發(fā)布時間：2018-07-18 16:04

【摘要】：目的：研宄以宗整脊綜合療法對腰椎管狹窄癥(LSS, lumbar stenosis)患者中期生存質(zhì)量(QOL)的影響,通過比較對患者生存質(zhì)量各維度的改善值情況。探索以生存質(zhì)量評價標準治療腰椎管狹窄癥的合理方案,并為臨床工作提供新依據(jù)。方法：本研究采取回顧性研究,查閱2010年1月-2015年6月在廣東省中醫(yī)院骨科住院治療的退行性腰椎管狹窄癥患者共189例,符合納入標準的并愿意配合課題工作的有98例,按照治療方案改為骨盆牽引組及整脊治療組。以生活質(zhì)量36問卷(The short-term 36, SF-36量表)為測評量表,分別對上述患者進行治療前后的評分,進行數(shù)據(jù)統(tǒng)計,從生理職能(Role-Physical, RP)、生理機能(Physical Functioning, PF)、總體健康狀況(General Health, GH)、軀體疼痛(Bodily Pain, BP)、社會功能(Social Functioning, SF)、精力(Vitality, VT)、精神健康(Mental Health, MH)、情感職能(Role-Emotional, RE)這8個維度評價兩種治療方法干預后患者的生存質(zhì)量情況以及改善情況。結(jié)果：1.治療后進行組內(nèi)比較,以宗整脊治療組的8個維度得分均高于骨盆牽引組得分,其中在生理機能、生理職能、軀體疼痛、社會職能、精神健康、精力這6個維度的評分有統(tǒng)計學差異。2.在對病程的生存質(zhì)量評分分析中,病程小于4年組內(nèi),整脊組的軀體疼痛的生存質(zhì)量評分高于骨盆牽引組,并且有統(tǒng)計學差異；另外在病程大于4年組內(nèi),整脊組的總體健康生存質(zhì)量評分高于骨盆牽引組,存在著統(tǒng)計學差異。3.不同性別在整脊及骨盆牽引治療患者中的各維度之間的生存質(zhì)量評分并沒有統(tǒng)計學差異。4.年齡小于65歲分組內(nèi),整脊組的軀體疼痛、社會職能情況、精神健康情況這三個維度評分高于骨盆牽引組,且存在統(tǒng)計學差異。在大于65歲的患者分組內(nèi),整脊組的生理機能、軀體疼痛兩個維度得分高于骨盆牽引組,并且均有統(tǒng)計學差異。5.隨訪時間小于1.5年的分組內(nèi),整脊組患者的總體健康情況生存質(zhì)量評分高于骨盆牽引組,骨盆牽引組的社會職能情況生存質(zhì)量評分高于整脊組,并且上述兩組數(shù)據(jù)存在組內(nèi)統(tǒng)計學差異。結(jié)論：1.患者在經(jīng)以宗整脊治療后而在生理機能、生理職能、軀體疼痛、社會職能、精神健康、精力這6個維度的評分較前提高,并且有統(tǒng)計學差異。以宗整脊治療對改善生理情況,緩解軀體疼痛,改善精神健康、精力以及改善社會職能有一定的幫助。在臨床工作應該根據(jù)患者具體情況選擇合理的治療方案。2.性別對于進行骨盆牽引治療及整脊治療后患者的生存質(zhì)量評分不存在影響。3.隨訪時間小于1.5年的整脊組患者的總體健康情況生存質(zhì)量評分較骨盆牽引組患者高,可能進行整脊治療對患者的總體健康有一定幫助；而整脊治療組的社會職能生存質(zhì)量得分較骨盆組低,可以建議患者加強與周圍親友交流及溝通。4.兩個年齡分組中整脊組患者在軀體疼痛這個維度評分高于骨盆牽引組,整脊治療可能在緩解疼痛較為有效。在小于65歲的年齡分組中整脊治療組的社會職能情況、精神健康情況的生存質(zhì)量得分高于骨盆牽引組,可能是整脊治療后患者癥狀緩解有助于其社會交際及精神健康情況。在大于65歲的患者分組內(nèi),整脊組的生理機能維度得分高于骨盆牽引組,可能整脊治療有助于改善生理機能。5.病程小于4年的整脊治療患者的軀體疼痛生存質(zhì)量評分相對骨盆牽引組較高,應該說整脊治療有助于緩解疼痛。另外,大于4年的整脊患者在總體健康維度得分高于骨盆牽引組,整脊治療可以對緩解軀體疼痛,同時也影響患者健康情況。6.以宗整脊療法治療腰椎管狹窄癥是一種療效確切,安全可靠及副作用少的治療方法,值得臨床推廣。
[Abstract]:Objective: To explore the effect of LSS (lumbar stenosis) on the mid-term quality of life (QOL) in patients with lumbar spinal stenosis (QOL), and to explore the rational plan for the treatment of lumbar spinal stenosis by comparing the quality of life of the patients with the quality of life. In this study, a retrospective study was conducted to examine 189 patients with degenerative lumbar spinal stenosis hospitalized in Department of orthopedics, Guangdong Province Traditional Chinese Medical Hospital, January 2010, -2015, and 98 cases in accordance with the standard and willing to cooperate with the subject work. The treatment scheme was changed into pelvic traction group and whole spine treatment group. The quality of life 36 questionnaire (The short-TE) was used. The RM 36, the SF-36 scale) was the assessment scale, and the scores of the patients before and after the treatment were calculated, from the physiological function (Role-Physical, RP), the physiological function (Physical Functioning, PF), the overall health status (General Health, GH), body pain (Bodily Pain), social function, energy. VT), the 8 dimensions of mental health (Mental Health, MH) and emotional function (Role-Emotional, RE) were used to evaluate the quality of life and improvement of the two treatments after intervention. Results: after 1. treatments, the scores of the 8 dimensions in the Zong chiropractic group were higher than those in the pelvic traction group. The scores of the 6 dimensions of function, somatic pain, social function, mental health, and energy were statistically different..2. was less than 4 years in the quality of life score analysis of the course of disease. The quality of life of the body pain in the whole spine group was higher than