腰背肌康复训练联合脊柱微调手法对腰椎间盘突出症患者功能康复、血液流变学和生活质量的影响

摘要 目的：探讨腰背肌康复训练联合脊柱微调手法对腰椎间盘突出症（LDH）患者功能康复、血液流变学和生活质量的影响。方法：采用随机数字表法，将我院2020年3月~2022年3月期间收治的120例LDH患者分为对照组（60例，腰背肌康复训练）和观察组（60例，腰背肌康复训练联合脊柱微调手法）。观察两组患者临床疗效、功能康复效果、血液流变学和生活质量。结果：观察组的临床总有效率高于对照组（P<0.05）。观察组干预4周后日本骨科协会腰椎功能（JOA）评分高于对照组，Oswestry功能障碍指数（ODI）、视觉模拟评分法（VAS）评分低于对照组（P<0.05）。观察组干预4周后腰部屈曲腰部活动范围（ROM）、伸展ROM、测屈ROM和屈肌肌力、伸肌肌力高于对照组（P<0.05）。观察组干预4周后全血高切黏度、全血低切黏度、红细胞聚集指数低于对照组（P<0.05）。观察组干预4周后躯体功能、精神健康、活力、躯体疼痛、社会功能、总体健康、情感职能、生理机能维度评分高于对照组（P<0.05）。结论：腰背肌康复训练联合脊柱微调手法用于LDH患者干预中，可改善血液流变学，促进功能康复，有利于患者生活质量的提高。

Effects of Lumbar Dorsal Muscle Rehabilitation Training Combined with Spinal Fine Tuning Manipulation on Functional Rehabilitation, Hemorheology and Quality of Life of Patients with Lumbar Disc Herniation

ABSTRACT Objective: To investigate the effect of lumbar dorsal muscle rehabilitation training combined with spinal fine tuning manipulation on functional rehabilitation, hemorheology and quality of life of patients with lumbar disc herniation (LDH). Methods: Using the method of random number table, 120 patients with LDH who were admitted in our hospital from March 2020 to March 2022 were divided into the control group (60 cases, lumbar dorsal muscle rehabilitation training) and the observation group (60 cases, lumbar dorsal muscle rehabilitation training combined with spinal fine tuning manipulation). The clinical efficacy, functional rehabilitation effect, hemorheology and quality of life of the two groups were observed. Results: The total clinical effective rate of the observation group was higher than that of the control group(P<0.05). 4 weeks after intervention, the Japanese Orthopaedic Association lumbar function (JOA) score of the observation group was higher than that of the control group, and the Oswestry Disability index (ODI) and visual analogue scale (VAS) scores were lower than those of the control group (P<0.05). 4 weeks after intervention, the waist flexion range of motion (ROM), extension ROM, flexor ROM, flexor muscle strength and extensor muscle strength of the observation group were higher than those of the control group(P<0.05). 4 weeks after intervention, the whole blood high-shear viscosity, whole blood low-shear viscosity and red blood cell aggregation index of the observation group were lower than those of the control group (P<0.05). 4 weeks after intervention, the scores of physical function, mental health, vitality, physical pain, social function, general health, emotional function and physiological function of the observation group were higher than those of the control group(P<0.05). Conclusion: Lumbar dorsal muscle rehabilitation training combined with spinal fine tuning manipulation in the intervention of patients with LDH can improve hemorheology, promote functional rehabilitation, and help improve the quality of life of patients.