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3、变中的应用 J.安徽医药,2017,21(1):94-96.20赵丁民,廖国庆,刘盛,等.原发胃肠间质瘤临床病理特征及预后分析:附314例报告 J.中国普通外科杂志,2019,28(4):467-473.(收稿日期:2020-12-16,修回日期:2021-02-02)筋膜释放技术联合核心稳定训练治疗慢性非特异性腰痛的疗效观察王艳文1,李雯燕2,武俊英2作者单位:1山西医科大学临床医学院,山西 太原030000;2山西医科大学第一临床医院康复科,山西 太原030000通信作者:武俊英,女,主任医师,硕士生导师,研究方向为脊柱、神经康复方面疾病,Email:摘要:目的 探究筋膜释放技术(MFR)
4、联合核心稳定训练(CSE)治疗慢性非特异性腰痛(CNLBP)的临床疗效。方法 选取2020年10月至2021年7月在山西医科大学第一医院治疗的40例CNLBP病人,采用随机数字表法分为观察组和对照组各20例。两组病人均接受核心稳定训练,观察组在此基础上进行筋膜释放技术治疗,治疗时间为2周。分别于治疗前、治疗1周及治疗2周后对两组病人进行疗效评估,评定方法包括Schober试验、视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)及恐惧-回避信念问卷(FABQ)。结果 治疗1周后,观察组与对照组Schober试验结果 (3.73 1.16)cm、(2.98 1.14)cm 与治疗前(3
5、.05 1.27)cm、(2.48 1.02)cm 比较均升高(P0.001),观察组与对照组的VAS评分 (2.90 1.28)分、(4.25 1.33)分、ODI评分 (12.00 4.18)分、(16.45 3.95)分 及FABQ评分 (36.60 11.16)分、(43.80 12.66)分 与治疗前 (4.70 1.13)分、(4.90 1.27)分、(19.20 4.50)分、(19.70 3.60)分、(45.90 14.06)分、(45.70 12.54)分 比较均降低(P0.05);且观察组的Schober试验结果、VAS评分及ODI评分均优于对照组,差异有统计学意义(P0
6、.05);治疗2周后,观察组与对照组Schober试验结果 (4.13 1.04)cm、(2.98 1.24)cm 与治疗前 (3.05 1.27)cm、(2.48 1.02)cm 比较均增加(P0.001),VAS评分 (1.45 1.22)分、(3.24 1.59)分、ODI分数 (5.35 2.78)分、(12.90 4.19)分 及FABQ评分 (29.95 9.93)分、(43.10 12.30)分与治疗前 (4.70 1.13)分、(4.90 1.27)分、(19.20 4.50)分、(19.70 3.60)分、(45.90 14.06)分、(45.70 12.54)分 比较均降低
7、(P0.001);且观察组结果均优于对照组,差异有统计学意义(P0.05)。结论 筋膜释放技术及核心稳定训练均能改善CNLBP病人的症状,但两者联合效果更佳。关键词:腰痛;慢性非特异性腰痛;筋膜释放技术;核心稳定训练Effectiveness of myofascial release combined with core stabilization exercise on chronic nonspecific low back painWANG Yanwen1,LI Wenyan2,WU Junying2Author Affiliations:1Shanxi Medical Univers
8、ity,Taiyuan,Shanxi 030000,China;2The First Hospital of Shanxi Medical University,Taiyuan,Shanxi 030000,ChinaAbstract:Objective To investigate the clinical effect of myofascial release(MFR)combined with core stabilization exercise(CSE)in individuals with chronic nonspecific low back pain(CNLBP).Metho
9、ds A total of forty participants with CNLBP from October 2020 to July 2021 in the First Hospital of Shanxi Medical University were randomly assigned into the experimental group(n=20)and the control group(n=20).CSE was applied for the participants in the control group for two weeks,while myofascial r
10、elease combined with core stabilization exercise was performed for two weeks for the participants in the experimental group.Participants were assessed by the Schober test,the Visual Analogue Scale(VAS),Oswestry Disability Index(ODI)and the Fear-avoidance Beliefs Questionnaire(FABQ)引用本文:王艳文,李雯燕,武俊英.筋
11、膜释放技术联合核心稳定训练治疗慢性非特异性腰痛的疗效观察 J.安徽医药,2023,27(2):302-306.DOI:10.3969/j.issn.1009-6469.2023.02.020.临床医学302安 徽 医 药 Anhui Medical and Pharmaceutical Journal 2023 Feb,27(2)at baseline,1 week and 2 weeks after treatment,respectively.Results One week after treatment,the results of the Schober test in the ex
12、perimental group and the control group(3.731.16)cm,(2.98 1.14)cm were higher than those before treatment(3.051.27)cm,(2.481.02)cm(P0.001)and VAS scores(2.901.28),(4.251.33),ODI scores(12.004.18),(16.453.95)and FABQ scores(36.60 11.16),(43.8012.66)were lower than those before treatment(4.701.13),(4.9
13、01.27),(19.20 4.50),(19.703.60),(45.9014.06),(45.7012.54)(P0.05).One week after treatment,the results of Schober test,VAS score and ODI score in the experimental group were better than those in the control group(P0.05).After 2 weeks of treatment,the Schober test results of experimental group and con
14、trol group(4.131.04)cm,(2.981.24)cm were increased compared with those before treatment(3.051.27)cm,(2.481.02)cm(P0.001).VAS scores(1.451.22),(3.241.59),ODI scores(5.352.78),(12.904.19)and FABQ scores(29.959.93),(43.1012.30)were lower than those before treatment(4.701.13),(4.901.27),(19.204.50),(19.
15、703.60),(45.9014.06),(45.7012.54)(P0.001),and all results of experimental group were better than those in the control group(P0.05)具 有 可 比 性。见表1。纳入标准:临床诊断为非特异性腰痛病人6(首先用红色预警信号剔除可能是骨折、肿瘤、感染等严重病理问题的腰痛病人;其次用感觉、肌力、反射等神经学检查和直腿抬高试验判定是否存在根性综合征及其严重程度,其余的为非特异性腰痛病人);疼痛至少个月;年龄范围为1860岁;经简易智能精神状态量表(MMSE)检查无认知功能障碍,
16、能理解量表内容并配合检查及治疗;2周内未服用过中西止痛药物。排除标准7:腰椎特殊疾病(如硬膜外脓肿、压缩性骨折、脊椎关节病、恶性肿瘤、马尾综合征);神经根疼痛、神经根病或椎管狭窄;全身性疾病(自身免疫性、感染性、血管性、内分泌、代谢性或肿瘤疾病),存在骨质疏松、严重出血倾向、精神病病人、孕妇;既往脊柱手术、神经根损伤及严重的心肺疾病;不愿意配合检查和训练,治疗中断或修改治疗方案者。1.2治疗方法1.2.1对照组给予核心稳定训练8:卷腹:病人仰卧位,双足踩地,双手置于腰部,收紧腹部,使头和双肩微微离地,保持78 s,每组20次;侧桥:病人左侧卧位,左前臂放在左肩以下的地面上,前臂和双足撑起身体,形成侧桥姿势,保持78 s,每组10表1慢性非特异性腰痛40例基线资料比较组别对照组观察组t(2)值P 值例数2020性别(男/女)/例9/118/12(0.10)0.749年龄/(岁,x s)39.7012.5636.9014.240.660.513病程/(月,x s)11.107.0311.456.940.160.875体质指数/(kg/m2,x s)22.401.9922.472.470.1