有氧耐力训练联合电针刺激疗法对脊柱侧弯患者术后康复效果的影响

陈燕红; 汤样华; 王红亚; 王维维

doi:10.16766/j.cnki.issn.1674-4152.002561

有氧耐力训练联合电针刺激疗法对脊柱侧弯患者术后康复效果的影响

doi: 10.16766/j.cnki.issn.1674-4152.002561

浙江中医药大学附属江南医院五病区，浙江杭州 311201

基金项目:

浙江省医药卫生科技计划项目 2019KY548

详细信息

通讯作者:
陈燕红, E-mail: 1952403625@qq.com

中图分类号: R681.5 R454.1
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出版历程
- 收稿日期: 2021-05-06
- 网络出版日期: 2022-09-23

Effect of aerobic endurance training combined with electroacupuncture stimulation therapy on postoperative rehabilitation of patients with scoliosis

Fifth Ward, Jiangnan Hospital Affiliated to Zhejiang University of Traditional Chinese

摘要

摘要: 目的探究有氧耐力训练联合电针刺激疗法对脊柱侧弯患者术后康复情况、VAS评分及SRS-22评分的影响。方法选取2018年9月—2019年9月浙江中医药大学附属江南医院收治的脊柱侧弯术后接受康复治疗的患者120例为研究对象，按照随机数字表法分为观察组和对照组，每组60例，对照组患者采取有氧耐力训练，观察组患者在对照组的基础上联合采用电针刺激疗法治疗，2组均持续治疗30 d，观察2组患者的康复效果、VAS评分及SRS-22评分情况。结果 2组患者首次站立时间[(2.92±0.33)d vs. (3.87±0.41)d]、首次站立持续时长[(9.34±1.22)min vs.(6.97±1.32)min]和治疗30 d后左右侧屈肌力比较，差异均有统计学意义(均P＜0.05)。治疗后30 d，观察组患者疼痛、自我形象、活动功能、心理健康、治疗满意度及总评分均高于对照组和本组治疗前，差异均有统计学意义(均P＜0.05)。术后治疗7、30 d，观察组患者VAS评分均低于对照组[(6.47±0.82)分vs.(5.75±0.67)分，(3.21±0.36)分vs.(3.98±0.34)分]，差异有统计学意义(均P＜0.05)。结论有氧耐力训练联合电针刺激疗法对脊柱侧弯患者术后具有更好的康复作用，能有效降低VAS评分、提升SRS-22评分值，可以更好地提升患者的生存质量。
- 有氧耐力训练 /
- 电针刺激 /
- 脊柱侧弯 /
- 视觉模拟评分 /
- 脊柱侧凸协会22项量表
Abstract: Objective To explore the effect of aerobic endurance training combined with electroacupuncture stimulation on postoperative rehabilitation, VAS score and SRS-22 score of patients with scoliosis. Methods A total of 120 patients who received rehabilitation therapy after scoliosis surgery in Jiangnan Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine from September 2018 to September 2019 were selected. The patients were divided into observation group and control group according to the random number table method, with 60 cases in each group. The patients in the control group were given aerobic endurance training, and the patients in the observation group were treated with electroacupuncture stimulation on the basis of the control group. Both groups were treated continuously for 30 days. The rehabilitation effect, VAS score and SRS-22 score of the two groups were observed. Results There were statistically significant differences in the time of first standing [(2.92±0.33) d vs. (3.87±0.41) d], the duration of first standing [(9.34±1.22) min vs. (6.97±1.32) min] and the strength of left and right lateral flexors after 30 days of treatment between the two groups (all P < 0.05). After 30 days of treatment, the pain, self-image, activity function, mental health, treatment satisfaction and total score in the observation group were higher than those in the control group and the observation group before treatment, and the differences were statistically significant (all P < 0.05). After 7 and 30 days of treatment, the VAS scores of the observation group were lower than those of the control group [(6.47±0.82) points vs. (5.75±0.67) points, (3.21±0.36) points vs. (3.98±0.34) points], and the difference was statistically significant (all P < 0.05). Conclusion Aerobic endurance training combined with electroacupuncture stimulation therapy has a better rehabilitation effect on patients with scoliosis after surgery. It can effectively reduce the VAS score, improve the SRS-22 score value, and better improve the quality of life of patients.
- Aerobic endurance training /
- Electroacupuncture stimulation /
- Scoliosis /
- Visual analogue scale /
- Scoliosis research society 22-item questionnaire scale

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表 1 2组脊柱侧弯术后患者一般资料比较

Table 1. Comparison of general data of patients after scoliosis between the two groups

