目的:观察悬吊运动疗法(SET)对颈椎病治疗前、后的表面肌电活动的影响，并与常规推拿治疗效果相比较，探讨SET治疗颈椎病的疗效。方法:将颈椎病患者40例按随机数字表法将40例患者分成SET组和对照组，每组20例。对照组采用常规的推拿治疗训练，SET组根据表面肌电图的结果实施特异性的SET治疗。2组患者均连续治疗6周。2组患者分别于治疗前和治疗6周后(治疗后)进行颈伸肌的sEMG测试[包括平均肌电值(AEMG)和中位频率斜率值(MF slope)]和视觉模拟评分(VAS)。结果:治疗后，SET组颈部竖脊肌和斜方肌的AEMG较组内治疗前均显著改善，差异均有统计学意义( P<0.05)。治疗后，2组患者颈部竖脊肌和斜方肌的MF slope较组内治疗前均显著降低，差异均有统计学意义( P<0.05)，且SET组治疗后颈部竖脊肌和斜方肌的MF slope与对照组治疗后比较，差异均有统计学意义( P<0.05)。治疗后，SET组和对照组的VAS评分分别为(2.1±1.3)分和(3.0±1.1)分，均较组内治疗前显著改善( P<0.05)，且SET组治疗后的VAS评分与对照组治疗后比较，差异亦有统计学意义( P<0.05)。对2组患者治疗前、后颈部竖脊肌和斜方肌MF slope降低值与VAS的变化值进行Pearson相关分析，SET组分别为( r＝0.463， P<0.05； r＝0.678， P<0.05)，对照组为( r＝0.550， P<0.05； r＝0.486， P<0.05)，即颈部竖脊肌和斜方肌的MF slope的下降率与VAS变化值呈显著正相关。 结论:SET可显著改善颈椎病患者的颈部肌肉功能，且疗效优于推拿治疗。

目的:观察综合康复治疗丘脑综合征的临床疗效.方法:将28例丘脑综合征患者随机分为观察组和对照组各14例,对照组给予运动疗法、针灸、物理因子治疗等常规康复治疗,观察组则在常规康复治疗基础上给予特异性的作业疗法,采用简式Fugle-Meyer运动功能评定量表(Fugl-Meyer motor assessment scale,FMMA)、感觉功能评定量表(Fugl-Meyer sensory assessment scale,FMSA)、世界卫生组织生活质量评定简表(the World Health Organization quality of life,WHOQOL)和目测类比评分法(visual analogue scale,VAS)进行疗效评定.结果:观察组FMMA、FMSA、WHOQOL和VAS评分改善程度均显著优于对照组(P＜0.05).结论:综合康复治疗可显著改善丘脑综合征患者患侧的运动功能、感觉功能、生活质量和疼痛程度,值得临床进一步研究和实践.

Objective: To explore the effect of Chattanooga Decompressive traction therapy system on cervical spondylotic radiculo -path.Methods:83 patients of cervical spondylotic radiculopath were divided into observation group (n=42) and control group (n=41 ) .Both groups received low frequency pluse treatment while the observation group was treated with decompressive traction therapy sys -tem, control group was treated with Conventional traction therapy .The effect was evaluated with Visual Analogue Scale ( VAS) and Japa-nese Yasuhisa Tanaka's assessment system .Results:The VAS score decreased and the Yasuhisa Tanaka's assessment score increased in both groups after treatment (P<0.05), and it was better in the observation group than in the control group (P<0.01).Conclusion:Decompressive traction therapy system could improve the therapeutic effect on cervical spondylotic radiculopath ,it should be worthy of clin-ical application .

目的 观察应用肌电图和MRI联合定位多节段腰椎间盘突出的病变节段,行非手术脊柱减压系统治疗腰椎间盘突出症的疗效.方法 共纳入40例多节段腰椎间盘突出症患者,采用随机数字表法分为联合定位组(应用肌电图和MRI联合定位)和对照组(应用MRI结合临床体征定位),每组20例,两组均给予非手术脊柱减压系统DRX9000治疗.分别于治疗前、治疗6周后对两组患者进行目测类比评分法(VAS)、下腰痛JOA评分量表的评定.结果 两组患者经过治疗6周后,VAS评分、下腰痛JOA评分量表均较治疗前有明显改善(P＜0.05),其中,VAS评分联合定位组优于对照组(P＜0.05),JOA评分联合定位组较对照组高,但差异无统计学意义(P＞0.05).结论 应用肌电图和MRI联合定位多节段腰椎间盘突出的病变节段,较单纯应用MRI结合临床体征定位准确,从而使非手术脊柱减压治疗更有效,值得临床广泛推广.

