Clinical Research On Treatment Of Degenerative Lumbar Spondylolisthesis By Lumbar And Abdominal Manipulation

Objective:To observe the clinical effects of combined lumbar and abdominal manipulation in the treatment of degenerative lumbar spondylolisthesis and explore its theoretical foundation of the manipulation.Methods:66 patients with degenerative lumbar spondylolisthesis were randomly divided into two groups according to the random number table method,33 cases in the observation group and 33 cases in the control group.In the control group,traditional therapy of hip flexion and knee flexion combined with basic therapy(traditional Chinese medicine fumigation and washing + trisflexion traction)were used.In the observation group,lumbar and abdominal manipulation combined with basic therapy((traditional Chinese medicine fumigation and washing + traction with three flexion positions)were used.Manipulation treatment was given once every 2 days,with a course of treatment for 14 days.The JOA score and NRS score of two groups were recorded before treatment and after 2 weeks of treatment respectively.The clinical effect was evaluated after 2 weeks of treatment.Results:1.In the course of this study,both the observation group and the control group had shedding cases,including 1 case in the observation group and 3 cases in the control group.All shedding cases were voluntary withdrawal of the subjects for personal reasons.Finally,62 complete cases were obtained with 32 cases in the observation group and 30 cases in the control group.2.Results of the total clinical effective rate of two groups according to JOA efficacy evaluation standard: In the observation group,6 cases got clinical control,9cases marked effectiveness,16 cases effectiveness and 1 case ineffectiveness;the total effective rate was 96.88%;In the control group,2 cases got clinical control,4 cases marked effectiveness,20 cases effectiveness,and 4 cases of ineffectiveness;the total effective rate was 86.67%.Mann-whitney U test showed that the difference in clinical efficacy between the two groups was statistically significant(P < 0.05).The overall effective rate of the observation group was better than that of the control group.The observation group and the control group were compared before and after treatment respectively.The NRS score and JOA score of DLS patients in the two groups were tested by paired sample t,showing that the score after treatment was better than before treatment,and the difference between two groups was statistically significant(P <0.05).The NRS score and JOA score of DLS patients in the two groups after treatment were tested by independent sample t test.The result showed that the observation group was better than the control group,and the difference between two groups was statistically significant(P < 0.05).Conclusion:1.Both traditional flexion hip pressure and combined lumbar and abdominal manipulation can relieve the lumbar pain and improve the spinal function in DLS patients,but the latter has more advantages;2.The combined lumbar and abdominal manipulation has definite short-term effect on the treatment of DLS patients,but the long-term effect needs further observation.