中医推拿联合康复锻炼对腰椎间盘突出症患者自我管理行为的影响

徐雪娣 陈木娇 江炜霞

【摘要】 目的：探討中医推拿联合康复锻炼在腰椎间盘突出症患者中的应用效果及对自我管理行为的影响。方法：选择2018年12月-2019年12月腰椎间盘突出症患者200例作为研究对象，将其随机分为对照组（n=100）和观察组（n=100）。对照组采用常规康复锻炼，观察组在对照组基础上联合中医推拿。比较两组视觉模拟疼痛（VAS）、Wswestry功能障碍指数（ODI）、日本骨科协会评估治疗分数（JOA）评分及自我管理行为。结果：干预后1个月，观察组VAS、ODI评分均低于对照组，JOA评分高于对照组，差异均有统计学意义（P<0.05）。干预后1个月，观察组饮食、运动、站姿、坐姿及劳动姿势评分均高于对照组，差异均有统计学意义（P<0.05）。结论：中医推拿联合康复锻炼用于腰椎间盘突出症患者中能减轻患者疼痛，改善患者肢体功能，有助于提高患者自我管理行为，值得推广应用。

【关键词】 中医推拿 康复锻炼 腰椎间盘突出症 肢体功能 自我管理行为

doi：10.14033/j.cnki.cfmr.2020.20.077 文献标识码 B 文章编号 1674-6805（2020）20-0-03

Effect of Traditional Chinese Medicine Massage Combined with Rehabilitation Exercise on Self-management Behavior of Patients with Lumbar Disc Herniation/XU Xuedi， CHEN Mujiao， JIANG Weixia. //Chinese and Foreign Medical Research， 2020， 18（20）： -188

[Abstract] Objective： To explore the effect of traditional Chinese medicine massage combined with rehabilitation exercise in patients with lumbar disc herniation and its effect on self-management behavior. Method： A total of 200 patients with lumbar disc herniation from December 2018 to December 2019 were selected as the research subjects， and they were randomly divided into the control group （n=100） and the observation group （n=100）. The control group used routine rehabilitation exercises， and the observation group combined with traditional Chinese medicine massage on the basis of the control group. The visual analog pain （VAS）， Wswestry Dysfunction Index （ODI）， Japanese Orthopaedic Association Evaluation Treatment Score （JOA） score and self-management behavior were compared between the two groups. Result： One month after intervention， VAS and ODI scores in the observation group were lower than those in the control group， and JOA score was higher than that in the control group， the differences were statistically significant （P<0.05）. One month after intervention， the diet， exercise， standing posture， sitting posture and labor posture score in the observation group were all higher than those in the control group， the differences were statistically significant （P<0.05）. Conclusion： Traditional Chinese medicine massage combined with rehabilitation exercise for patients with lumbar disc herniation can relieve patients pain， improve patients limb function， help improve patients self-management behavior， and is worthy of popularization and application.

[Key words] Traditional Chinese medicine massage Rehabilitation exercise Lumbar disc herniation Limb function Self-management behavior

First-authors address： Sihui Traditional Chinese Medicine Hospital， Sihui 526200， China

腰椎间盘突出症是由于腰椎髓核、纤维环及软骨板等组织发生不同程度退行性改变，且在外力因素作用下，导致椎间盘纤维环破裂，且髓核组织从破裂部位脱出，压迫相邻的脊神经根[1]。患者发病早期临床症状缺乏典型性，随着病情不断发展，将会引起疼痛、下肢麻木等。康复锻炼是腰椎间盘突出症患者中常用的治疗方法，能通过核心力量训练增加腰部周围肌肉、韧带力量，提高腰椎的稳定性[2]。而中医推拿属于中医治疗方法，能发挥舒筋活络、松解粘连功效[3]。因此，本研究以腰椎间盘突出症患者为研究对象，探讨中医推拿联合康复锻炼在腰椎间盘突出症患者中的应用效果及对自我管理行为的影响，现报道如下。

1 資料与方法

1.1 一般资料

选择2018年12月-2019年12月腰椎间盘突出症患者200例作为研究对象，纳入标准：（1）均符合腰椎间盘突出症诊断标准[4]，均经过X线片/CT检查确诊;（2）符合中医推拿/康复锻炼治疗适应证，且患者均可耐受。……