that in the pelvic traction group, and there were differences in the overall planning. In addition, the whole spine group was more than 4 years, and the whole spine group The overall health quality score was higher than that in the pelvic traction group. There was a statistical difference in.3.. There was no statistical difference in the quality of life scores between the different sexes in the whole spine and pelvic traction patients. The.4. age was less than 65 years old, and the body pain, social function, and mental health were the three dimensions of the whole spine group. The score of degree score was higher than that in pelvic traction group, and there was a statistical difference. In the group of patients older than 65 years old, the score of physiological function and body pain in the whole spine group was higher than that in the pelvic traction group, and there were statistically significant differences in the.5. follow-up time of less than 1.5 years. The overall health quality score of the patients with whole spinal cord group was higher than that of the pelvis. In the traction group, the score of the social function of the pelvic traction group was higher than that of the whole group, and there was a statistical difference between the two groups. Conclusion: the scores of the 1. patients were improved in physiological function, physiological function, somatic pain, social function, mental health, energy and energy, and the scores of the 6 dimensions were higher than before. Statistical differences. The treatment of Zong chiropractic has some help to improve physical condition, relieve somatic pain, improve mental health, energy, and improve social function. In clinical work, a reasonable treatment scheme should be selected according to the specific condition of the patient,.2. sex for the quality of life of the patients after pelvic traction treatment and whole spinal therapy. The overall health quality score of the patients with.3. follow-up less than 1.5 years was higher than those in the pelvic traction group. It may be helpful for the overall health of the patients, while the social function score of the whole spine treatment group was lower than that in the pelvic group, and it was suggested that the patients should be strengthened with the surrounding relatives and friends. In the two age groups of the two age groups, the whole spine group was higher than the pelvic traction group. The whole ridge therapy may be more effective in alleviating pain. The social function of the whole spine group in the age group of less than 65 years of age was higher than the pelvic traction group. In patients older than 65 years of age, the score of the physiological function dimension of the whole spine group is higher than that of the pelvic traction group. It may be helpful to improve the somatic pain quality score of the patients with physiological function.5. for less than 4 years. There is a higher traction group. It should be said that spinal cord therapy helps relieve pain. In addition, the overall health dimension of the patients who are more than 4 years is higher than the pelvic traction group. The whole ridge therapy can relieve somatic pain and also affect the health of the patients. The treatment of lumbar spinal stenosis is an effective, safe, reliable and auxiliary treatment for the treatment of lumbar spinal stenosis by.6.. Less effective treatment is worthy of clinical promotion.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R244.1

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