组别	例数	性别(例)		年龄 (x±s，岁)	Cobb角 (x±s，°)
组别	例数	男性	女性	年龄 (x±s，岁)	Cobb角 (x±s，°)
观察组	60	25	35	17.45±3.67	59.86±10.23
对照组	60	23	37	18.53±4.04	60.12±11.07
统计量		0.139^a		-1.533^b	-0.134^b
P值		0.709		0.128	0.894
注：^a为χ²值，^b为t值。

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表 2 2组脊柱侧弯术后患者治疗后首次站立时间和脊柱屈肌力情况(x ±s)

Table 2. The first standing time and spinal flexor strength of patients after scoliosis surgery in the two groups

组别	例数	首次站立时间 (d)	首次站立持续时间 (min)	脊柱左侧屈肌力(kg)		脊柱右侧屈肌力(kg)
组别	例数	首次站立时间 (d)	首次站立持续时间 (min)	治疗前	治疗后	治疗前	治疗后
观察组	60	2.92±0.33	9.34±1.22	23.86±3.92	30.45±5.67^a	24.07±4.56	30.98±5.43^a
对照组	60	3.87±0.41	6.97±1.32	24.04±4.14	27.74±5.32	24.16±4.81	28.11±5.24
t值		13.982	10.213	0.245	2.700	0.105	2.946
P值		< 0.001	< 0.001	0.783	0.007	0.916	0.004
注：与同组治疗前比较，^aP＜0.05。

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表 3 2组脊柱侧弯术后患者治疗前后SRS-22评分情况(x ±s，分)

Table 3. SRS22 scores of patients after scoliosis surgery in the two groups before and after treatment

组别	例数	疼痛		自我形象		活动功能
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	60	2.95±0.76	4.68±0.43^a	2.96±0.61	4.71±0.51^a	3.66±0.22	4.67±0.39^a
对照组	60	3.01±0.68	4.06±0.42	2.98±0.58	3.98±0.38	3.74±0.27	4.21±0.41
t值		0.456	7.988	0.184	8.891	1.780	6.297
P值		0.648	< 0.001	0.854	< 0.001	0.076	0.002

组别	例数	心理健康		治疗满意度		总分
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	60	3.37±0.46	4.54±0.40^a	2.99±0.57	4.23±0.35^a	16.13±0.75	22.25±1.89^a
对照组	60	3.36±0.41	4.01±0.38	3.01±0.38	3.44±0.32	15.99±0.87	19.94±1.72
t值		0.126	6.879	0.226	12.904	0.944	7.002
P值		0.900	< 0.001	0.821	< 0.001	0.346	0.001
注：与同组治疗前比较，^aP＜0.05。

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表 4 2组脊柱侧弯术后患者治疗后VAS评分情况(x ±s，分)

Table 4. VAS scores of patients after scoliosis surgery in the two groups after treatment

组别	例数	治疗7 d	治疗30 d
观察组	60	5.75±0.67	3.21±0.36
对照组	60	6.47±0.82	3.98±0.34
t值		5.267	12.045
P值		0.006	< 0.001

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参考文献(21)

