Study On Relative Factors Affecting Tuina Curative Effect In Lumbar Disc Herniation

Objectives: To analyze prognostic relative factors affecting the tuina treatment outcomeof lumbar disc herniation so as to establish the theoretic basis for a further improvement ofcurative effect.Methods: A total of 80 patients with lumbar disc herniation admitted from November2005 to February 2007 were collected.There were 48 males and 32 females.The sex ratio was1.5:1. Extruded position distributing:12 cases in the position of lumbar 3 to lumbar 4,35cases in the position of lumbar 4 to lumbar 5, 33 cases in the position of lumbar 5 to sacrum1.Type classified with CT distributing: 20 cases in the bulge type,26 cases in the protrusiontype,23 cases in the extrusion type, 11 cases in the sequestration type. All the clinicalparameters including age,sex,paroxysm process, clinical performance, type of herniation,whether nerve root is pressed or not, whether lateral recess is narrow or not, position ofherniation,and size of herniation were investigated as predictive risk factors. In order to findthe risk factors,the data was dealt with x~2 test and binary logistic, analysis (the parameters withP＜0.05).All of statistic was treated with SPSS 12.0.Results: 10 days was a course of treatment.All the patients were treated 2 course.We useimproved macnabs' criterion to value curative effect. Univariate analysis demonstrated thatmany factors were significantly correlated with the curative outcome of lumbar discherniation,such as paroxysm process,clinical performance,type of herniation, whether nerveroot is pressed or not,and whether lateral recess is narrow or not.The binary logistic analysisshowed that paroxysm process, clinical performance, and type of herniation were thesignificant independent predictors.Conclusion: Paroxysm process, clinical performance, and type of herniation were thesignificant independent predictors of curative outcome of lumbar disc herniation.So bulge type LDH and protrusion type are the first choice of tuna treatment.The patient of extrusiontype LDH can be treated by tuna. The sequestration type LDH is forbidden to use tuina. Forthe patient of Long paroxysm process or serious clinical performance we must increase thecourse of tuna treatment.