【目的】 观察龙氏治脊疗法联合易筋经四式治疗腰椎间盘突出症的临床疗效。【方法】 选取 2024年 7月至 2024年 12月 广东省第二中医院针灸康复科住院部收治的68例明确诊断为LDH的患者为研究对象。按随机数字表将患者随机分为观察组 和对照组，每组各34例。对照组给予龙氏治脊疗法治疗，观察组在对照组治疗的基础上，联合易筋经四式锻炼，2组均治疗 2周，并于治疗后1个月进行随访。治疗2周后，评价2组临床疗效。观察2组患者治疗前后疼痛视觉模拟量表（VAS）评分的 变化情况，以及Oswestry功能障碍量表（ODI）评分、日本骨科医师协会量表（JOA）评分的情况。使用DIERS formetric 3D评估 系统评估 2 组患者的腰曲最大角度、骨盆倾斜角度、椎体最大旋转角度的变化情况。【结果】（1）观察组总有效率为 94.12% （32/34），对照组为91.18%（31/34）。2组患者均取得较好疗效，但差异无统计学意义（P＞0.05）。（2）治疗后，2组患者的VAS 评分明显改善（P＜0.05），且观察组在改善 VAS 评分方面明显优于对照组，差异有统计学意义（P＜0.05）。治疗后 1 个月随 访，观察组VAS评分明显改善（P＜0.05），且观察组在改善VAS评分方面明显优于对照组，差异有统计学意义（P＜0.05）。（3）治 疗后，2组患者的JOA、ODI评分均明显改善（P＜0.05），且观察组在改善JOA、ODI评分方面明显优于对照组，差异有统计 学意义（P＜0.05）。治疗后1个月随访，观察组JOA、ODI评分明显改善（P＜0.05），且观察组在改善JOA、ODI评分方面明显 优于对照组，差异有统计学意义（P＜0.05）。（4）治疗后，2组患者的腰曲最大角度、骨盆扭转角度、椎体最大旋转角度均明 显改善（P＜0.05），且观察组在改善腰曲最大角度、骨盆扭转角度、椎体最大旋转角度方面明显优于对照组，差异有统计学 意义（P＜0.05）。治疗后1个月随访，观察组腰曲最大角度、骨盆扭转角度、椎体最大旋转角度均明显改善（P＜0.05），且观 察组在改善腰曲最大角度、骨盆扭转角度、椎体最大旋转角度方面明显优于对照组，差异有统计学意义（P＜0.05）。【结论】 龙 氏治脊疗法联合易筋经四式治疗腰椎间盘突出症，可明显改善患者脊柱、骨盆偏移角度并增强稳定性，减轻患者的疼痛症 状与活动受限等情况，从而提高患者生活质量，疗效显著。

Objective To evaluate the clinical efficacy of Long’s spinal manipulation therapy combined with four postures of rotational tendon-releasing maneuver in treating lumbar disc herniation（LDH）. Methods Sixty-eight patients diagnosed with LDH were enrolled from the Department of Acupuncture and Rehabilitation at Guangdong Second Traditional Chinese Medicine Hospital between July 2024 and December 2024. Patients were randomly divided into an observation group and a control group using a random number table，with 34 cases in each group. The control group received Long’s spinal manipulation therapy，while the observation group received additional training in four postures of rotational tendon-releasing maneuver. Both groups were treated for 2 weeks，with a 1-month follow-up. Clinical efficacy was evaluated after treatment by comparing Visual Analogue Scale（VAS） scores，Oswestry Disability Index（ODI） scores，and Japanese Orthopaedic Association（JOA） scores before and after intervention. Spinal parameters including maximum lumbar curvature angle，pelvic tilt angle，and maximum vertebral rotation angle were assessed using the DIERS formetric 3D evaluation system. Results （1） The total effective rate was 94.12%（32/34） in the observation group and 91.18%（31/34） in the control group，and both groups achieved ideal therapeutic efficacy，but the difference was not statistically significant（P＞0.05）.（2） After treatment，the VAS scores of patients in the two groups significantly improved（P＜0.05），and the observation group was significantly superior to the control group in improving VAS scores， with statistically significant differences（P＜0.05）. At the 1-month follow-up after treatment， the VAS score of the observation group significantly improved（P＜0.05），and the observation group was significantly superior to the control group，and the difference was statistically significant （P＜0.05）.（3） After treatment，the JOA and ODI scores of the patients in the two groups significantly improved（P＜0.05），and the observation group was significantly superior to the control group in improving the JOA and ODI scores，and the difference was statistically significant（P＜0.05）. At 1-month follow-up after treatment， JOA and ODI scores of the observation group significantly improved（P＜ 0.05）， and the observation group was significantly superior to the control group， with statistically significant differences（P＜0.05）.（4） After treatment， the maximum angle of lumbar flexion， pelvic torsion angle， and maximum rotation angle of the vertebral body of the two groups of patients were significantly improved（P＜0.05）， and the observation group was significantly better than the control group， and the difference was statistically significant（P＜0.05）. At the 1-month follow-up after treatment，the maximum angle of lumbar flexion，pelvic torsion angle， and maximum vertebral rotation angle of the observation group were significantly improved（P＜ 0.05）， and the observation group was significantly superior to the control group， and the difference was statistically significant（P＜0.05）. Conclusion The combination of Long’s spinal manipulation therapy and four postures of rotational tendon-releasing maneuve significantly improves spinal alignment， reduces pain and disability，and enhances quality of life in patients with LDH，demonstrating notable clinical efficacy.

R246.9

广东省中医药研究开发重点实验室开放课题资助项目（编号：20233003）；广东省临床教学基地教学改革研究资助项目（编号： 粤高教函[2023]32 号）；广州地区中西医协同临床重大创新技术建设资助项目（编号：穗卫函[2023]2318号）