生汤;推拿手法;腰椎间盘突出症;中药汤剂 [中图分类号] R68 [文献标识码] A[文章编号]1673-7210(2009)08(b)-090-02 Treatment of lumbar intervertebral disc protrusion by traction with the practices and traditional Chinese medicion XIE Yunhua, WAN Xiaoling, CHEN Jian (Wanjiang Hospital of Dongguan City, Guangdong Province, Dongguan523050, China) [Abstract] Objective: To observe the effect of traction with the practices and traditional Chinese medicine in treatment of lumbar intervertebral disc protrusion. Methods: 191 patients who suffered from lumbar intervertebral disc protrusion were treated by traction with the practices and traditional Chinese medicion. Results: 70 cases of clinically were cured, 82 cases were markedly effective, 23 cases were in general, 16 cases were invalid, the efficiency was 91.6%. Conclusion: Treatment of lumbar intervertebral disc protrusion by traction with the practices and traditional Chinese medicine is effective and has some clinical value. [Key words] Duhuojisheng Decoction; Mnipulation; Lmbar intervertebral disc protrusion; Chinese medicine decoction 腰椎间盘突出症属中医“腰痛”和“痹证 ”的范畴,是临床上的常见病和多发症之一,是引起临床上腰腿痛的主要原因之一,多见于青壮年及老年人[1],病情常反复发作,患者痛苦大,严重影响患者的生活和工作。本病治疗方法主要为手术治疗和非手术治疗,二者临床治疗效果无明显区别,且手术作为开创性治疗方式有一定风险。中医治疗本病有较好的疗效,且不良反应少[2]。我院2004年6月～2008年6月采用中药独活寄生汤配合正复按摩手法治疗腰椎间盘突出症191例,收到了较为满意的效果,现报道如下: 1 资料与方法 1.1 一般资料 本组研究对象191例均经影像学检查确诊,其中,男140例,女51例;年龄最大58岁,最小24岁,平均36岁;病程最长10年,最短20 d,平均86 d;其中,L3~4椎间突出7例,L4~5椎间盘突出107例,L5~S1椎间盘突出53例,伴有骶椎裂14例,伴有椎管狭窄10例。191例均有不同程度的腰痛症状和脊柱活动受限。合并有单侧下肢痛者154例,双侧下肢痛者37例,并且在疼痛区均有不同程度的麻木感。直腿抬高试验及加强试验均为阳性,其中45°者54例。椎旁及棘突有一般压痛者147例,椎旁压痛并向下肢放射者44例。脚拇趾背伸力量减弱者91例,小腿外侧或足背皮肤感觉障碍者73例,跟腱反射减弱者93例。 1.2 方法 1.2.1 骨盆牵引采用电动牵引床行骨盆牵引。患者取仰卧位,固定骨盆、胸廓,抬高躯干25°,以自身体重的重量行持续牵引,1次/d,每次40～60 min,牵引后卧床休息30 min,2周为1个疗程,每疗程间隔1周。 1.2.2 按摩手法[3-4]牵引治疗完成后,进行腰背部及下肢的放松5 min,然