[1]	谢菡, 马正良, 陈正香, 等. 脊柱侧弯矫形术术后使用氟比洛芬酯注射液镇痛效果的影响因素分析[J]. 药物流行病学杂志, 2018, 27(1): 10-13, 41. https://www.cnki.com.cn/Article/CJFDTOTAL-YWLX201801004.htm XIE H, MA Z L, CHEN Z X, et al. Analysis of Influence Factors of Postoperative Analgesia by Flurbiprofen Axetil Injection after Scoliosis Surgery[J]. Chinese Journal of Pharmacoepidemiology, 2018, 27(1): 10-13, 41. https://www.cnki.com.cn/Article/CJFDTOTAL-YWLX201801004.htm
[2]	马偲铭, 王连成, 杜良波, 等. 物理治疗脊柱侧弯特定运动对轻度青少年特发性脊柱侧凸的康复疗效[J]. 中国临床研究, 2021, 34(9): 1240-1244. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCK202109020.htm MA S M, WANG L C, DU L B, et al. Rehabilitation effect of PSSE on mild adolescent idiopathic scoliosis[J]. Chinese Journal of Clinical Research, 2021, 34(9): 1240-1244. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCK202109020.htm
[3]	庄乾宇. 青少年特发性脊柱侧凸的病因学研究现状和进展[J]. 中华骨与关节外科杂志, 2021, 14(5): 337-343. doi: 10.3969/j.issn.2095-9958.2021.05.05 ZHUANG Q Y. Overview of the current knowledge on the etiology of adolescent idiopathic scoliosis[J]. Chinese Journal Bone and Joint Surgery, 2021, 14(5): 337-343. doi: 10.3969/j.issn.2095-9958.2021.05.05
[4]	吴敏, 夏涛. 功能性康复训练对青少年特发性脊柱侧弯患者术后改善的影响[J]. 护理实践与研究, 2019, 16(24): 84-86. https://www.cnki.com.cn/Article/CJFDTOTAL-HLSJ201924036.htm WU M, XIA T. Effect of functional rehabilitation training on postoperative improvement in adolescent patients with idiopathic scoliosis[J]. Nursing Practice and Research, 2019, 16(24): 84-86. https://www.cnki.com.cn/Article/CJFDTOTAL-HLSJ201924036.htm
[5]	王宏博, 高延征, 施新革, 等. 新型脊柱侧弯软件测量脊柱侧弯Cobb角的可靠性研究[J]. 中华实用诊断与治疗杂志, 2020, 34(7): 710-713. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZD202007017.htm WANG H B, GAO Y Z, SHI X G, et al. Reliability of a new scoliosis software for measuring Cobb Angle of scoliosis[J]Journal of Chinese Practical Diagnosis and Therapy, 2020, 34(7): 710-713. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZD202007017.htm
[6]	郑亚利. 正骨推拿联合电针治疗青少年特发性脊柱侧弯56例[J]. 医学食疗与健康, 2021, 19(12): 29-30. https://www.cnki.com.cn/Article/CJFDTOTAL-YXSL202112014.htm ZHENG Y L. Treatment of 56 cases of adolescent idiopathic scoliosis with bone-setting massage and electroacupuncture[J]. Medical Diet and Health, 2021, 19(12): 29-30. https://www.cnki.com.cn/Article/CJFDTOTAL-YXSL202112014.htm
[7]	殷春芳, 张健, 吕守正. 神经肌肉关节促进法联合矫形器治疗特发性脊柱侧弯青少年的效果[J]. 医疗装备, 2020, 33(4): 87-88. https://www.cnki.com.cn/Article/CJFDTOTAL-YLZB202004061.htm YIN C F, ZHANG J, LV S Z. Effect of neuromuscular joint promotion combined with orthosis in the treatment of adolescent idiopathic scoliosis[J]. Chinese Journal of Medical Device, 2020, 33(4): 87-88. https://www.cnki.com.cn/Article/CJFDTOTAL-YLZB202004061.htm
[8]	张永锋, 杨勇, 李鹏飞. 穴位电针刺激对腰椎间盘突出症术后残留神经功能损害的治疗作用[J]. 检验医学与临床, 2020, 17(16): 2394-2396. doi: 10.3969/j.issn.1672-9455.2020.16.041 ZHANG Y F, YANG Y, LI P F. Therapeutic effect of acupoint electroacupuncture stimulation on residual neurological impairment after lumbar disc herniation[J]. Laboratory Medicine and Clinic, 2020, 17(16): 2394-2396. doi: 10.3969/j.issn.1672-9455.2020.16.041
[9]	任杰, 李月娥, 杜改团. 夹脊穴电针刺激配合普拉提斯运动疗法在腰椎间盘突出症术后康复中的作用[J]. 中医药导报, 2017, 23(2): 3. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZB201702021.htm REN J, LI Y E, DU G T. Effect of electroacupuncture at Jiaji point combined with Pilates exercise therapy on postoperative rehabilitation of lumbar disc herniation[J]. Guiding Journal of Traditional Chinese Medicine and Pharmacology, 2017, 23(2): 3. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZB201702021.htm
[10]	吕瑛, 陈越, 李丽, 等. 电针刺激伸肌结合辨证取穴治疗卒中偏瘫腕踝关节痉挛的临床研究[J]. 针灸临床杂志, 2019, 35(3): 35-38. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJLC201903010.htm LYU Y, CHEN Y, LI L, et al. Clinical Observation on Wrist-Ankle Spasm of Hemiplegic Paralysis Treated by Electro-Needling Extensor and Acupoints of Syndrome Differentiation[J]. Journal of Clinical Acupuncture and Moxibustion, 2019, 35(3): 35-38. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJLC201903010.htm
