【摘要】 背景:对腰椎间盘突出症患者过去多主张物理疗法治疗,应用被动治疗与主动功能锻炼相结合的方法在国内外逐渐受到重视,腰椎间盘突出症患者早期进行功能锻对功能恢复,减轻疼痛与麻木等症状有明显作用。目的:应用功能锻炼等方法改善腰椎间盘突出症患者的临床症状,探讨其作用机制。设计:前后对照试验。地点和对象:选择2000-05/2003-05辽宁中医学院腰椎间盘突出症患者100例,男57例,女43例,年龄16～72岁。干预:主动功能锻炼:扶物锻炼法。扶住某一物体,做屈曲(弯腰)背伸等动作三四周后,增加步行或上下楼梯等方法,时间、强度自行掌握。被动锻炼方法:在医生指导下或借助于辅助设置控制条件下的功能锻炼。进行功能锻炼前后观察症状、体征等治疗状况。主要观察指标:疗效评定结果及影像学变化。结果:腰及下肢麻痛症状改善者,直腿抬高达70°以上,生理曲度基本恢复,胜任原工作者,82例;症状基本消失,尚有轻微残余腰痛及小腿外侧麻痛,但能坚持原工作者,12例;症状、体征无明显变化者,6例。总有效率为94%。功能锻炼或治疗的前后对照结果表明,CT检查的改变不明显。结论:功能锻炼方法可明显提高腰椎间盘突出症患者的治疗效果。CT结果不能作为疗效评估的主要依据,对腰椎间盘突出症的疗效评估要以症状体征为主。更多还原

【Abstract】 BACKGROUND:Physical treatment got used to be claimed for lumbar disc herniation(LDH)therapy. Combination of passive and initiative treatment was gradually attention getting at home and abroad,early initiative functional training may have obvious effects on symptoms such as functional recovery,pain release,and anaesthesia in LDH patients. OBJECTIVE:To improve clinical symptom of LDH patients using functional training and other methods,and to explore the mechanism. DESIGN:Pre post comparison experiment. SETTING and PARTICIPANTS:One hundred LDH patients,57 males and 43 females,aged 16-72 years were selected from Liaoning College of Traditional Chinese Medicine from May 2000 to May 2003. INTERVENTIONS:Initiative functional training:holding exercise.Hold on to some objects,after bending oneself (bending the waist)about three or four rounds,the time and intensity were self controlled.Passive training methods: functional training under doctor directions or by assistance of auxiliaries manipulated conditions. MAIN OUTCOME MEASURES:Therapeutic effect evaluating results and imageology changes. RESULTS:Eighty two cases were with improved lumbar and lower extremity anaesthesia,straight leg raise over 70°, physical curvature almost recovered.and being competent enough for their job;12 better cases were present as essentially vanished symptom,yet with slightly residual low back pain as well as lateral leg anesthesia and pain,but can insist on their job;6 were ineffective without apparent changes in symptom and physical sign.Total effective rate was 94%. Results of functional training or before and after treatments showed that there were no significant changes in CT examination. CONCLUSION:The therapeutic effect of functional training on the syndrome of LDH can be apparently improved. Therapeutic effect assessment might not be mainly based on results of CT,but on symptoms and signs.更多还原