Clinical Observation And Optimization Research Among Chinese And Western Rehabilitation Therapies For Lumbago Disease Based On Real World

Objective: Observe the acceptance of patients with low back pain in real clinic for different rehabilitation treatment schemes,and compare the difference between the higher acceptance schemes and exercise therapy according to different therapeutic observation indicators,so as to screen out the optimal rehabilitation schemes and provide reference for clinicians.Methods: According to the principle of real world research,this study did not set up randomized grouping,and all subjects who met the inclusion criteria were given the same health education,so that they could choose one or more(2 to 5)treatment schemes of five treatment factors(including acupuncture,manipulation,kinesiotherapy,traction and physical agents therapy)according to their real wishes.Each week,they were treated 2-3 times,a total of 10 times of treatment,respectively,before treatment,five times after treatment,10 times after treatment completed the collection of the corresponding data in the case report form,mainly including the general information of patients and the observation indicators of curative effect(VAS,finger-to-ground distance,JOA total score,ODI,SF-36 physiological total score and mental total score),and entered into the electronic clinical data management system.Finally,the data of 317 patients in the third-class A hospital were collected for statistical analysis.The groups with more than 10 cases were compared with each other.Result: 1.In the acute attack period,the number of cases was the highest,with 42 cases,and the number of cases in the remaining group was less than 10;in the chronic remission period,there were 7 groups with more than 10 cases: the manipulation group(84),exercise Therapy group(48 people),physiotherapy group(29 people),technique + acupuncture group(18 people),technique + physiotherapy group(15 people),acupuncture group(15 people),traction group(14 people).2.The comparison results of the two pairs of groups at three time points in the acute and chronic phase showed that most of the indicators improved significantly with time points(P<0.05).The following are the exceptions(P>0.05): For SF-36 physiological total score and mental total score,there was no significant improvement in the chronic physiotherapy group and the acupuncture group after 5 treatments and 10 treatments,respectively.3.After 10 treatments in the chronic remission period,the results of the comparison between the efficacy indicators showed that there was no significant difference in the VAS score between the manipulation group and the exercise therapy(P>0.05),and the other 5 groups were significantly higher than the exercise therapy.Group(P<0.05).According to the regression coefficient,VAS score was ranked from low to high as traction group(?=7.10),manipulation + physiotherapy group(?=9.54),manipulation + acupuncture group(?=12.68),acupuncture group(?=15.91),physiotherapy group(?=17.10).In terms of finger-to-ground distance,there was no significant difference between the manipulation + physiotherapy group and the exercise therapy group(P>0.05).The other five groups were significantly higher than the exercise therapy group(P<0.05).According to the regression coefficient,the finger-to-ground distance was ranked from low to high as manipulation group(?=4.86),traction group(?=5.16),physiotherapy group(?=8.33),acupuncture group(?=13.83),manipulation + acupuncture group(?= 14.70).The total score of JOA in 6 groups was significantly lower than that in exercise therapy group(P<0.05).According to the regression coefficient,the total score of JOA was ranked from high to low as manipulation group(?=-1.22),traction group(?=-2.52),acupuncture group(?=-3.42),manipulation + acupuncture group(?=-3.64),physiotherapy group(?=-3.79),manipulation + physiotherapy group(?=-4.31).There was no significant difference in ODI between the manipulation group and the exercise therapy group(P>0.05).The other five groups were significantly higher than the exercise therapy group(P<0.05).According to the regression coefficient ODI,the order was manipulation + acupuncture group(?=6.03),manipulation + physiotherapy group(?=6.47),acupuncture group(?=9.82),traction group(?=13.64),physiotherapy group(?=17.82).There was no significant difference in the total physiological score of SF-36 between the manipulation group and the physiotherapy + manipulation group(P>0.05).The other four groups were significantly lower than the exercise group(P<0.05).According to the regression coefficient,the total physiological score of SF-36 was sorted from high to low as manipulation + acupuncture group(?=-10.589),traction group(?=-11.78),acupuncture group(?=-17.28),physiotherapy group(?=-24.67).In terms of SF-36 total mental score,there was no significant difference between manipulation group,traction group and physiotherapy + manipulation group(P>0.05),and the other three groups were significantly lower than that of exercise therapy group(P<0.05).According to the regression coefficient,the total mental score of SF-36 was sorted from high to low as manipulation + acupuncture group(?=-8.56),acupuncture group(?=-14.93),physiotherapy group(?=-16.86).Conclusion: 1.In real clinic,the acceptance of single-factor therapy is much higher than that of multi-factor combination therapy.The acceptance of manipulation is much higher than that of other treatments,whether as a single treatment or a factor in combination therapy.2.In real clinical practice,single acupuncture and physiotherapy have no significant effect on improving the quality of life of patients with chronic remission of low back pain.3.In addition to single exercise therapy,single manipulation has the best effect in improving pain,lumbar mobility,lumbar function and quality of life of patients with chronic remission of low back pain in tertiary hospitals in six groups with better clinical acceptance.It is the best scheme recommended when patients do not choose independent exercise in a short time.