The Clinical Research Of Standardized Manipulation Methods To Treat The Lumbar Disc Herniation

ObjectivesTo objectively assess the efficacy and safety of standardized manipulation methods to treat the lumbar disc herniation, a preliminary study for the extensive use of the technique.Methods50 participants were randomly allocated to an intervention (n=25) or control (n=25) group. The intervention group attended standardized manipulation with an trained clinician once two days for 3 weeks, every time lasted about 20 min. The control group received traction treatment everyday for 3 week, every time lasted about 30 min. Questionnaires such as JOA for lumbar, Roland-Morris scale and back pain/limb VAS score assessed the changes in lumbar pain and daily function pre-treatment, one week after treatment, two weeks after treatment, three weeks after treatment,21 days after finishing the treatment and 42 days after finishing the treatment. CT evaluation of the lumbar spine in patients included the sagittal index (SI), aspect ratio (P), AN value and computerized tomographynumber. Statistics used the SPSS13.0 statistical data analysis software package, enumeration data were denoted with rate and compared with X2 test; measurement data were denoted with mean±standard deviation, and compared with a t test, the test level a= 0.05.ResultThe average case history was 13 months (1 month-3 years), the baseline of two groups was equilibrate, without significant difference. According to lumbar JOA, the experimental group had better effects than the control group (t=2.714, p<0.05), according to Roland-Morri score, between two groups there was not significant difference (t=0.911, p>0.05), according to low back pain VAS score, he experimental group had better effects than the control group (t=2.414, p<0.05), according to VAS leg pain score, two groups were not significant difference (t=1.459, p=0.151>0.05). All the patient were follow-up:under the lumbar JOA, two groups no significant difference (t=.919, p>0.05); according to Roland-Morri scale, two groups no significant difference (t=0.906, p) 0.05); according to back pain VAS score, two groups were not significantly different (t=1.462, p>0.05), according to VAS leg pain score, two groups were not significantly different (t=2.43, p=0.809>0.05).From the lumbar CT, the there were 28 in L4/5 segment, accounting for 56%; 15 in L5/S1 segment accounting for 30%; 7 in L4/5 and L5/S1 combined segment accounting for 14%; At equal pace there were 24 in left, accounting for 48%; 19 in the right, accounting for 38%; 7 in the center, accounting for 14%.Images change in the two group had no significantly difference between pre-treatment and post-treatment.According to Hu you gu type, all the distribution were in the I level, and in the sagittal plane, the prominence were mainly in area 1 or 2, in the coronal plane, the prominence were mainly in area a.Safe observation, including blood pressure pulse respiratory blood urine ECG, above indicators have no significant deterioration before and after treatment.GonclusionStandardized manipulation methods to treat the lumbar disc herniation for lumbar disc herniation is effective and safe, and worthy of promotion.