Abstract:

Objective　To explore the application effect of acupoint massage along meridians combined with lumbar orthopedic fixation support in the postoperative rehabilitation of patients with lumbar disc herniation (LDH). Methods　A retrospective study was conducted. 82 patients with LDH who underwent surgical treatment at Baoji Hospital of Traditional Chinese Medicine from January 2021 to December 2023 were selected. They were divided into two groups according to the postoperative adjuvant treatment methods, with 41 cases in each group.Control group: 17 males and 24 females, with an average age of (44.36±7.39) years, and a disease duration of (24.52±8.11) months. They were treated with lumbar orthopedic fixation stent assistance.Observation group: 21 males and 20 females, with an average age of (42.31±7.05) years, and a disease duration of (26.84±8.94) months. They were treated with acupoint massage along the meridians combined with a lumbar orthopedic fixation brace as an auxiliary therapy.Compare the Visual Analogue Scale (VAS) scores, lumbar range of motion, lumbar function, quality of life, and adverse reactions of the two groups of patients before treatment, at 2 weeks and 4 weeks after treatment.Statistical methods employed were the χ² test, F test, and t test. Results　At 2 weeks and 4 weeks of treatment, the VAS scores for the waist [(4.34±0.86) points,(2.11±0.42) points], the VAS scores for the legs [(3.42±0.68) points,(2.23±0.45) points] and the ODI scores [(35.42±4.43) points,(19.64±2.46) points] in the observation group were significantly lower than those before treatment.Comparisons between the two groups before and after treatment showed statistically significant differences (F_groups=26.875, F_time= 31.624, F_interaction=24.728; F_groups=24.615, F_time=29.653, F_interaction=23.511; F_groups=21.932, F_time=25.441, F_interaction=20.125; all P<0.001_groups, all P<0.001_time, all P<0.001_interaction).The flexion and extension activities of the lumbar spine, as well as the JOA score, in the observation group all showed significant increases compared to those before treatment. When comparing the two groups before and after treatment, the differences were statistically significant(F_groups=22.506, F_time=27.491, F_interaction=21.631; F_groups=23.726, F_time=30.745, F_interaction=21.223; F_groups=18.417, F_time=22.586, F_interaction=15.745; P_groups<0.001, P_time<0.001, P_interaction<0.001).After 2 weeks of treatment, the SF-36 score of the observation group was higher than that of the control group [(83.11±6.39) points vs.(79.42±6.10) points], and the difference was statistically significant (t=2.675, P=0.009). Conclusion　Acupoint massage along the meridians combined with a spinal orthopedic fixation brace for LDH patients during postoperative rehabilitation can effectively reduce pain levels, improve lumbar spine function and joint mobility, and enhance the quality of life.

Key words:

Lumbar intervertebral disc herniation, Massage by selecting acupoints along meridians, Lumbar orthopedic fixator, Postoperative rehabilitation, Lumbar range of motion, Lumbar function, Degree of pain

摘要：

目的　探究循经取穴推拿联合腰部骨科固定支架在腰椎间盘突出症（LDH）患者术后康复中的应用效果。方法　采用回顾性研究，选取2021年1月至2023年12月宝鸡市中医医院行手术治疗的82例LDH患者，根据术后辅助治疗方法分为两组，每组41例。对照组：男17例、女24例，年龄（44.36±7.39）岁，病程（24.52±8.11）个月，予以腰部骨科固定支架辅助治疗；观察组：男21例、女20例，年龄（42.31±7.05）岁，病程（26.84±8.94）个月，予以循经取穴推拿联合腰部骨科固定支架辅助治疗。比较两组患者治疗前、治疗2周、4周时视觉模拟评分法（VAS）评分、腰椎活动度及腰椎功能、生活质量，以及不良反应。统计学方法采用χ²检验、F检验、t检验。结果　治疗2周、4周时，观察组腰部VAS评分［（4.34±0.86）分、（2.11±0.42）分］、腿部VAS评分［（3.42±0.68）分、（2.23±0.45）分］和ODI评分［（35.42±4.43）分、（19.64±2.46）分］均较治疗前减少，两组治疗前后比较，差异均有统计学意义（F_组间=26.875、F_时间=31.624、F_交互=24.728，F_组间=24.615、F_时间=29.653、F_交互=23.511，F_组间=21.932、F_时间=25.441、F_交互=20.125；均P_组间<0.001，均P_时间<0.001，均P_交互<0.001）；腰椎前屈、后伸活动度、JOA评分观察组均较治疗前增加，两组治疗前后比较，差异均有统计学意义（F_组间=22.506，F_时间=27.491，F_交互=21.631；F_组间=23.726，F_时间=30.745，F_交互=21.223；F_组间=18.417，F_时间=22.586，F_交互=15.745；P_组间<0.001，P_时间<0.001，P_交互<0.001）。治疗2周后，观察组SF-36评分高于对照组［（83.11±6.39）分比（79.42±6.10）分］，差异有统计学意义（t=2.675，P=0.009）。结论　循经取穴推拿联合腰部骨科固定支架用于LDH患者术后康复，可有效减轻患者疼痛程度，提高腰椎功能和关节活动度，促进生活质量提升。

关键词:

腰椎间盘突出症, 循经取穴推拿, 腰部骨科固定支架, 术后康复, 腰椎活动度, 腰椎功能, 疼痛程度