仰卧下肢悬吊牵引结合中医理筋治筋疗法治疗腰椎管狭窄症的分层随机对照研究*

作者：海 渊1，翟 绅2，樊金辉1，胡闯北1，王 甜1，石淇允1，宋永伟1

单位：1.河南省洛阳正骨医院（河南省骨科医院），河南 洛阳 471002； 2.河南中医药大学骨伤学院，河南 郑州 450046]

引用：引用：海渊，翟绅，樊金辉，胡闯北，王甜，石淇允，宋永伟.仰卧下肢悬吊牵引结合中医理筋治筋疗法治疗腰椎管狭窄症的分层随机对照研究[J].中医药导报,2026,32(3):76-81.

DOI：10.13862/j.cn43-1446/r.2026.03.013

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摘要：目的：观察仰卧下肢悬吊牵引结合中医理筋治筋疗法治疗腰椎管狭窄症（LSS）的疗效及安全性。方法：采用分层随机分组方法，将126例LSS患者根据合并腰椎滑脱情况分层，再随机分为治疗组和对照组，各63例。在中医理筋治筋疗法治疗基础上，对照组患者予常规三屈位牵引治疗，治疗组患者予仰卧下肢悬吊牵引治疗。治疗3周后评价两组患者治疗前后疼痛视觉模拟（VAS）评分、下腰痛日本骨科协会（JOA）评分、Oswestry功能障碍指数（ODI），并评价临床疗效。结果：治疗组总有效率[94.74%(54/57）]高于对照组[81.03%（47/58）]，差异有统计学意义（P＜0.05）。分层分析显示，合并腰椎滑脱的LSS患者中，治疗组总有效率高于对照组（P＜0.05）；单纯LSS患者中，两组有效率差异无统计学意义（P>0.05）。治疗后，两组各项指标均显著改善（P<0.05），且治疗组指标改善优于对照组（P<0.05）。分层分析显示，治疗后，合并腰椎滑脱的LSS患者中，治疗组各指标均优于对照组（P<0.05）；单纯LSS患者中，两组各项指标比较，差异无统计学意义（P>0.05）。治疗期间两组不良反应发生率比较，差异无统计学意义（P>0.05）。结论：仰卧下肢悬吊牵引结合中医理筋治筋疗法可有效缓解LSS患者症状与体征，安全性高，且对合并腰椎滑脱的LSS患者疗效优于常规三屈位牵引。

关键词：腰椎管狭窄症；腰椎滑脱；悬吊牵引；三屈位牵引；中医理筋治筋疗法;分层随机

Abstract：Objective: To observe the efficacy and safety of supine lower limb suspension traction combined with traditional Chinese medicine (TCM) tendon-regulating therapy for lumbar spinal stenosis (LSS). Methods: Using a stratified randomization method, 126 LSS patients were first stratified based on the presence of concomitant lumbar spondylolisthesis and then randomly assigned to a treatment group and a control group, with 63 patients in each group. Both groups received TCM tendon-regulating therapy as the basic treatment. The control group underwent conventional triple-flexion traction, while the treatment group received supine lower limb suspension traction. After 3 weeks of treatment, the Visual Analogue Scale (VAS) for pain, the Japanese Orthopaedic Association (JOA) low back pain score, and the Oswestry Disability Index (ODI) were evaluated in both groups before and after treatment, and the clinical efficacy was assessed. Results: The total effective rate in the treatment group [94.74% (54/57)] was significantly higher than that in the control group [81.03% (47/58)], with a statistically significant difference (P<0.05). Stratified analysis showed that among LSS patients with concomitant spondylolisthesis, the total effective rate of the treatment group was significantly higher than that of the control group (P<0.05); among patients with simple LSS, the difference in efficacy between the two groups was not statistically significant (P>0.05). After treatment, all indicators significantly improved in both groups (P<0.05), and the improvement in the treatment group was superior to that in the control group (P<0.05). Stratified analysis indicated that among LSS patients with concomitant spondylolisthesis, all indicators in the treatment group were better than those in the control group (P<0.05); among patients with simple LSS, there were no statistically significant differences in any indicators between the two groups (P>0.05). During the treatment period, the incidence of adverse reactions showed no statistically significant difference between the two groups (P>0.05). Conclusion: Supine lower limb suspension traction therapy combined with traditional Chinese medicine tendon-regulating therapy can effectively alleviate symptoms and signs in LSS patients with high safety. Its efficacy is superior to conventional triple-flexion traction for LSS patients with concomitant lumbar spondylolisthesis.

Key words：lumbar spinal stenosis; lumbar spondylolisthesis; suspension traction; triple-flexion traction; traditional Chinese medicine tendon-regulating therapy; stratified randomization

发布时间：2026-03-28

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