畅气通络手法护理对非特异性下腰痛的应用效果研究

中华养生保健 ›› 2022, Vol. 40 ›› Issue (21): 82-85.

畅气通络手法护理对非特异性下腰痛的应用效果研究

范超¹, 杨强^2,*

1.内蒙古自治区包头市第四医院中医康复科,内蒙古包头,014030;
2.内蒙古自治区妇幼保健院麻醉科,内蒙古呼和浩特,010017

出版日期:2022-11-01 发布日期:2022-11-01
通讯作者: ^*杨强,E-mail：45432522@qq.com。
作者简介:范超（1983.10-）,女,汉族,籍贯：内蒙古自治区包头市,本科,主管护师,研究方向：康复护理。
基金资助:
内蒙古自治区卫生健康委项目（项目编号：000014348/ 2021-70367）

Study on the Application Effect of Qi and Collateral Manipulative Nursing on Non-Specific Low Back Pain

FAN Chao¹, YANG Qiang^2,*

1. Department of Traditional Chinese Medicine, Rehabilitation of the Fourth Hospital of Baotou City, Baotou Neimenggu, 014030, China;
2. Department of Anesthesiology, Maternal and Child Health Hospital of Inner Mongolia Autonomous Region, Huhehaote Neimenggu, 010017, China

Online:2022-11-01 Published:2022-11-01

摘要/Abstract

摘要： 目的探讨畅气通络手法护理对非特异性下腰痛的应用效果。方法回顾性选择2019年1月~2022年1月内蒙古自治区包头市第四医院收治的非特异性下腰痛患者126例作为研究对象,根据护理方法分为畅气通络手法组与传统组,各63例。传统组给予常规功能锻炼护理,畅气通络手法组在传统组的基础上给予畅气通络手法护理,两组均护理观察2个月。观察两组的总体疗效、护理前后肌筋膜激痛点总体疼痛情况、腰部关节活动情况、表面肌电值变化情况。结果护理前,两组患者的肌筋膜激痛点疼痛视觉模拟评分（Visual analogue scale,VAS）、腰部关节活动Oswestry功能障碍指数（Oswestry disability index,ODI）评分、屈曲状态与背伸状态的表面肌电信号（Surface Electromyography,sEMG）对比,差异无统计学意义（P>0.05）;护理后,两组患者的肌筋膜激痛点VAS评分、ODI评分、屈曲状态sEMG值均显著低于护理前,且畅气通络手法组评分均显著低于传统组,差异有统计学意义（P<0.05）。护理后,畅气通络手法组的总有效率显著高于传统组,差异有统计学意义（P<0.05）。结论对非特异性下腰痛患者应用畅气通络手法,能缓解其肌筋膜激痛点的疼痛,改善腰部功能与表面肌电水平,提高总体疗效。

关键词: 肌筋膜激痛点, 非特异性下腰痛, 畅气通络手法, 表面肌电, 腰部功能

Abstract: Objective Study on the application effect of qi and collaterals manipulative nursing on non-specific low back pain. Methods A total of 126 patients with non-specific low back pain who were diagnosed and treated in the Department of Traditional Chinese Medicine Rehabilitation of the Fourth Hospital of Baotou City, Inner Mongolia from January 2019 to January 2022 were retrospectively selected as the research subjects. According to the nursing methods, they were divided into a Qi and collateral manipulative group and a traditional group with 63 cases each. The traditional group were given routine functional exercise nursing, and the Qi and collateral manipulative group were given the Qi and collateral manipulative nursing on the basis of the treatment of the traditional group. Both groups were given nursing observation for 2 months. The overall curative effect of the two groups was observed, and the overall pain of myofascial trigger points, the activity of the waist joints, and the surface electromyography were evaluated before and after nursing. Results Before nursing, the visual analogue scale (VAS) of myofascial trigger point pain, the oswestry disability index (ODI) score of lumbar joint activity, the surface electromyography(sEMG) of flexion and dorsi-extension states, the difference was not statistically significant(P>0.05). After nursing, the VAS of myofascial trigger points, lumbar joint activity ODI scores and flexion state sEMG value of the two groups of patients were significantly lower than those before nursing, and the Qi and collaterals manipulation group was also significantly lower than the traditional group, the difference was statistically significant(P<0.05). The total effective rate of the Qi and collateral manipulative group after nursing which were significantly higher than the traditional group, the difference was statistically significant(P<0.05). Conclusion The application of Qi and collateral manipulative nursing in non-specific low back pain can relieve the pain of myofascial trigger points, improve lumbar function and surface EMG level, thereby improving the overall curative effects.

Key words: myofascial trigger points, non-specific low back pain, qi and collateral manipulation, surface electromyography, lumbar function

中图分类号:

R473

范超, 杨强. 畅气通络手法护理对非特异性下腰痛的应用效果研究[J]. 中华养生保健, 2022, 40(21): 82-85.

