摘要
目的：探讨手法松解联合盐酸乙哌立松片口服治疗腰背肌筋膜炎的临床疗效。方法：将60例腰背肌筋膜炎患者随机分为观察组和对照组,每组30例。观察组采用手法松解联合盐酸乙哌立松片口服治疗,对照组采用芬必得布洛芬缓释胶囊加盐酸乙哌立松片口服治疗。治疗前后分别采用视觉模拟评分量表（visual analogue scale,VAS）和Oswestry功能障碍指数（Oswestry disability index,ODI）对患者腰背部疼痛和腰椎功能进行评估。治疗结束后即根据ODI改善率评价疗效,并随访观察2组患者临床复发情况,记录复发时间。结果：治疗前2组患者VAS评分和ODI评分组间比较,差异均无统计学意义[（7.3±0.9）分,（7.2±1.1）分;t=0.381,P=0.352;（40.4±4.7）分,（39.9±3.5）分;t=0.499,P=0.309]。治疗结束后2组患者VAS评分和ODI评分均较治疗前降低[（7.3±0.9）分,（1.5±0.6）分;t=28.987,P=0.000;（7.2±1.1）分,（1.9±0.8）分;t=21.399,P=0.000;（40.4±4.7）分,（11.6±2.9）分;t=28.665,P=0.000;（39.9±3.5）分,（13.9±2.9）分;t=31.456,P=0.000];且观察组VAS评分和ODI评分均低于对照组[（1.5±0.6）分,（1.9±0.8）分;t=2.633,P=0.005;（11.6±2.9）分,（13.9±2.9）分;t=-3.107,P=0.001]。根据ODI改善率评价疗效,观察组优8例、良22例;对照组优1例、良27例、可2例;观察组疗效优于对照组（Z=-2.793,P=0.005）。60例患者均获随访,随访时间12-36个月,中位数22个月。60例患者均出现复发;治疗结束至症状复发的时间观察组（17.1±7.5）个月,对照组（12.2±6.5）个月;观察组复发较对照组晚（t=2.764,P=0.004）。结论：手法松解联合盐酸乙哌立松片口服治疗腰背肌筋膜炎,可有效缓解疼痛、改善腰椎功能,疗效优于芬必得布洛芬缓释胶囊加盐酸乙哌立松片口服,且更有利于延缓复发。
Objective：To explore the clinical curative effects of myofascial manipulative release combined with oral application of eperisone hydrochloride tablets for treatment of lumbodorsal myofascitis.Methods：Sixty patients with lumbodorsal myofascitis were random-ly divided into observation group and control group,30 cases in each group.The patients in observation group were treated with myofascial manipulative release combined with oral application of eperisone hydrochloride tablets,while the patients in control group were treated with oral application of ibuprofen sustained -release capsules and eperisone hydrochloride tablets.The lumbodorsal pain and lumbar function were evaluated by using visual analogue scale（VAS）and Oswestry disability index（ODI）respectively before and after the treatment.The curative effect was evaluated according to the ODI improvement rate after the end of the treatment and the patients were followed up.The clinical recurrences were observed and the recurrence time was recorded.Results：There was no statistical difference in VAS scores and ODI scores between the 2 groups before treatment（7.3 ＋/-0.9 vs 7.2 ＋/-1 .1 points,t=0.381 ,P=0.352;40.4 ＋/-4.7 vs 39.9 ＋/-3.5 points,t=0.499,P=0.309）.The VAS scores and ODI scores decreased in both of the 2 groups after the end of the treatment compared to pre-treatment（7.3＋/-0.9 vs 1 .5 ＋/-0.6 points,t=28.987,P=0.000;7.2 ＋/-1 .1 vs 1 .9 ＋/-0.8 points,t=21 .399,P=0.000;40.4＋/-4.7 vs 1 1 .6＋/-2.9 points,t=28.665,P=0.000;39.9 ＋/-3.5 vs 1 3.9 ＋/-2.9 points,t=31 .456,P=0.000）.The VAS scores and ODI scores were lower in observation group compared to control group（1 .5 ＋/-0.6 vs 1 .9 ＋/-0.8 points,t=2.633,P=0.005;1 1 .6＋/-2.9 vs 1 3.9＋/-2.9 points,t=-3.1 07,P=0.001 ）.According to the ODI improvement rate,8 patients obtained an ex-cellent result and 22 good in observation group;while 1 patient obtained an excellent result,27 good and 2 fair in control group.The observation group surpassed the control group in the total curative effects（Z=-2.793,P=0.005）.Sixty patients in the 2 groups were fol-lowed up for 1 2-36 months with a median of 22 months.The recurrence was found in all of the patients.The time from end-of-treatment to symptom recurrence was longer in observation group（1 7.1 ＋/-7.5 months）compared to control group（1 2.2＋/-6.5 months）and there was statistical difference between the 2 groups（t=2.764,P=0.004）.Conclusion：The combination therapy of myofascial manipulative re-lease and oral application of eperisone hydrochloride tablets can effectively relieve lumbodorsal pain and improve lumbar function in the treatment of lumbodorsal myofascitis,moreover,its curative effect is better than that of oral application of ibuprofen sustained-release cap-sules and eperisone hydrochloride tablets,and it is more conducive to delaying the recurrence.
出处
《中医正骨》
2016年第9期23-26,共4页
The Journal of Traditional Chinese Orthopedics and Traumatology
关键词
筋膜炎
腰背肌
推拿
脊柱
神经肌肉非去极药
布洛芬
复发
fasciitis
lumbodorsal muscles
manipulation, spinal
neuromuscular nondepolarizing agents
ibuprofen
recurrence