AIM:To observe the changes of surface electromyogram (sEMG) of electromyogram biofeedback therapy on brachial plexus injury, compared with conventional treatment,so as to investigate the curative effect of electromyogram biofeedback therapy on brachial plexus injury. Methods:24 patients whose brachial plexus were injury were divided into 2 groups randomly:a control group and a therapy group. 12 patients of the control group were treated with routine acupuncture and physical therapy. 12 patients of the therapy group were treated with electromyogram biofeedback on the basis of routine therapy. All patients’ maximum amplitude and electromyographic integral value were recorded to estimate curative effect and analyze statistics. Results:All the indications of the two groups were improved,compared with pretherapy. There were distinctive differences between the two groups.Conclusion:Electromyogram biofeedback therapy in conjunction with routine acupuncture and physical therapy can increase curative effect on brachial plexus injury more effectively than conventional therapy.

目的 观察非手术脊柱减压系统配合悬吊运动技术(sling exercise therapy,SET)治疗腰椎间盘突出症下背痛的近期及远期疗效.方法 选取腰椎间盘突出症患者100例,随机分为对照组和观察组各组50例.对照组予非手术脊柱减压系统DRX 9000治疗,观察组在非手术脊柱减压系统DRX 9000治疗基础上采用悬吊运动技术治疗.分别于治疗前、治疗6周后、治疗2年后对两组患者进行腰椎间盘突出症下背痛视觉模拟评分(VAS)疼痛评定.结果 两组患者治疗6周后、2年后下背痛VAS评分均较治疗前下降(P＜0.05);观察组与对照组相比,VAS评分改善更明显(P＜0.05).结论 在非手术脊柱减压系统治疗的基础上,配合悬吊运动技术治疗腰椎间盘突出症下背痛在近、远期均有良好的疗效,且优于单纯应用脊柱减压系统的治疗.

Objective To investigate the timing options of conservative treatment and operation treatment for lum-bar intervertebral disc. Methods From May 2012 to August 2013,the clinical data of 120 patients with lumbar disc herni-ation were retrospectively analyzed. Ninety-four patients(78. 33% )underwent conservative treatment,mainly including ac-upuncture,traction,massage therapy,physical therapy and drug therapy. Twenty-six patients(21. 67% )underwent opera-tion treatment,the proportion was 21. 67% ,mainly including semi laminectomy and windowing method. Before and after treatment,the changes of symptoms and signs and recovery daily living were evaluated,and the treatment effects were com-pared. Results The total effective rate was 91. 48% in the treatment group and 92. 30% in the control group,there was significant difference(P ﹥ 0. 05). Conclusions The curative effects of conservative treatment and operation treatment for lumbar disc are the same. The key lies in strict master of contraindications in the treatment process,grasp the timing of treatment options,in order to improve the lumbar function of patients.

在临床康复学的教学中,分别使用病例导入教学法与传统教学法,通过对学生的考试成绩及调查问卷进行分析,发现病例导入教学法能有效激发学生的兴趣,培养临床思维和分析、解决问题的能力,将理论与实际紧密联系在一起,从而提高教学质量.

Objective To observe the effect of spinal decompression system DRX9000 and reduction traction manipulation in the treatment of lumbar disc herniation.Methods Eighty patients with lumbar disc herniation in the second hospital of Fuzhou were randomly divided into two groups,the observation group (40 cases) were taken electric traction treatment,the control group (40 cases)were taken the traditional manual traction.To observe the efficacy of the two groups before treatment and one month after treatment.Results One month after the treatment,33 cases were excellent in the observation group,5 cases were good,the excellent and good rate was 95％.In the control group,21 cases were excellent,good in 8 cases,the excellent and good rate was 72.5％,the difference between the two groups was significant(P ＜ 0.05).Compared with Oswestry score before and after treatment,the Oswestry scores decreased significantly in the treatment group (P ＜ 0.05).Conclusions Electric traction is a new method which is to restore its shape in the treatment of lumbar intervertebral disc lesion,it has a good clinical therapeutic effect.

Objective To explore the effect of spinal decompression system on lumbar disc herniation. Methods 83 patients of lumbar disc herniation were divided into observation group(n=42) and control group(n=41). Both groups received massage therapy, while the observation group was treated with spinal decompression system in addition. The effect was evaluated with Visual Analogue Scale(VAS) and Japanese Orthopedic Association(JOA) assessment of low back pain. Results The VAS score decreased and the JOA score increased in both groups after treatment(P<0.05), and it was better in the observation group than in the control group(P<0.01). Conclusion Spinal decompression system could improve the therapeutic effect on lumbar disc herniation.

骨关节炎(osteoarthritis,OA)指由多种因素引起关节软骨纤维化、皲裂、溃疡、脱失而导致的关节疾病.病因尚不明确,其发生与年龄、肥胖、炎症、创伤及遗传等因素有关.骨关节炎好发于负重大、活动多的关节,如膝、髋、踝、手、脊柱等关节,亦称为骨关节病、退行性关节炎等. 骨关节炎可分为原发性和继发性两类.原发性骨关节炎多发生于中老年,女性多于男性.发病原因不明,与遗传和体质因素有一定的关系.继发性骨关节炎可发生于青壮年,继发于创伤、炎症、关节不稳定、慢性反复的积累性劳损或先天性疾病等.

