本文選題：退行性腰椎滑脫癥 + 三步五法�。� 參考：《云南中醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:通過(guò)觀(guān)察三步五法和常規(guī)推拿手法治療退行性腰椎滑脫癥的臨床療效,初步探討三步五法的療效依據(jù)和作用機(jī)理,為臨床治療退行性腰椎滑脫癥提供一種安全、有效的治療方法。方法:采用隨機(jī)對(duì)照分組方法,將符合納入標(biāo)準(zhǔn)的65例患者隨機(jī)分為2組,其中試驗(yàn)組33例,脫落3例;對(duì)照組32例,脫落2例。試驗(yàn)組采用三步五法進(jìn)行推拿治療,對(duì)照組采用常規(guī)推拿手法(參考王華蘭主編《推拿治療學(xué)》中的治療方法)進(jìn)行推拿治療,每次治療時(shí)間為30分鐘;兩組患者除行推拿治療外均配合導(dǎo)引功法進(jìn)行鍛煉。以上治療每日1次,2周為1個(gè)療程,共執(zhí)行1個(gè)療程。分別觀(guān)察治療前、療程結(jié)束后的“疼痛程度(PD)”及“JOA評(píng)分”變化,對(duì)相關(guān)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析,比較兩組的臨床療效。結(jié)果:1.完成本課題研究的60例患者,經(jīng)1個(gè)療程的治療后,30例試驗(yàn)組中臨床控制6例、顯效10例、有效13例、無(wú)效1例,總有效率為96.67%;30例對(duì)照組中臨床控制2例、顯效6例、有效20例、無(wú)效2例,總有效率為93.33%。經(jīng)秩和檢驗(yàn),試驗(yàn)組和對(duì)照組總體療效相比,差異具有統(tǒng)計(jì)學(xué)意義(P0.05),說(shuō)明三步五法組總體療效優(yōu)于常規(guī)推拿手法組。2.在疼痛程度的降低方面,兩種手法治療前后組內(nèi)比較,差異均具有統(tǒng)計(jì)學(xué)意義(P0.05);療程結(jié)束后組間比較,差異亦具有統(tǒng)計(jì)學(xué)意義(P0.05),說(shuō)明三步五法組在降低患者疼痛程度方面優(yōu)于常規(guī)推拿手法組。3.在臨床癥狀、體征的改善方面,兩種手法治療前后組內(nèi)評(píng)分比較,差異均具有統(tǒng)計(jì)學(xué)意義(P0.05);療程結(jié)束后組間比較,差異亦具有統(tǒng)計(jì)學(xué)意義(P0.05),說(shuō)明三步五法組在改善患者臨床癥狀、體征方面優(yōu)于常規(guī)推拿手法組。結(jié)論:1.經(jīng)1個(gè)療程的治療后,三步五法組和常規(guī)推拿手法組均能降低患者疼痛程度及改善臨床癥狀、體征;但組間比較,三步五法組均優(yōu)于常規(guī)推拿手法組;2.經(jīng)1個(gè)療程的治療后,三步五法組的總體療效優(yōu)于常規(guī)推拿手法組,三步五法值得在臨床上推廣運(yùn)用。
[Abstract]:Objective: to observe the clinical curative effect of three step five method and conventional massage in treating degenerative lumbar spondylolisthesis, and to explore the curative effect basis and mechanism of three step five method, so as to provide a kind of safety for clinical treatment of degenerative lumbar spondylolisthesis.An effective treatment.Methods: 65 patients who met the inclusion criteria were randomly divided into two groups, including 33 cases in the experimental group and 3 cases in the control group, and 32 cases in the control group, 2 cases in the control group.The experimental group was treated with three steps and five methods, while the control group was treated with conventional massage manipulation (referring to the treatment method in Wang Hua Lan's editor of Tuina Therapy), each time was 30 minutes.In addition to massage treatment, the two groups of patients with guidance exercises.The above treatment was given once a day for 2 weeks as a course of treatment, and a course of treatment was performed.The changes of pain degree and JOA score before and after treatment were observed, and the related data were statistically analyzed to compare the clinical efficacy of the two groups.The result is 1: 1.After one course of treatment, there were 6 cases of clinical control, 10 cases of remarkable effect, 13 cases of effective and 1 case of ineffectiveness. The total effective rate was 96.67% in the control group (2 cases, 6 cases).Effective 20 cases, ineffective 2 cases, the total effective rate is 93.33.By rank sum test, compared with the control group, the overall curative effect of the trial group was significantly higher than that of the control group (P 0.05), indicating that the total curative effect of the three-step five-method group was better than that of the conventional massage manipulation group .2.In terms of pain reduction, the differences between the two groups before and after treatment were statistically significant (P 0.05), and after the end of the course of treatment, there was a significant difference between the two groups.The difference was also statistically significant (P 0.05), indicating that the three step five method group was superior to the conventional massage group in reducing the pain degree of the patients. 3.In the aspect of improvement of clinical symptoms and signs, there were significant differences in the scores between the two groups before and after the treatment, the difference was statistically significant (P 0.05), and the comparison between the two groups after the end of the course of treatment,The difference was also statistically significant (P 0.05), which indicated that the three step five method group was superior to the routine massage group in improving the clinical symptoms and signs of the patients.Conclusion 1.After one course of treatment, the three step five method group and the routine massage manipulation group can both reduce the pain degree and improve the clinical symptoms and signs, but the three step five method group is better than the routine massage manipulation group 2.After one course of treatment, the overall curative effect of the three-step five-method group was better than that of the conventional massage manipulation group, and the three-step five-method method was worth popularizing in clinical practice.
【學(xué)位授予單位】：云南中醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R244.1

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