【作者】 张重文；

【导师】 金宏柱；

【作者基本信息】 南京中医药大学 ， 针灸推拿学， 2011， 博士

【摘要】 目的：观察和评价台湾骨节正骨推拿法治疗腰椎间盘突出症的临床疗效,并对其进行总结,以其寻找临床运用保守疗法治疗腰椎间盘突出症的更佳方法。方法：参照中国中医药管理局发布的“中华人民共和国中医药行业标准”之“中医病症诊断疗效标准”制定腰椎间盘突出症诊断标准,收集了2009.6-2010.6在台湾楠桐中医医院、鼎瀚中医门诊部和华夏中医医院治疗且符合纳入标准的腰椎间盘突出症患者60例,编号后随机分入骨节正骨推拿法治疗组及传统推拿对照组,治疗组30例,对照组30例。每日推拿治疗1次,每次治疗30分钟左右,每周治疗不少于4次,最长两次治疗间隔不超过1天,7次为一个疗程。疗效评定标准参照1994年国家中医药管理局制定的《中医病症诊断疗效标准》制定(ZY/T001.9-94),并以治疗前后日本矫形外科学会(JOA)的腰痛疾患综合评定标准、直观模拟量表(VAS), Oswestry功能障碍指数问卷表(ODI),观察、比较两组患者的疼痛、生活质量改善情况。所得数据用SPSS 16.0统计软件统计处理。结果：1.治疗组治疗后无效1例,有效5例,显效10例,治愈13例,总有效率96.65%;对照组治疗后无效3例,有效8例,显效11例,治愈6例,总有效率89.3%。两组的疗效经比较有明显差异(P=0.042<0.05)2.两组JOA评分治疗前后均有明显差异(P=0.000<0.05);治疗后两组间比较,有显著差异(P=0.000<0.05),治疗组优于对照组。3.两组患者治疗后VAS评分与治疗前均有明显差异(P=0.000<0.05);两组间治疗后比较也有明显差异(P=0.028<0.05)。4.两组患者治疗治疗前后的Oswestry功能障碍指数评分比较,治疗组优于对照组(P=0.004<0.05)。结论：台湾骨节正骨推拿是基于中医传统正骨推拿的“骨错缝和筋出槽”理论,结合现代生物力学理论而形成的推拿新技术,是通过三维定位方法直接定位半脱位部位,用垂直于患部的“寸力”来改变偏歪的椎体,并且基于脊柱的“基座”理论,更大提高了临床疗效,改善了患者生活质量,减轻了患者疼痛,本疗法安全、高效,疗效可靠,值得临床推广。更多还原

【Abstract】 Objective:Observation and evaluation of the clinical effects of the treatment of lumbar disc hemiation with joint massage orthopedic of Taiwan, and its conclusion, the purpose is to explore better methods of conservative treatment of lumbar disc herniation.Methods:According to Traditional Chinese Medicine in China issued by "Chinese medicine industry standard of People’s Republic of China" of the "Chinese disease diagnosis and efficacy of standard" diagnostic criteria for the development of lumbar disc herniation,60 patients were collected from June 2009 to June 2010 in Nan Tong Chinese Medicine Hospital in Taiwan, Ding Han Chinese clinics and Chinese medicine hospitals and met the inclusion criteria for treatment of lumbar disc herniation and were randomly divided into joint massage orthopedics treatment group and control group, traditional massage, the treatment group of 30 patients in the control group of 30 patients. Treatment once a day, about 30 minutes each treatment, treatment was not less than 4 times per week for up to two treatment intervals of not more than 1 day,7 times as a course of treatment. Evaluation standard reference to the State Drug Administration in 1994 established "Chinese disease diagnosis and efficacy standards"(ZY/T001.9-94), and in Japan before and after treatment orthopedics Society (JOA) with low back pain disorders comprehensive assessment standards, visual simulation Scale (VAS), Oswestry Disability Index questionnaire function (ODI), observed and compared the two groups were pain, quality of life improvement. The data was analyzed using statistical software SPSS 16.0.Results:1. In the treatment group, after treatment,1 case was ineffective,5 cases had effects,10 cases had remarkable effects,13 cases were cured, and the total efficiency was 96.65%; in the control group,3 cases were ineffective,8 cases had effects,11 cases had remarkable effects,6 cases were cured, and the total efficiency was 89.3%. There was a remarkable difference between the two groups (P= 0.042<0.05).2. JOA score before and after treatment both groups were different (P= 0.000<0.05); between the two groups after treatment, there was a remarkable difference (P= 0.000<0.05), the treatment group was better than the control group.3. The two groups after treatment VAS scores before treatment were significantly different (P= 0.000<0.05); comparison between the two groups after treatment, there are significant differences (P= 0.028<0.05).4. Two groups of patients before and after treatment Oswestry functional disability index scores, the treatment group was better than the control group (P= 0.004<0.05).Conclusion:Joints orthopedics massage of Taiwan is based on traditional Chinese medicine massage theory of "bone staggered joints and tendons out of the wrong slot", combined with modern bio-mechanics, new technologies and the formation of massage, three-dimensional localization by direct targeting subluxation of the site, with a vertical affected part of the "inch power" to change the skew of the vertebral body, and is based on the spine theory of the "base", greatly improved the clinical efficacy and improved quality of life, reduced pain in patients, This kind of treatment is safety, efficient, good curative effects, and is worthy to be popularized.更多还原