[11]	骆书信, 杜洛民, 张鹏, 等. 《中医整脊常见病诊疗指南》推广及临床应用体会[C]//第十次全国整脊学术交流大会论文集. [出版者不详], 2014: 70-71. LUO S X, DU L M, ZHANG P, et al. Experience in popularization and clinical application of "Guide for Diagnosis and Treatment of Common chiropractic Diseases in Traditional Chinese Medicine"[C]//Proceedings of the 10th National Chiropractic Academic Exchange Conference. [Publisher unknown], 2014: 70-71.
[12]	徐少婷, 葛宝峰, 徐寅干. 实用骨科学[M]. 4版. 北京: 人民军事卫生出版社, 2012: 2116-2124. XU S T, GE B F, XU Y G. Practical Osteology[M]. 4edition. Beijing: People's Military Medical Publishing House, 2012: 2116-2124.
[13]	殷莉, 阿比旦·阿不力孜. 罗森塔尔效应护理在脊柱侧弯手术患者中的应用价值[J]. 医学临床研究, 2018, 35(1): 202-204. https://www.cnki.com.cn/Article/CJFDTOTAL-YXLL202001078.htm YIN L, ABIDAN·Abulizi. Application value of Rosenthal effect nursing in patients undergoing scoliosis surgery[J]. Journal of Clinical Research, 2018, 35(1): 202-204. https://www.cnki.com.cn/Article/CJFDTOTAL-YXLL202001078.htm
[14]	朱垒, 赵卫锋, 吴玉彬. 2020年郑州市中小学生脊柱侧弯调查与康复干预研究[J]. 医药论坛杂志, 2021, 42(12): 79-84. https://www.cnki.com.cn/Article/CJFDTOTAL-HYYX202112021.htm ZHU L, ZHAO W F, WU Y B. Investigation and rehabilitation intervention of primary and secondary school students with scoliosis in Zhengzhou in 2020[J]. Journal of Medical Forum, 2021, 42(12): 79-84. https://www.cnki.com.cn/Article/CJFDTOTAL-HYYX202112021.htm
[15]	周璇, 杜青, 梁菊萍, 等. 脊柱侧凸特定运动疗法治疗轻度青少年特发性脊柱侧凸患者的疗效观察[J]. 中华物理医学与康复杂志, 2016, 38(12): 927-932. ZHOU X, DU Q, LIANG J P, et al. Treating patients with mild adolescent idiopathic scoliosis using scoliosis-specific exercises[J]. Chinese Journal of Physical Medicine and Rehabilitation, 2016, 38(12): 927-932.
[16]	何诚, 万文俊. 头电针联合新Bobath技术治疗脑卒中患者下肢运动功能障碍的疗效观察[J]. 中国中医基础医学杂志, 2021, 27(2): 275-279. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJC202102027.htm HE C, WAN W J. Effect of Scalp Electro-acupuncture Combined with New Bobath Technique on Stroke Patients with Lower Limb Motro Dysfunction?[J]. Chinese Journal of Basic Medicine in Traditional Chinese Medicine, 2021, 27(2): 275-279. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJC202102027.htm
[17]	陈梦婕, 罗义, 马琪超, 等. 青少年特发性脊柱侧弯的冠状位平衡与足底压力的相关性[J]. 中华全科医学, 2020, 18(4): 542-546. doi: 10.16766/j.cnki.issn.1674-4152.001293 CHEN M J, LUO Y, MA Q C, et al. Correlation between spinal coronal balance and static plantar pressure in children with adolescent idiopathic scoliosis[J]. Chinese Journal of General Practice, 2020, 18(4): 542-546. doi: 10.16766/j.cnki.issn.1674-4152.001293
[18]	陈炎春, 卫法泉, 孔飞娟. 脊柱侧弯矫形术中七氟烷联合丙泊酚静吸复合麻醉对SEP及MEP的影响[J]. 中华全科医学, 2017, 15(3): 418-420, 527. doi: 10.16766/j.cnki.issn.1674-4152.2017.03.016 CHEN Y C, WEI F Q, KONG F J. Effects of sevoflurane combined with propofol intravenous-inhalation anesthesia on SEP and MEP in patients with scoliosis correction surgery[J]. Chinese Journal of General Practice, 2017, 15(3): 418-420, 527. doi: 10.16766/j.cnki.issn.1674-4152.2017.03.016
[19]	王京良, 屈玉疆, 李先海, 等. 正骨推拿联合电针治疗青少年特发性脊柱侧弯41例[J]. 西部中医药, 2019, 32(10): 4. https://www.cnki.com.cn/Article/CJFDTOTAL-GSZY201910035.htm WANG J L, QU Y J, LI X H, et al. Orthopedic Massage Joined with Acusector in Treating 41 Cases of Adolescent Idiopathic Scoliosis[J]. Western Journal of Traditional Chinese Medicine, 2019, 32(10): 4. https://www.cnki.com.cn/Article/CJFDTOTAL-GSZY201910035.htm
[20]	PANJABI M M. The stabilizing system of the spine. Part Ⅰ. Function, dysfunction, adaptation, and enhancement[J]. Spinal Disord, 1992, 5(4): 383-389.
[21]	郑秋菊. 电针结合整脊法治疗青少年特发性脊柱侧弯临床观察[J]. 实用中医药杂志, 2021, 37(3): 470-472. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYAO202103070.htm ZHENG Q J. Clinical Observation on Electroacupuncture Combined with Chiropractic in Treatment of Juvenile Idiopathic Scoliosis[J]. Journal of Practical Traditional Chinese Medicine, 2021, 37(3): 470-472. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYAO202103070.htm