【摘要】：目的:探討手法松解聯(lián)合鹽酸乙哌立松片口服治療腰背肌筋膜炎的臨床療效。方法:將60例腰背肌筋膜炎患者隨機分為觀察組和對照組,每組30例。觀察組采用手法松解聯(lián)合鹽酸乙哌立松片口服治療,對照組采用芬必得布洛芬緩釋膠囊加鹽酸乙哌立松片口服治療。治療前后分別采用視覺模擬評分量表(visual analogue scale,VAS)和Oswestry功能障礙指數(shù)(Oswestry disability index,ODI)對患者腰背部疼痛和腰椎功能進行評估。治療結(jié)束后即根據(jù)ODI改善率評價療效,并隨訪觀察2組患者臨床復發(fā)情況,記錄復發(fā)時間。結(jié)果:治療前2組患者VAS評分和ODI評分組間比較,差異均無統(tǒng)計學意義[(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]。治療結(jié)束后2組患者VAS評分和ODI評分均較治療前降低[(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];且觀察組VAS評分和ODI評分均低于對照組[(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]。根據(jù)ODI改善率評價療效,觀察組優(yōu)8例、良22例;對照組優(yōu)1例、良27例、可2例;觀察組療效優(yōu)于對照組(Z=-2.793,P=0.005)。60例患者均獲隨訪,隨訪時間12~36個月,中位數(shù)22個月。60例患者均出現(xiàn)復發(fā);治療結(jié)束至癥狀復發(fā)的時間觀察組(17.1±7.5)個月,對照組(12.2±6.5)個月;觀察組復發(fā)較對照組晚(t=2.764,P=0.004)。結(jié)論:手法松解聯(lián)合鹽酸乙哌立松片口服治療腰背肌筋膜炎,可有效緩解疼痛、改善腰椎功能,療效優(yōu)于芬必得布洛芬緩釋膠囊加鹽酸乙哌立松片口服,且更有利于延緩復發(fā)。
[Abstract]:Objective: to investigate the clinical effect of manipulation relaxation combined with epiperisone hydrochloride tablets in the treatment of lumbar back fasciitis. Methods: sixty patients with lumbar dorsum fasciitis were randomly divided into observation group and control group with 30 cases in each group. The control group was treated with Fenbid ibuprofen sustained-release capsule and epiperisone hydrochloride tablets orally. The patients' lumbar back pain and lumbar function were evaluated by visual analogue scale (visual analogue scale,VAS) and Oswestry dysfunction index (Oswestry disability index,ODI) before and after treatment. After the treatment, the curative effect was evaluated according to the improvement rate of ODI, and the clinical recurrence of the two groups was observed and the recurrence time was recorded. Results: there was no significant difference in VAS score and ODI score between the two groups before treatment [(7.3 鹵0.9), (7.2 鹵1.1); t = 0.381, P = 0.352; (40.4 鹵4.7), (39.9 鹵3.5); T = 0.499, P = 0.309]. After treatment, the scores of VAS and ODI in the two groups decreased [(7.3 鹵0.9), (1.5 鹵0.6); (28.987, P < 0.001); (7.2 鹵1.1), (1.9 鹵0.8); (21.399, P < 0.001); (40.4 鹵4.7,11.6 鹵2.9,28.665, P < 0.001; 39.9 鹵3.5,13.9 鹵2.9; t = 31.456, P = 0.000); The scores of VAS and ODI in the observation group were lower than those in the control group [(1. 5 鹵0. 6), (1. 9 鹵0. 8); t = 2.63, P < 0. 05; (11.6 鹵2. 9), (13.9 鹵2. 9); t = 3. 107, P < 0. 001]. According to the improvement rate of ODI, 8 cases were excellent in the observation group, 22 cases were good in the observation group, 1 case was excellent in the control group, 27 cases were good and 2 cases were fair. The curative effect of the observation group was better than that of the control group (Z = 2.793, P < 0.005). 60 patients were followed up for 12 months for 36 months with a median of 22 months. The time from the end of treatment to the recurrence of symptoms was (17.1 鹵7.5) months in the observation group and (12.2 鹵6.5) months in the control group, and the recurrence time in the observation group was later than that in the control group (t = 2.764, P = 0.004). Conclusion: manual relaxation combined with epiperisone hydrochloride tablets can effectively relieve pain and improve lumbar spine function, which is better than Fenbid ibuprofen sustained-release capsule and epiperisone hydrochloride tablets oral, and is more beneficial to delay recurrence.
【作者單位】： 中國中醫(yī)科學院望京醫(yī)院;
【分類號】：R686.3

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