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  本文關鍵詞： 腰椎間盤突出癥 核心肌群穩(wěn)定性 艾灸 運動訓練　出處：《南京中醫(yī)藥大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:觀察腰椎間盤突出癥患者射頻消融術后核心肌力訓練聯(lián)合艾灸治療的臨床療效。方法:將60例已進行單針單節(jié)射頻消融術治療的腰椎間盤突出癥患者隨機分為常規(guī)治療組(C組,n=20)、核心肌力訓練組(E組,n=22)和核心肌力訓練聯(lián)合艾灸治療組(EM組,n=21)。C組:給予常規(guī)術后治療;E組:給予常規(guī)術后治療和核心肌力訓練治療;EM組:給予常規(guī)術后治療、核心肌力訓練和局部艾灸治療。分別于治療開始前第1天(1st day,1d)、1周(1st week,1w)和12周(12th week,12w)訓練結束后評價患者疼痛程度(VAS)、Oswestry功能障礙指數(shù)(ODI)水平、腰背肌伸肌肌力、蜷腹肌力。結果:治療前,各組VAS、ODI和腰背伸肌肌力、蜷腹肌力水平無明顯差異(P0.05)。①與1d相比,各組在1w時的VAS均降低(P0.05),12w時VAS顯著降低(P0.01);與C組相比,在1w、12w時E組VAS低于C組且差異有統(tǒng)計學意義(P0.05),EM組VAS低于C組且差異顯著(P0.01);與E組相比,EM組在1w、12w時VAS更低,差異有統(tǒng)計學意義(P0.05)。②與1d相比,各組在1w和12w時的ODI均降低(P0.05),12w時降低且差異顯著(P0.01);與C組相比,E組在1w時ODI較低,但差異無統(tǒng)計學意義(P0.05),在12w時更低,差異有統(tǒng)計學意義(P0.05);與C組相比,EM組在1w時ODI更低,差異有統(tǒng)計學意義(P0.05),12w時ODI更低,差異顯著(P0.01);與E組相比,1w時EM組ODI更低,但兩組結果無顯著差異(P0.05),在12w時EM組ODI低于E組且差異有統(tǒng)計學意義(P0.05)。③與1d相比,各組在1w時的挺腹時間均提高,差異有統(tǒng)計學意義(P0.05),在12w時E組、EM組挺腹時間明顯提高,與治療前差異顯著(P0.01);E、EM組與C組相比,在1w時挺腹時間長于C組,差異有統(tǒng)計學意義(P0.05),在12w時E組、EM組挺腹時間更長,差異顯著(P0.01);E組與EM組相比較,1w、12w時EM組挺腹時間更長,但兩組結果無顯著差異(P0.05)。④與1d相比,各組在1w時的蜷腹時間均提高,差異有統(tǒng)計學意義(P0.05),在12w時E組、EM組顯著提高(P0.01);E組、EM組與C組相比,在1w時蜷腹時間均長于C組,差異有統(tǒng)計學意義(P0.05),在12w時E組、EM組蜷腹時間顯著長于C組(P0.01);E組與EM組相比較,1w、12w時EM組蜷腹時間更長,但兩組結果無顯著差異(P0.05)。結論:①單獨核心肌力訓練或者核心肌力訓練聯(lián)合艾灸治療均可以促進腰椎間盤突出癥患者射頻消融術后疼痛緩解;②核心肌力訓練聯(lián)合艾灸治療促進腰椎間盤突出癥患者射頻消融術后疼痛緩解,效果優(yōu)于單獨進行核心肌力訓練治療;③單獨核心肌力訓練或者核心肌力訓練聯(lián)合艾灸治療均可以促進腰椎間盤突出癥患者射頻消融術后運動功能恢復;④核心肌力訓練聯(lián)合艾灸治療與單獨核心肌力訓練相比,12周時對運動功能恢復的促進有明顯效果,但1周時效果并不優(yōu)于單獨進行核心肌力訓練。
[Abstract]:Objective: to observe the clinical effect of core muscle strength training combined with moxibustion in patients with lumbar disc herniation after radiofrequency ablation. Sixty patients with lumbar disc herniation who had been treated with single needle radiofrequency ablation were randomly divided into routine treatment group (. Group C. The core muscle strength training group (group E) and the moxibustion group (group B) were given routine postoperative treatment. Group E: routine postoperative treatment and core muscle strength training; Group EM was treated with routine postoperative treatment, core muscle strength training and local moxibustion treatment. The first day of treatment was 1 day before the beginning of treatment. The pain degree and the Oswestry dysfunction index (ODI) were evaluated after 12 weeks and 12 weeks of training. Results: before treatment, there was no significant difference in the muscle strength of VASO ODI and extensor lumbar dorsalis muscle, and the level of cuddle abdominus muscle strength in each group (P0.05.1 vs 1 d). The VAS of each group was significantly lower than that of P0. 05 and P0. 01 at 12 weeks. Compared with group C, the VAS of group E was lower than that of group C at 12 weeks, and the difference was statistically significant. The VAS of group E was lower than that of group C (P 0.05) and the difference was significant (P 0.01). Compared with E group, the VAS of EM group was lower than that of E group at 12 weeks after 1 week, and the difference was statistically significant (P 0.05) compared with that of 1 day. The ODI of each group decreased at 1 and 12 weeks, and the difference was significant (P 0.01). Compared with group C, the ODI of group E was lower at 1 week, but the difference was not statistically significant (P 0.05), but it was lower at 12 weeks (P 0.05). Compared with group C, the ODI of EM group was lower than that of group C at 1 week, and the ODI was lower at 12 weeks after P0.05, and the difference was significant (P 0.01). The ODI of EM group was lower than that of E group at 1 week, but there was no significant difference between the two groups (P 0.05). At 12 weeks, the ODI of EM group was lower than that of E group, and the difference was statistically significant (P 0.05). At 12 weeks, the time of occipitostomy in group E was significantly higher than that before treatment (P 0.01). Compared with group C, the time of occipitostomy in group E was longer than that in group C at 1 week, the difference was statistically significant (P 0.05), and that in group E was longer than that in group E at 12 weeks, and the difference was significant (P 0.01). Compared with EM group, group E was longer than EM group at 12 weeks, but there was no significant difference between the two groups (P 0.05.4). Compared with group 1, the time of curling up abdomen in each group was increased at 1 week. The difference was statistically significant (P 0.05). At 12 weeks, E group was significantly higher than that of EM group (P 0.01). Compared with group C, group E had a longer time of curling up abdomen at 1 week than group C, the difference was statistically significant (P 0.05), and at 12 weeks, group E was significantly longer than that of group C. The curling time of EM group was significantly longer than that of group C (P 0.01). Compared with EM group, group E had longer time of curling up abdomen than EM group at 12 weeks after 1 week. However, there was no significant difference between the two groups (P 0.05). Conclusion either the core muscle strength training alone or the core muscle strength training combined with moxibustion therapy can promote pain relief after radiofrequency ablation in patients with lumbar disc herniation. 2the effect of core muscle strength training combined with moxibustion in promoting pain relief after radiofrequency ablation in patients with lumbar intervertebral disc herniation was better than that of core muscle strength training alone; (3) single core muscle strength training or core muscle strength training combined with moxibustion therapy can promote the recovery of motor function after radiofrequency ablation in patients with lumbar disc herniation. (4) the effect of core muscle strength training combined with moxibustion treatment on the recovery of motor function at 12 weeks was significantly higher than that of single core muscle strength training, but the effect at 1 week was not better than that of core muscle strength training alone.
【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R681.53;R493

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