【摘要】 目的:应用麦肯基力学诊疗技术联合超短波治疗与应用慢牵引和超短波治疗腰腿痛患者进行疗效比较。方法:选择2002-10/2003-10南阳市中心医院理疗康复门诊收治的腰腿痛患者100例。随机分为两组,治疗组50例和对照组50例,患者知情同意。①治疗组采用麦肯基力学治疗方法联合超短波治疗。麦肯基力学治疗方法包括:腰椎姿势不良综合征的治疗;腰椎功能不良综合征的治疗;腰椎间盘移位综合征的治疗;麦肯基力学治疗腰腿痛的练习方法:分7节,前4节前俯屈曲练习,后3节是向后伸展练习。以上治疗做10d。超短波治疗:功率为250W,波长7.37m,电流4A,输出频率40.68MHz,治疗20min/次,1次/d,做10服d。②对照组采用慢牵引和超短波治疗。牵引力15～30kg,1次/d,做10d。超短波治疗同治疗组。③两组均于10d后运用改进的腰腿痛评分量表(分为腰背痛、腿痛或麻木感、步态、直腿抬高试验、感觉障碍、运动障碍、日常生活受限制程度等12项,每项分为0～3分,0分为无障碍,3分为重度障碍)评分值计算疗效判定标准。优:临床症状体征消失,日常活动无障碍,病情程度积分<5分。良好:临床症状体征明显好转,改善率≥50%。无效:临床症状及体征无明显改善或加重,改善率<50%。改善率=犤(治疗前评分-治疗后评分)/治疗前评分犦×100%。结果:按意向处理分析,100例患者均进入结果分析。治疗组优38例,良11例,无效1例。对照组优25例,良19例,无效6例。治疗组总有效率显著高于对照组总有效率犤98%(49/50),88%(44/50),P<0.01犦。结论:麦肯基力学方法对于非手术治疗的腰腿痛患者是一种比较安全和有效的疗法。其作用在于能通过自我主动改变体位运动,逐渐拉长腰背肌肉的适应性,使缩短的肌肉组织重建丧失的功能和增强运动能力,与物理疗法并用疗效更显著。更多还原

【Abstract】 AIM: To compare Mchenzie mechanics principle plus ultrashort wave and chronic traction plus ultrashort wave in the treatment of lumbar and leg pain. METHODS: One hundred patients with lumbar and leg pain admitted to the Outpatients of Physiotherapy and Rehabilitation, Nanyang Central Hos-pital from October 2002 to October 2003 were enrolled, and were random-ized into treatment group and control group with 50 cases in each group. All the patients agreed to participate in the study. ①Mchenzie mechanics principle and ultrashort wave were used in the treatment group. Mchenzie mechanics principle included treatment for abnormal posture syndrome of lumbar spine, treatment for abnormal function syndrome of lumbar spine, and treatment for displacement of lumbar intervertebral disc. Treatment plan of Mchenzie mechanics principle consisted of seven sections, four sections of anterior flexion training and three sections of posterior extension training, and the uration of treatment was 10 days. Ultrashort wave treat-ment (Duty: 250 W, wave-length: 7.37 m, current: 4 A, output: 40.68 MHz, 20 minutes once a day) was performed for 10 days. ② Chronic traction (pull strength: 15-30 kg, once a day) and ultrashort wave (the same as that in the treatment group) were used in the control group. The duration of treatment was 10 days. ③ Ten days after treatment, modified scale for lumbar and leg pain was performed in the two groups. The scale includes twelve items, low back pain, leg pain or numbness, gait, straight-leg raising test, sensory disorder, motor disorder, and limited degree of daily living, 0-3 scores for each item: score 0 as no disorder, 3 as severe disorder. Criteria for therapeutic effect included disappearance of clinical symptoms and signs, without disturbance in daily living, score on disease condition < 5. Obvious improvement in clinical symptoms and signs with the improved rate ≥ 50% was considered as effective. No change or aggravation in clinical symptoms and signs with the improved rate < 50% was considered as ineffective[Improved rate=(pretreatment score-posttreatment score) /pretreatment score × 100%]. RESULTS: According to the intention-to-treat analysis, 100 cases were all involved in the result analysis. There were 38 effective cases, 11 fair cases and 1 ineffective case in the treatment group, and 25, 19 and 6 in the con-trol group. The total effective rate in the treatment group was 98%(49/50), significantly higher than 88%(44/50) in the control group(P < 0.01). CONCLUSION: Mchenzie mechanics principle is a safe and effective therapy for non-operation patients with lumbar and leg pain. It can stretch the adaptive shortened tissues of muscles of low back to reconstruct the function of muscle and promote the motor function through auto-postural al-teration.更多还原