The Length Of The Lever Of Massage Combined With Exercise Training In The Treatment Of Lumbar Disc Herniation Clinical Research

Objective:Under the guidance of TCM theory, using the lever length massage treatment of lumbar intervertebral joint of training.Through VAS score and JOA score to evaluate treatment effect and compare the length of lever of massage combined power training clinical efficacy and safety of the treatment of lumbar intervertebral disc protrusion, to explore its mechanism of treatment of lumbar intervertebral disc protrusion, to improve the clinical curative effect of lumbar disc prolapse, provide reliable basis for further popularization and application.Methods:1 Case selection and groupingIn September 2014 to December 2015 in hebei cangzhou combine traditional Chinese and western medicine during massage and rehabilitation of hospital outpatient patients as the research object of the lumbar intervertebral disc protrusion.In the sequence of Numbers to the patient, using the stochastic indicator method divided into treatment group and control group, two groups of participants included 120 patients, the treatment group and control group(n = 60).2 TreatmentTreatment group: first use after reinforcement technique, then give a short lever reconstructive technique, has a long lever reconstructive technique, short lever reconstructive technique, 1 / d, long lever reconstructive technique, 1 / w;Achievement method combined with stomach back achievement method, lie on your back arch bridge two kinds of skills training, 2 times/d, 7 for a period of treatment, observation of four procedures.Control group: Richard reinforcement technique and the length of lever reconstructive technique, method and course of treatment.3 Observed indicatorObserve VAS score and the JOA score before and after treatment in both groups, the subjective evaluation of patients pain and improve symptoms and signs.4 Clinical observation onCompare two groups of patients with total effective rate of treatment, to judge of two kinds of therapy, comparing the two groups before and after treatment of VAS score and JOA score changes, between groups comparing the differences between them.5 Diagnostic criteriaWith reference to the state administration of traditional Chinese medicine in 1994 issued by the "standard of diagnosis of disease and curative effect of traditional Chinese medicine" in TCM diagnosis standard of lumbar disc prolapse and the second edition of the lumbar disc disease in western medicine diagnostic criteria.6 Statistical methodsMeasurement data using t test and rank and inspection, to mean + /-standard deviation(?x±s) said, count data using Wilcoxon test, a = 0.05,P? 0.05,it's considered the difference was statistically significant.Test data using statistical software spss20.0 processing.Results: 1 General data analysis 1.1 Gender to compare the two groups of patients with X2 test, P = 0.592 > 0.05, there was no statistically significant difference, comparable; 1.2 Two groups of patients age by t test, P = 0.575 > 0.05, there was no statistically significant difference, comparable; 1.3 Two groups of patients with clinical course via Wilcoxon test, P = 0.567 > 0.05, there was no statistically significant difference, comparable; 1.4 Two groups of patients severity by t test, VAS score, P = 0.585 > 0.05, JOA score, P = 0.526 > 0.05, there were no statistically significant difference, comparable.Show two groups of patients with general information includes gender, age, course of difference after statistics analysis meaningless, comparable. 2 Two groups of patients with general curative effect comparisonTreatment group of 60 cases, clinical cure 26 cases(43.33%), 28 cases(46.67%), and 4 cases were effective, accounted for 6.67%, invalid in 2 cases, accounting for 3.33%, total effective rate was 96.67%;Control group 60 cases, clinical cure 18 cases(30%), 20 cases were markedly effective, accounted for 33.33%, 14 cases(23.33%), and to be null and void, 8 cases(13.33%), the total effective rate was 86.67%.Via Wilcoxon test, two groups of patients with total effective compared statistically significant difference(P < 0.05), indicating that the lever length of massage combined with power training more significant to the curative effect of lumbar disc prolapse. 3 VAS scores before and after treatment in both groups the result analysisBy t test, VAS score after treatment in both groups had significant difference compared with before treatment(P < 0.01);Compare the differences between two groups after treatment has no statistical significance(P > 0.05), shows that the two groups in terms of improving the waist pain have curative effect. 4 JOA score before and after treatment in both groups the result analysisJOA score by t test, two groups of patients before and after treatment, scores were significantly higher(P < 0.05);Comparison between the two groups after treatment, the treatment group feels obstacle, before the function was improved significantly(P < 0.01), and other symptoms are no statistically significant difference(P > 0.05), to show that the treatment group patients with sensory disturbance, bending forward curative effect is superior to the control group.Conclusion:1 Two therapy has good curative effect on lumbar intervertebral disc protrusion, but length of lever massage combined method training method curative effect is more significant.2 By two groups before and after treatment in patients with visual analogue scale(VAS) is found that both kinds of therapy can relieve the patient's pain symptoms, relieve the pain of patients, improve the patient's quality of work life.3 By JOA score before and after treatment in both groups is found that both kinds of therapy can improve patients with two groups of patients' subjective feelings, objective signs, daily activities and other symptoms and signs, but the length of the lever of massage combined power training method in improving patients' feeling obstacle, proneness function effect more apparent.4 Length levers combined massage skills training as a non-drug therapy method, is light, simple, safe and reliable with no pain, no side effects, patients economic burden, small trauma, less adverse reaction etc, is worth further clinical application.But due to the factors such as time, money, observation period is shorter, the lack of long-term follow-up, also did not rule out the positive result of accidental factors.In clinical research in the future, we will make up the defects, strongly insisted on a large scale, multicenter, randomized, controlled study design principle, adopt a variety of scale to evaluate curative effect, analyze the multiple factors, make the results more credible authority.