FAN Chao, YANG Qiang. Study on the Application Effect of Qi and Collateral Manipulative Nursing on Non-Specific Low Back Pain[J]. ZHONGHUA YANGSHENG BAOJIAN, 2022, 40(21): 82-85.

参考文献

[1] 颜宾宏,牛坤.中医推拿对LBP患者腰肌组织温度及血清5-HT和β-EP的影响[J].海南医学院学报,2022,28(3):204-208.
[2] 王博,王旭凯,李云飞,等.腰骶部正骨手法治疗腰椎间盘突出症合并骶髂关节紊乱[J].吉林中医药,2022,42(1):107-110.
[3] 吕智桢,朱清广,孔令军,等.手法加载对慢性下腰痛模型大鼠降钙素基因相关肽和神经生长因子的影响[J].中国骨伤,2021,34(3):282-287.
[4] Stieven F F, Ferreira G E, de Araújo F X, et al. Immediate Effects of Dry Needling and Myofascial Release on Local and Widespread Pressure Pain Threshold in Individuals With Active Upper Trapezius Trigger Points: A Randomized Clinical Trial[J]. J Manipulative Physiol Ther,2021,44(2):95-102.
[5] 谢志勇,白金山,见国繁,等.三位六步手法联合倒立悬挂牵引治疗腰椎间盘突出症疗效观察[J].河北中医,2021,43(6):992-995.
[6] 张横滔,任燕,陆华,等.整脊手法结合核心肌群训练治疗腰椎间盘突出症疗效观察[J].辽宁中医杂志,2021,48(1):115-118.
[7] 凌耀权,杨仁轩,邓聪,等.“畅气通络”手法联合针刺百会穴治疗颈椎病的效果及对血流速度的影响[J].中国医药导报,2017,14(16):82-85.
[8] 施玉博,郭卫春,余铃.非特异性下腰痛:北美脊柱协会(NASS)循证医学指南解读[J].中国修复重建外科杂志,2021,35(10):1336-1340.
[9] 姚乃礼,中医证候鉴别诊断学[M].人民卫生出版社,2002:216-218.
[10] 孙兵,车晓明(整理).视觉模拟评分法(VAS)[J].中华神经外科杂志,2012,28(6):645.
[11] 刘绮,麦明泉,肖灵君,等.中文版Oswestry功能障碍指数评定慢性腰痛患者的反应度研究[J].中国康复医学杂志,2010,25(7):521-524.
[12] 袁林章,朱毅松,谢冰,等.手法及针刺治疗腰椎后关节紊乱症的研究进展[J].中国中医急症,2021,30(3):558-560,564.
[13] 苏志超,杜鑫,闫华琼,等.基于四海理论探讨腹部推拿治疗慢性下腰痛所致抑郁[J].河南中医,2021,41(8):1152-1154.
[14] 王明星,李树怀,董小磊,等.针刺联合正骨手法治疗复发性产后骨盆环损伤综合征疗效观察[J].现代中西医结合杂志,2021,30(26): 2882-2885,2890.
[15] 肖清明,吴昔钧,尹恒,等.基于肌筋膜链理论手法治疗退变性腰椎失稳的疗效观察[J].中国骨伤,2020,33(10):928-932.
[16] 公丕见,戴文娟,于荣鑫.热敏灸联合推拿对腰椎间盘突出症患者TXB2、PGE2水平及腰椎功能的影响[J].针灸临床杂志,2020,36(11): 17-21.
[17] 赵启,赵利敬,袁帅,等.基于“筋滞骨错”理论指导下腰腹联合手法治疗腰椎手术失败综合征临床研究[J].河南中医,2020,40(3):459-462.
[18] 吴树旭,黄俊霖,郭俊彪.畅气通络点穴法治疗非特异性下腰痛的临床观察[J].广州中医药大学学报,2021,38(5):973-979.
[19] 邓栋,余永庆,杨博文,等.浮针疗法联合手法治疗第三腰椎横突综合征风寒阻络型临床研究[J].河北中医,2020,42(3):442-447.
[20] 陈亚锋,司晓华,刘艳,等.“筋骨平衡”思想指导推拿治疗骶髂关节紊乱症临床观察[J].河北中医,2020,42(11):1700-1704.
[21] 苏志超,杜鑫,闫华琼,等.基于“四海理论”的腹部推拿治疗慢性下腰痛伴发抑郁状态的临床随机对照研究[J].天津中医药,2020, 37(10):1136-1141.
[22] 张鑫杰,宫顺国,王俊发,等.手法联合刃针治疗腰椎间盘突出症临床疗效观察[J].河北中医,2021,43(8):1371-1374.