【摘要】：腰椎間盤突出癥(Lumbar Disc Herniation,LDH)是目前最常見的骨科疾病之一。在諸多非手術(shù)療法中,核心穩(wěn)定性訓(xùn)練被視為有效的運(yùn)動(dòng)療法,應(yīng)用于LDH患者的康復(fù)治療中。本課題通過編制一套簡單且行之有效的訓(xùn)練方案,并采用臨床實(shí)驗(yàn)的方法,驗(yàn)證核心穩(wěn)定性訓(xùn)練對(duì)腰椎間盤突出癥患者的康復(fù)治療效果。為核心穩(wěn)定性訓(xùn)練在LDH患者康復(fù)治療中的應(yīng)用提供可操作的經(jīng)驗(yàn)。本課題運(yùn)用文獻(xiàn)綜述、實(shí)驗(yàn)研究、數(shù)理統(tǒng)計(jì)和邏輯分析的方法。根據(jù)腰椎運(yùn)動(dòng)學(xué)特點(diǎn)、腰椎功能肌群的作用原理及核心穩(wěn)定性訓(xùn)練的階段性設(shè)計(jì)原理,遵循區(qū)別對(duì)待、系統(tǒng)訓(xùn)練、循序漸進(jìn)、頻率適宜、直觀性原則,編制了由“四足支撐”、“跪姿平板支撐”、“平板支撐”、“肩橋”、“單腿肩橋”、“屈膝側(cè)臥支撐”、“直膝側(cè)臥支撐”、“俯臥T字背伸”、“手支撐收腿”、“跪姿轉(zhuǎn)體”10個(gè)動(dòng)作組成的核心穩(wěn)定性訓(xùn)練方案。并通過選取2016年3月到8月在龍巖中醫(yī)院住院部就診的LDH患者(50名),隨機(jī)分為采用“基礎(chǔ)治療”的對(duì)照組(25人)和采用“基礎(chǔ)治療+核心穩(wěn)定性訓(xùn)練”的觀察組(25人)進(jìn)行對(duì)照實(shí)驗(yàn)。兩組患者性別、年齡、病程和治療前三項(xiàng)觀測(cè)指標(biāo)評(píng)分結(jié)果均無顯著差異性。在治療3周后和治療8周后再次進(jìn)行三項(xiàng)觀測(cè)指標(biāo)的測(cè)量。在3個(gè)月后進(jìn)行隨訪,確定復(fù)發(fā)人數(shù)。研究結(jié)果顯示,兩組患者組通過不同的方案治療后,視模擬評(píng)分法(VAS)、腰椎治療評(píng)價(jià)表(JOA)、腰椎功能障礙指數(shù)(ODI)三項(xiàng)觀測(cè)指標(biāo)評(píng)分結(jié)果比治療前都有顯著性差異(P0.05);治療3周后和的三項(xiàng)觀測(cè)指標(biāo)評(píng)分結(jié)果觀察組比對(duì)照組好,并具有統(tǒng)計(jì)學(xué)上的顯著意義(P0.05);治療8周后的三項(xiàng)觀測(cè)指標(biāo)評(píng)分結(jié)果觀察組比對(duì)照組好,并具有統(tǒng)計(jì)學(xué)上的顯著意義(P0.05);3個(gè)月后對(duì)照組有4人復(fù)發(fā),觀察組有1人復(fù)發(fā)。研究結(jié)論表明,采用“基礎(chǔ)治療+核心穩(wěn)定性訓(xùn)練”的治療方案比單純采用“基礎(chǔ)治療”的方案,對(duì)腰椎間盤突出癥患者的康復(fù)治療效果更佳,特別是對(duì)患者中期的療效影響更大。核心穩(wěn)定性訓(xùn)練不僅能緩解患者的臨床疼痛、改善體征、恢復(fù)腰椎功能,還能有效降低復(fù)發(fā)率,適用于臨床的康復(fù)治療。
[Abstract]:Lumbar disc protrusion (Lumbar Disc Herniation,LDH) is one of the most common orthopaedic diseases at present. In many non-surgical treatments, core stability training is regarded as an effective exercise therapy, which is used in the rehabilitation of LDH patients. In this paper, a set of simple and effective training scheme was compiled, and the method of clinical experiment was used to verify the rehabilitation effect of core stability training on patients with lumbar disc protrusion. It provides operational experience for the application of core stability training in rehabilitation treatment of LDH patients. In this paper, literature review, experimental research, mathematical statistics and logical analysis are used. According to the kinematic characteristics of lumbar vertebrae, the action principle of lumbar functional muscle group and the phased design principle of core stability training, following the principles of differential treatment, systematic training, gradual and orderly training, suitable frequency and intuitionism, the system is supported by "four feet". "kneeling flat support", "shoulder bridge", "one-legged shoulder bridge", "bending knee side support", "straight knee side lying support", "prone T back extension", "hand support stop leg", The core stability training scheme composed of 10 movements of kneeling position and turning body. From March to August 2016, 50 LDH patients were selected from the inpatient department of Longyan traditional Chinese Medicine Hospital. The patients were randomly divided into two groups: control group (n = 25) treated with basic therapy and observation group (n = 25) with core stability training of basic therapy. There was no significant difference in sex, age, course of disease and the scores of the three indexes before treatment between the two groups. Three observation indexes were measured after 3 weeks of treatment and 8 weeks after treatment. The patients were followed up after 3 months to determine the number of recurrence. The results showed that after the two groups were treated with different regimens, the visual simulation score (VAS), lumbar vertebra treatment evaluation form (JOA), The scores of lumbar dysfunction index (ODI) were significantly different from those before treatment (P 0.05). After 3 weeks of treatment, the scores of the three observation indexes in the observation group were better than those in the control group, and there was significant statistical significance (P 0.05). After 8 weeks of treatment, the scores of the three indexes in the observation group were better than those in the control group, and had significant statistical significance (P 0.05). After 3 months, 4 patients in the control group and 1 in the observation group had recurrence. The results showed that the rehabilitation effect of "basic treatment core stability training" was better than that of "basic treatment" alone. In particular, it has a greater impact on the curative effect in the middle stage of the patients. Core stability training can not only relieve clinical pain, improve signs and restore lumbar function, but also effectively reduce recurrence rate, which is suitable for clinical rehabilitation.
【學(xué)位授予單位】：集美大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R681.53

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