| Low back pain(LBP)is a common clinical disease that is easily to recurrent,it will affect the daily life and work severely.LBP is divided into three categories according to the modern medicine research,that is nonspecific low back pain,nerve root compression or push tube stenosis associated low back pain and specific spine-origin low back pain.Nonspecific low back pain in TCM belongs to the "pain" category,its pathogenesis is the outside invasion,meridian block;kidney loss,sudden sprain,blood stasis blocking collaterals.In western medicine,nonspecific low back pain(NLBP)refers to the chronic low back pain that is original in the waist with no nerve root involvement or lumbar organic lesions.It is related to many factors,such as occupation,gender,age,social psychological pressure,etc,pathological mechanisms of which include muscle strain and ligament injury,degeneration of lumbar intervertebral disc and endplate injury.Non-specific low back pain(CNLBP)is developed from NLBP for more than 3 months.In the treatment of CNLBP,traditional Chinese medicine massage is the first choice.At present,more and more researches on CNLBP is focused on the stability of lumbar spine and the change of biological structure.Core muscle training is taken for the treatment,to achieve effective relief of pain,improve the quality of life by rehabilitation therapy,and strengthen the core muscle training,which is also the important measure to to prevent recurrence of CNLBP.In recent years,one of the most respected training method for core muscle is the Pilates exercise.As one of the methods for the treatment of NLBP,Pilates exercise is a soothing functional practice.Pilates is a sports fitness system named,founded and promoted by Germany Joseph Pilates.It is mainly for the core muscle group,which not only improves the body muscle strength and coordination,but also strengthens the body spine and back combined with Pilates breathing,so that the body can maintain a good condition,the fitness value of which is very high.With the in-depth study of the exercise,the Pilates is not only used in daily physical exercise,but also in the field of medical and rehabilitation applications,which is gradually increasing.However,whether the efficacy of Pilates exercise is superior to the traditional massage therapy is still lack of sufficient evidence,and whether the combination will improve the efficacy is not clear.Objective: To investigate whether Pilates exercise combined with TCM massage and Danhong can improve the efficacy,in order to provide a better treatment for clinical practice.Methods:(1)60 patients with CNLBP who met the criteria were randomly divided into two groups,each group had 30 cases.(2)Traditional group: TCM massage combined with Danhong therapy was accepted,basic prescriptions of Huantiao,Chengfu,Yinmen,Weizhong,Taixi,Kunlun and Yaobeiyu were selected in TCM massage,combined with acupoints selection was based on syndrome differentiation and manual adjustment of small joints,25 minutes per treatment,5 times a week for 2 weeks.40 ml of Danhong was dissolved in 250 ml of 5% glucose injection with slow infusion,once a day,for 2 weeks.If the patient had a history of diabetes,250 ml of 0.9% sodium chloride injection could be used,once a day.(3)Treatment in the Pilates group is based on the traditional group with additional Pilates exercise.Pilates exercise was underwent in the exercise function training room under the guidance of the same professional rehabilitation therapist.4 set of Pilates exercises were included in this study: that was cat-type adjustment,two-point support,spine extension,hip lift.5-10 times for each set of exercise,with 10 seconds break for each time,the training load gradually increased,it can be increased to 15 times for each set of exercise for a total of 2 cycles.5 treatment per week for 10 times.(4)VAS and ODI were used for evaluating the results before,2 weeks after and 12 weeks after the treatment in both groups,SPSS 16.0 was used for statistical analyze.Results:(1)There were no significant differences in age,gender and disease course before the treatment in both groups(P>0.05);(2)Among 60 cases in this study,4 dropped out or lost to follow-up,of which,3 were in the traditional group 2 were with poor outcomes and did not finish the treatment,1 was lost to follow-up);one was in the Pilates group(one was not adhere to the treatment according to the prescribed time).After statistical analysis,there was no significant difference between the baseline(age,disease course,VAS and ODI before and after treatment)of the shedding cases in both groups and patients who completely finished the treatment(P>0.05).(3)2 weeks after the treatment,VAS and ODI values decreased compared with those before the treatment(P<0.05);follow-up 12 weeks after the treatment,VAS and ODI values still decreased compared with with those before the treatment,the difference was statistically significant(P<0.05);however,scores in the traditional group significantly rose again compared with those of 2 weeks after treatment,the difference was statistically significant(P<0.05),and it was not significant in the Pilates group,the difference was not statistically significant(P>0.05).Back pain degree of VAS and ODI scores in the Pilates group at any time-point were better than those of the traditional group,he difference was statistically significant(P<0.01).Conclusions: TCM massage combined with Danhong can improve CNLBP and increased Pilates training can significantly improve the short-term and long-term treatment effect and reduce the risk of recurrence. |
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