超声波联合悬吊治疗腰椎间盘突出症的临床疗效对比分析

doi:10.3877/cma.j.issn.2096-0263.2020.05.008

目的

比较超声波治疗、悬吊治疗以及超声波联合悬吊治疗对缓解腰椎间盘突出症患者疼痛及功能障碍的疗效对比分析。

方法

前瞻性收集2019年1月至2019年6月在河北医科大学第三医院康复科门诊及住院收治的30例患者，年龄28~45岁，男性与女性患者各15例。均符合腰椎间盘突出症的诊断标准。将30例患者按照随机数字表法随机分为3组，每组各10人。分别为超声波治疗组、悬吊治疗组、超声波联合悬吊治疗组。每组每天治疗一次，连续治疗2 w，治疗前后进行疼痛VAS评分、ODI指数评分来评价患者疼痛及功能的改善情况。

结果

30例患者获得随访，随访时间为治疗后4~8 w。三组治疗后VAS评分均较治疗前明显降低，差异有统计学意义（F=20.582，P<0.001）。三组治疗后VAS评分均较治疗前降低，差异有统计学意义（F=3.069，P=0.043）。三组治疗后VAS评分，超声波组联合悬吊组降低最明显（t=12.676，P<0.001）。三组治疗后ODI指数评分均较治疗前降低，差异有统计学意义（F=399.67，P<0.001）。三组治疗后ODI指数评分，超声波组联合悬吊组最低（t=12.737，P<0.001）。

结论

超声波及悬吊治疗均可以减轻腰椎间盘突出症患者的疼痛及改善功能障碍。超声波联合悬吊治疗能更有效的减轻腰椎间盘突出症患者的疼痛及改善功能障碍。

关键词: 椎间盘退变, 腰椎, 超声波治疗, 悬吊

Objective

The aim of the present study was to evaluate the efficiency of sling exercise, therapeuticultrasound, therapeuticultrasound and sling exercise in patients to alleviate pain and improve lumbar function with lumbar disc herniation.

Methods

Individuals were selected from a list of patients being followed at the department of Rehabilitation in the third hospital of Hebei Medical University. 30 patients who were diagnosed with lumbar disc herniation were collected, the diagnoses were established upon medical history, physical examination, and results of imaging studies. The patients were randomly divided into three groups: therapeuticultrasound group received 14 sessions of ultrasonic therapy to the lumbar region, Sling exercise group received 14 sessions of sling exercise, and therapeuticultrasound and sling exercise group received therapeuticultrasound and sling exercise therapy 14 sessions of therapeuticultrasound to the lumbar region,7 sessions per week, 2 weeks. The VAS and ODI were compared with the assessment of the patients before and at the end of the therapy.

Results

At the end of treatment, three groups VAS scores (F=3.069, P=0.043) and ODI scores (t=12.676, P<0.001) was lower than that at the beginning of treatment (P<0.05), at the end of treatment the VAS scores (F=59.400, P<0.001) and of the ODI scores (t=12.737, P<0.001) of ultrasonic and sling exercise therapy group was lower than the other group, the difference is significantly.

Conclusion

All three groups could reduce pain and improve lumbar function, and the ultrasonic and sling exercise therapy was most effective for lumbar disc herniation treatment in the three groups.

Key words: Intervertebral disc degeneration, Lumbar vertebrae, Ultrasonic therapy, Suspension

表1 30例腰椎间盘突出症患者一般资料比较

组别	例数	年龄（岁， ±s）	性别（例，男/女）	病程（月， ±s）	VAS（分， ±s）	ODI（分， ±s）
悬吊治疗组	10	38±5	6/4	6.4±2.5	6.3±1，1	73±2
超声波治疗组	10	40±10	5/5	5.7±1.9	6.1±1.2	73±2
超声波联合悬吊组	10	41±8	4/6	5.2±2.3	6.1±1.2	75±3
统计值	?	F=0.469	χ²=0.800	F=0.732	F=0.095	F=1.094
P值	?	0.631	0.670	0.490	0.910	0.349

表1 30例腰椎间盘突出症患者一般资料比较

组别	例数	年龄（岁， ±s）	性别（例，男/女）	病程（月， ±s）	VAS（分， ±s）	ODI（分， ±s）
悬吊治疗组	10	38±5	6/4	6.4±2.5	6.3±1，1	73±2
超声波治疗组	10	40±10	5/5	5.7±1.9	6.1±1.2	73±2
超声波联合悬吊组	10	41±8	4/6	5.2±2.3	6.1±1.2	75±3
统计值	?	F=0.469	χ²=0.800	F=0.732	F=0.095	F=1.094
P值	?	0.631	0.670	0.490	0.910	0.349

图3 仰卧悬吊训练

表2 三组腰椎间盘突出症患者VAS评分比较（分，±s）

组别	例数	治疗前	治疗结束时	t值	P值
超声波治疗组	10	6.3±1.1	4.5±0.8	9.000	<0.001
悬吊治疗组	10	6.1±1.2	4.6±1.0	9.000	<0.001
超声波联合悬吊组	10	6.1±1.2	2.8±0.6	12.676	<0.001
F值	?	0.095	3.069	?	?
P值	?	0.910	0.043	?	?

表2 三组腰椎间盘突出症患者VAS评分比较（分，±s）

组别	例数	治疗前	治疗结束时	t值	P值
超声波治疗组	10	6.3±1.1	4.5±0.8	9.000	<0.001
悬吊治疗组	10	6.1±1.2	4.6±1.0	9.000	<0.001
超声波联合悬吊组	10	6.1±1.2	2.8±0.6	12.676	<0.001
F值	?	0.095	3.069	?	?
P值	?	0.910	0.043	?	?

表3 三组腰椎间盘突出症患者ODI指数评分比较（%，±s）

组别	例数	治疗前	治疗结束时	t值	P值
超声波治疗组	10	73.2±2.5	65.6±2.5	13.077	<0.001
悬吊治疗组	10	73.4±2.3	64.8±1.7	10.167	<0.001
超声波联合悬吊组	10	74.8±3.0	60.0±1.6	12.737	<0.001
F值	?	1.094	4.255	?	?
P值	?	0.349	<0.001	?	?

表3 三组腰椎间盘突出症患者ODI指数评分比较（%，±s）

组别	例数	治疗前	治疗结束时	t值	P值
超声波治疗组	10	73.2±2.5	65.6±2.5	13.077	<0.001
悬吊治疗组	10	73.4±2.3	64.8±1.7	10.167	<0.001
超声波联合悬吊组	10	74.8±3.0	60.0±1.6	12.737	<0.001
F值	?	1.094	4.255	?	?
P值	?	0.349	<0.001	?	?

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The effect of combining therapeutic ultrasound and sling exercise for lumbar disc herniation

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The effect of combining therapeutic ultrasound and sling exercise for lumbar disc herniation