颈部肌肉、椎间盘、后纵韧带以及小关节异常等均可导致颈部肌肉活动障碍、甚至疼痛。在各种颈部疾患中，颈椎病是最常见慢性病之一，过去多发生于中老年人群；但随着人们生活、工作方式改变，近年来颈椎病发病情况逐渐呈年轻化趋势，其中大部分患者与长时间姿势不良有关。重体力劳动者容易诱发颈椎强直，而静态工作者由于主要负荷集中在颈部等少量小肌群上，长时间固定姿势容易使这些肌肉超负荷，从而诱发颈肌紧张综合征[1]。如有数据统计发现，上海陆家嘴金融贸易区从业人员中有17.53％明确患有颈椎病[2]。

目的探讨截肢后幻肢痛的中西医结合康复治疗方法。方法采用针刺治疗、经皮电神经刺激疗法、超声波药物透入疗法、运动疗法、中药熏洗治疗、药物静滴治疗、心理治疗等中西医结合康复措施对截肢后幻肢痛患者进行综合治疗,采用简化的McGill疼痛问卷(SF-MPQ)进行评定。结果21例患者治疗前后疼痛评定指数(PRI)、现时疼痛强度(PPI)均有明显改善(P<0.01)。结论对截肢后幻肢痛应及早采取多手段的中西医结合综合康复治疗。

目的观察寰枢椎微调手法对颈性眩晕的临床疗效,并与常规推拿手法作疗效比较。方法将颈性眩晕患者83例随机分为2组,其中对照组41例采用常规推拿手法治疗,治疗组42例在常规推拿手法治疗基础上,加用寰枢椎微调手法,采用颈性眩晕症状与功能评估量表来评定疗效并进行统计学分析。结果治疗后2组临床症状和各项指标与治疗前比较均有改善,但2组间差异有非常显著性(P<0.01)。结论寰枢椎微调手法结合常规推拿治疗较单纯常规推拿治疗更能有效地提高颈性眩晕的疗效。

Objective: To design and make “T” adjustable ankle-foot orthotics (AFO) and evaluate its effects on preventing and correcting ankle malformation. Methods: (1) Forty cases of paraplegia, hemiplegia and fracture wearing “T” AFO (“T” group) and 34 cases wearing traditional AFO (tradition group) were observed about their ankle activity maintenance. (2) Ten patients wearing adjustable AFO (adjustable group) were observed their ankles' activity change. Results: Ankles' activity of 3 patients in the “T” group and 10 cases in the tradition group had no improvement. There was significant difference between the two groups (P0.01). Ankle malformation of 8 cases in the adjustable group have shown distinct improvement. Conclusion: “T” AFO can guard against foot-drop, strephenopodia and strephexopodia. Meanwhile, adjustable AFO can correct ankle malformation better. These two kinds of improved AFO not only keep their original functions but also increase and enlarge the functions of preventing and correcting.

运用物理因子,中药薰洗及运动疗法分阶段治疗小儿肘部骨折.经治疗前后比较,肘关节活动度( ROM)与改良巴氏指数明显提高.表明早期合理地进行综合康复治疗,能有效地减轻或消除肘关节肿痛,增加 ROM,明显改善肘关节运动功能.

膝关节僵直的临床治疗比较棘手,该症通常由下肢骨折后长期制动、膝关节及关节周围组织创伤或炎症等引发关节滑动装置纤维化、挛缩及粘连等引起.其主要临床症状为膝关节屈曲受限或者伸直位僵直,并伴有股四头肌挛缩,弹性及活动度减弱,髌膝关节活动度减少或消失,严重影响了患者的工作、学习及生活,并同时在经济方面造成巨大损失.我科自2003年以来,联合采用中药及运动康复治疗膝关节创伤后僵直患者32例,取得满意疗效.现报道如下.

据统计,足下垂、足内翻及下肢外旋畸形等症状,在截瘫和偏瘫患者早期的发生率高.依靠传统,常规的徒手治疗方法,很难得到好的效果,现代康复治疗中,一般采用踝足矫形器( AFO)来预防和矫正其畸形.为了提高踝足矫形器的功效,对踝足矫形器进行改进,观察其应用效果.

目的研究反射性交感神经营养不良( RSD)患者综合康复治疗的效果.方法对 52例 RSD患者进行综合康复治疗,采用简化 McGill疼痛调查量表、水肿计分、肤色改变计分、关节活动度等评定疗效并进行统计学分析.结果治疗后临床症状和各项指标与治疗前比较差异均有显著性( P< 0.01).结论临床综合康复治疗对 RSD患者疼痛的缓解、功能的恢复具有肯定的效果.

近年来,笔者运用中药熏蒸疗法配合关节松动术治疗肩周炎65例,疗效满意,现报告如下.