中医社区综合干预退行性腰椎不稳症的近期疗效观察
The Recent Observation of Therapeutic Effect on Comprehensive Intervention with Traditional Chinese Medicine for Degenerative Lumbar Instability Syndrome in the Community
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摘要: 目的 探讨社区内中医综合干预对退行性腰椎不稳症的防治效果，为制定适合于中国国情的以社区为基础的中医综合干预方案提供依据与帮助。方法 筛选符合退行性腰椎不稳症诊断标准的患病人群，随机分为对照组36例和干预组28例，干预组在对症治疗同时，通过举办健康讲座、心理疏导、指导督促功能锻炼，开展中药熏蒸理疗、针灸、针刀或手法等中医保守治疗措施，对患者进行社区内综合干预，对照组只给予常规对症治疗。2组随访6月，对患者进行疾病认知情况、临床症状变化、手术率及影像学等方面的评估。结果 干预组对疾病认知度评分较对照组高（P<0.01)。干预前2组患者JOA评分、Oswestry功能障碍评分差异无统计学意义，经治疗2组患者JOA评分、Oswestry功能障碍评分较前均有改善(P<0.01)；治疗后干预组JOA评分高于对照组（P<0.05），Oswestry功能障碍评分较对照组低（P<0.05），JOA优良率高于对照组（P<0.01）。干预组手术率低于对照组（P<0.05）。干预组、对照组影像学治疗前后均有改变，差异无统计学意义(P>0.05)。结论 社区内中医综合干预近期疗效确切，能缓解退行性腰椎不稳症患者的临床症状，提高患者对疾病的认知程度，降低手术率，改善患者的生活质量。Abstract: OBJECTIVE To explore the effect on comprehensive intervention with traditional Chinese medicine in the community for degenerative lumbar instability syndrome so as to provide supports and aids for establishing a comprehensive intervention protocol suitable for China and on the basis of community. METHODS All the patients of degenerative lumbar instability syndrome meeting the criteria were divided into the intervention group with 28 cases in it and the control group with 36 cases in it. Intervention group were given symptomatic treatment， accompanied with comprehensive intervention including health lecture， psychological counseling， functional exercises and various conservative treatment such as fumigation with herbs， acupuncture and moxibustion， acupotomy， maneuver， while control group were only provided symptomatic treatment. Both of the two groups were followed up for 6 months to evaluate following aspects: awareness of the disease， changes of clinical symptoms， the surgery rate and the medical imaging. RESULTS The intervention group's score of awareness of the disease was higher than that of control group with statistical significance (P<0.01). There was no statistical significance of JOA score and Oswestry Disability Index (ODI) in both groups before treatment (P>0.05). Improvement of JOA score and ODI can be observed in two groups after treatment. There was a statistical significant (P<0.01). Compared with control group， post-treatment JOA score of intervention group was higher (P<0.05)， as well as good rate of JOA (P<0.01). However， ODI and ratio of surgery of intervention group were lower than that of control group (P<0.05). There was no statistical significance of the changes of medical imaging during the 6 months (P>0.05). CONCLUSION Comprehensive intervention with traditional Chinese medicine has an obvious effect on treating degenerative lumbar instability syndrome which can alleviate the clinical symptoms， enhance awareness of the disease， decrease the surgery rate and improve the life quality of patients.
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