三维呼吸联合腰腹部核心肌群训练、三维平衡正脊手法应用于腰椎间盘突出症的临床观察-现代医学

三维呼吸联合腰腹部核心肌群训练、三维平衡正脊手法应用于腰椎间盘突出症的临床观察

单位：1. 南京明基医院康复医学科, 江苏南京 210000;
2. 南京明基医院骨科, 江苏南京 210000;
3. 江苏省中医院针灸康复科, 江苏南京 210000

分类号：R493

出版年·卷·期（页码）：2025·53·第二期（237-243）

摘要：

目的：探究三维呼吸联合腰腹部核心肌群训练、三维平衡正脊手法在腰椎间盘突出症(LDH)的应用效果。方法：选取2023年3月—2024年7月南京明基医院LDH患者120例为研究对象，按照随机数字表法分为A、B、C组，各40例。A组采用三维平衡正脊手法，B组在A组基础上联合腰腹部核心肌群训练，C组在B组基础上联合三维呼吸。比较3组治疗前后疼痛程度(VAS评分)、腰椎功能障碍情况(JOA评分)、腰椎活动度、腹横肌、多裂肌肌肉厚度。结果： 5例患者脱落并剔除，最终纳入115例，其中A组39例、B组38例、C组38例。治疗30 d后，3组VAS评分、JOA评分、腰椎活动度、腹横肌、多裂肌肌肉厚度等指标均较治疗前改善(均P＜0.05)；其中，C组VAS评分低于A、B组，B组低于A组(P＜0.05)；C组JOA评分高于A、B组，B组高于A组(P＜0.05)；C组腹横肌、多裂肌肌肉厚度高于A、B组，B组高于A组(P＜0.05)；C组腰椎前屈、后伸、侧屈活动度高于A、B组，B组高于A组(P＜0.05)。结论：三维呼吸联合腰腹部核心肌群训练、三维平衡正脊手法治疗LDH，能增加腹横肌、多裂肌肌肉厚度，增加腰椎稳定性，减轻疼痛程度，提高腰椎活动功能。

Objective: To explore the effect of three dimensional breathing combined with waist and abdominal core muscle training and three-dimensional balanced chiropractic manipulation on lumbar disc herniation(LDH). Methods: A total of 120 LDH patients in Najing Mingji Hospital from March 2023 to July 2024 were selected as the study objects, and they were divided into groups A, B and C according to random number table method, with 40 cases each. Group A was trained with three-dimensional balanced positive ridge technique, group B was trained with waist and abdominal core muscles on top of group A, and group C was trained with three dimensional breathing on top of group B. The pain degree(VAS score), lumbar dysfunction(JOA score), lumbar motion, muscle thickness of transverse abdominalis muscle and multifidus muscle were compared before and after treatment among the three groups. Results: 5 cases were excluded, resulting in the final inclusion of 115 cases, comprising 39 cases in group A, 38 cases in group B, and 38 cases in group C. After 30 days of treatment, VAS score, JOA score, lumbar motion, the thickness of transverse abdominalis muscle and multifidus muscle in the three groups were improved compared with those before treatment(all P<0.05); the VAS score of group C was lower than that of group A and group B, and group B was lower than group A(P<0.05); the JOA score of group C was higher than that of group A and group B, and group B was higher than group A(P<0.05); the muscle thickness of transverse abdominal muscle and multifidus muscle in group C was higher than that in group A and group B, and the muscle thickness in group B was higher than that in group A(P<0.05); lumbar anterior flexion, posterior extension and lateral flexion in group C were higher than those in group A and group B, and group B was higher than group A(P<0.05). Conclusion: Three-dimensional breathing combined with waist and abdominal core training and three-dimensional balanced chiropractic manipulation for LDH can increase the muscle thickness of the transverse and multifidus muscles of the abdomen, increase the stability of the lumbar spine, reduce the degree of pain, and improve the function of the lumbar spine.

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