腰腹调衡推拿治疗慢性非特异性腰痛临床研究

Clinical Study of Lumbar-Abdominal Balancing Tuina in the Treatment of Chronic Non-Specific Low Back Pain

摘要:

目的：观察腰腹调衡推拿治疗慢性非特异性腰痛（CNLBP） 的疗效。方法：选取2025年2月—2026年2月于广州中医药大学深圳医院（福田） 治疗的70例CNLBP患者，采用随机数字表法分为试验组和对照组，每组35例。试验组接受腰腹调衡推拿方案治疗，对照组采用常规推拿方案治疗，2组均完成2个疗程的治疗。治疗前及治疗2个疗程后分别采用剪切波弹性成像（SWE） 技术检测2组患者患侧腰部竖脊肌（静息状态） 及腹横肌（激活状态） 的杨氏模量平均值（Emean），评定视觉模拟评分法（VAS） 评分、日本骨科协会（JOA） 评分，比较2组临床疗效，观察不良反应发生情况。结果：与治疗前相比，2组治疗后的竖脊肌Emean均降低（P＜0.05），腹横肌Emean均升高（P＜0.05）；试验组竖脊肌Emean低于对照组（P＜0.05），腹横肌Emean高于对照组（P＜0.05）。与治疗前相比，2组患者治疗后的VAS评分均降低（P＜0.05），JOA评分均升高（P＜0.05）；试验组VAS评分低于对照组（P＜0.05），JOA评分高于对照组（P＜0.05）。试验组临床疗效优于对照组（P＜0.05）。治疗期间，2组均未出现不良反应。结论：腰腹调衡推拿能够有效降低CNLBP患者竖脊肌的静息张力，同时提升腹横肌的激活水平，可有效减轻腰痛、改善腰腹部肌群的功能失衡状态，其整体疗效优于常规推拿治疗，安全性较高。

Abstract:

Abstract： Objective： To observe the clinical efficacy of lumbar-abdominal balancing tuina in the treatment of chronic non-specific low back pain （CNLBP）. Methods： A total of 70 patients with CNLBP treated at Shenzhen Hospital（ Futian） of Guangzhou University of Chinese Medicine from February 2025 to February 2026 were enrolled and randomly divided into a trial group and a control group using the random number table method，with 35 cases in each group. The trial group received lumbar-abdominal balancing tuina，while the control group received conventional tuina. Both groups completed two courses of treatment. Before treatment and after two courses of treatment， shear wave elastography （SWE） was used to measure the mean Young's modulus （Emean） of the erector spinae （at rest） and the transversus abdominis （during activation） in both groups. The Visual Analogue Scale （VAS） score and the Japanese Orthopaedic Association （JOA） score were also assessed. Clinical efficacy was compared between the two groups，and the incidence of adverse reactions was observed. Results： After treatment， Emean of the erector spinae decreased significantly （P＜0.05）， while that of the transversus abdominis increased significantly （P＜0.05）， compared with baseline values. Intergroup comparison showed that the Emean of the erector spinae in the trial group was lower than that in the control group （P＜0.05），and the Emean of the transversus abdominis was higher than that in the control group （P＜ 0.05）. After treatment， VAS scores decreased significantly （P＜0.05） and JOA scores increased significantly （P＜ 0.05） compared to baseline. The trial group showed lower VAS scores and higher JOA scores than the control group （P＜ 0.05）. The clinical efficacy of the trial group was superior to that of the control group （P＜0.05）. No adverse reactions occurred in either group during treatment. Conclusion：Lumbar-abdominal balancing tuina can effectively reduce the resting tension of the erector spinae and enhance the activation of the transversus abdominis in patients with CNLBP， thereby alleviating symptoms and improving the functional imbalance of the lumbar and abdominal muscles. Its overall therapeutic effect is superior to conventional tuina，with a favorable safety profile.