| ObjectivesTo observe the clinical effect of manipulation on degenerative lumbar instability based on"regulating the balance of muscles and bones,taking tendons as the first",to provide a basis for the guiding role of the theory of "regulating the balance of muscles and bones,taking tendons as the first" in manipulation treatment,and to improve the therapeutic effect of manipulation on degenerative lumbar instability.Methods75 patients with degenerative lumbar instability who met the inclusion criteria and exclusion criteria were randomly divided into 3 different treatment groups according to the random number table method:25 cases in group A were treated with lumbar muscle function exercise alone;25 cases in group B were treated with oral celecoxib capsule combined with lumbar and dorsal muscle functional exercise;Group C,25 cases were treated with manipulation combined with lumbar and dorsal muscle functional exercise.VAS score,JOA score,ODI score and lumbar back muscle tension test were used to evaluate the curative effect.Results1.During the study,there were 4 cases who fell off because the patients could not cooperate with the treatment or adopted other treatment methods during the treatment and follow-up period,including 2 cases in group A,1 case in group B and 1 case in group C.The cases who finally completed the treatment and were followed up were 23 cases in group A,24 cases in group B and 24 cases in group C.Finally,a total of 71 patients with degenerative lumbar instability successfully completed the clinical study and were followed up.There was no significant difference in age,sex and course of disease among the three groups(P>0.05),which indicated that the baseline data of the three groups were comparable.2.VAS score:①The VAS scores of the three groups before treatment were compared with each other,and there was no significant difference between the scores of each group.②Comparison of the data before and after treatment in the three groups,the pain in group A was relieved immediately after treatment and 1 month follow-up after treatment as compared with that before treatment(P<0.05),and the pain in one month follow-up after treatment was also significantly improved compared with that immediately after treatment(P<0.05);In group B,the pain was relieved immediately after treatment and 1 month after treatment compared with before treatment(P<0.05),and the pain was also significantly improved at 1 month after treatment compared with immediately after treatment(P<0.05);In group C,the pain was relieved immediately after treatment and 1 month follow-up after treatment compared with before treatment(P<0.05),and the pain was also significantly improved after 1 month follow-up compared with immediately after treatment(P<0.05).③ There was no significant difference between the scores of the three groups before treatment(P>0.05);The scores of group B and group C immediately after treatment were significantly improved compared with those of group A,and the difference was statistically significant(P<0.05);There was no significant difference in scores between group B and group C immediately after treatment(P>0.05);There was no significant difference in score between group B and group C at one month follow-up after treatment(P>0.05).3.JOA score:① The JOA scores of the three groups before treatment were compared with each other,and there was no significant difference between the scores of each group.② There was no significant difference between the scores of the three groups before and after treatment in group A(P>0.05),and the pain was significantly improved after one month of follow-up compared with that immediately after treatment(P<0.05);In group B,the pain was relieved immediately after treatment and 1 month after treatment compared with before treatment(P<0.05),and there was no significant difference between the follow-up score of 1 month after treatment and the score immediately after treatment(P>0.05);In group C.the pain was relieved immediately after treatment and 1 month after treatment compared with before treatment(P<0.05),but there was no significant difference between 1 month after treatment and the score immediately after treatment(P>0.05).③ There was no significant difference between the scores of the three groups before treatment(P>0.05);There was no significant difference between the scores of group B and group C immediately after treatment and group A immediately after treatment(P>0.05);There was no significant difference in scores between group B and group C immediately after treatment(P>0.05);The pain in group B and C was significantly relieved at 1 month follow-up after treatment compared with that in group A(P<0.05);The pain in group B was significantly improved compared with that in group C at one month follow-up after treatment(P<0.05).4.ODI score:① The ODI scores of the three groups before treatment were compared with each other,and there was no significant difference in scores among the groups.② Comparing the data before and after treatment in the three groups,the lumbar dysfunction in group A was relieved immediately after treatment and 1 month follow-up after treatment as compared with that before treatment(P<0.05),and 1 month follow-up after treatment was compared with that immediately after treatment.The difference was statistically significant(P<0.05);In group B,the quality of daily life was improved immediately after treatment and 1 month after treatment compared with before treatment(P<0.05),but there was no significant difference between 1 month after treatment and immediately after treatment(P>0.05);In group C,the difference was statistically significant immediately after treatment and 1 month after treatment compared with before treatment(P<0.05).Compared with the score immediately after treatment,the lumbar function was significantly improved one month after treatment.The difference was statistically significant(P<0.05).③ There was no significant difference between the scores of the three groups before treatment(P>0.05);The scores of group B and group C immediately after treatment were significantly improved compared with those of group A,and the difference was statistically significant(P<0.05);There was no significant difference in scores between group B and group C immediately after treatment(P>0.05);The scores of group A and group B were significantly different from those of group C at 1 month follow-up after treatment(P<0.05);There was no significant difference in the 1-month follow-up score between group B and group A(P>0.05).5.Measurement of bilateral lumbar and dorsal muscle tension:① The shift value of bilateral lumbar paravertebral muscle 200g pressure level(L200g)before treatment,that is,lumbar and dorsal muscle tension,was compared with each other in the three groups.There was no significant difference in scores among the groups.② Comparing the data of the three groups before and after treatment,the bilateral muscle tension in group A immediately after treatment and 1 month after treatment were significantly improved compared with those before treatment(P<0.05),and the 1 month follow-up after treatment was compared with the immediate muscle tension test results after treatment.The bilateral difference was statistically significant(P<0.05);In group B,there were significant differences in bilateral displacement values immediately after treatment and 1 month after treatment compared with those before treatment(P<0.05),and there was no significant difference in bilateral muscle tension recovery between 1 month after treatment and immediately after treatment(P>0.05);In group C,the difference was statistically significant immediately after treatment and 1 month after treatment compared with beforetreatment(P<0.05).Compared with the score immediately after treatment,the recovery of muscle tension at 1 month after treatment was not comparable(P>0.05).③ There was no significant difference between the scores of the three groups before treatment(P>0.05);The scores of group B and group C immediately after treatment were significantly improved compared with those of group A immediately after treatment.The difference was statistically significant(P<0.05).The right muscle tension of group B and group C recovered to varying degrees immediately after treatment,but there was no significant change in the right muscle tension displacement value of group B compared with group A(P>0.05).Compared with group B immediately after treatment,the right waist muscle function of group C was significantly improved(P<0.05);The bilateral lumbar muscle function of group B and group C recovered in different degrees after 1 month follow-up compared with that of group A(P<0.05);Compared with group A,the left muscle tension displacement was not comparable in group B(P>0.05),but the recovery of right lumbar muscle tension was more obvious(P<0.05)Conclusion1.After treatment,the VAS score,JOA score,ODI score and bilateral lumbar and back muscle tension test of patients in groups A,B and C were improved compared with those before treatment,and the overall curative effect of group B and C was better than that of group A.2.There was no significant difference in curative effect between group C and group B immediately after treatment,but the JOA score,ODI score and muscle tension of right lumbar back muscle in group C were more significant than those in group B.3.Manipulation based on the theory of "regulating the balance of bones and muscles and putting tendons first" has obvious curative effect on degenerative lumbar instability,can effectively improve pain symptoms and dysfunction of patients,improve the quality of life of patients,and can be popularized in clinic. |
PDF Full Text Request