康复锻炼联合心理干预护理对腰椎间盘突出症患者生活质量的影响及疗效分析

The Impact of Rehabilitation Exercises Combined with Psychological Intervention on the Quality of Life and Therapeutic Efficacy in Patients with Lumbar Disc Herniation

摘要: 目的：探讨康复锻炼联合心理干预护理对腰椎间盘突出症(LDH)患者生活质量及临床疗效的影响，为优化LDH综合治疗方案提供循证依据。方法：采用回顾性对比试验设计，纳入2022年6月至2024年6月新疆生产建设兵团第九师医院收治的160例LDH患者，分为对照组(n = 80，常规护理)和观察组(n = 80，常规护理 + 康复锻炼联合心理干预)。比较两组腰腿VAS评分、ODI评分、焦虑(SAS)、抑郁(SDS)、心境状态(POMS)、生活质量(GQOL-74)及康复依从性差异，采用SPSS 27.0进行统计分析。结果：干预12周后，观察组在各项评估指标上均显著优于对照组(P < 0.05)。具体表现为：1) 疼痛与功能改善方面：观察组VAS评分(3.8 ± 1.2分)较对照组(5.2 ± 1.5分)降低26.9%，ODI评分(32.5 ± 7.5分)较对照组(45.6 ± 8.2分)改善28.7%；2) 心理状态改善方面：观察组SAS评分(38.5 ± 5.9分)较对照组(42.3 ± 6.7分)降低9.0%，SDS评分(39.2 ± 6.3分)较对照组(43.8 ± 7.1分)降低10.5%，POMS评分(10.8 ± 2.8分)较对照组(14.5 ± 3.2分)改善25.5%；3) 生活质量方面：观察组GQOL-74评分(78.6 ± 10.2分)较对照组(65.3 ± 9.1分)提高20.4%；4) 康复依从性方面：观察组总依从率达90.00%，显著高于对照组的78.75% (χ² = 4.456, P = 0.023)。结论：康复锻炼联合心理干预护理能显著缓解LDH患者疼痛症状，改善腰椎功能，有效调节焦虑抑郁等负性情绪，全面提升生活质量，并显著提高康复治疗依从性。该综合干预模式通过生理-心理双重调节机制发挥协同作用，具有显著的临床效益，值得在LDH临床治疗中推广应用。建议后续研究可采用多中心、大样本的前瞻性随机对照试验进一步验证其长期疗效，并深入探讨其作用机制。

Abstract: Objective: To investigate the impact of a combined intervention of rehabilitation exercises and psychological intervention on the quality of life and clinical outcomes in patients with lumbar disc herniation (LDH), providing evidence-based support for optimizing comprehensive treatment strategies for LDH. Methods: A retrospective comparative study design was employed, including 160 LDH patients admitted to the Ninth Division Hospital of Xinjiang Production and Construction Corps from June 2022 to June 2024. The participants were divided into a control group (n = 80, receiving routine care) and an observation group (n = 80, receiving routine care plus combined rehabilitation exercises and psychological intervention). The study compared the Visual Analog Scale (VAS) scores for back and leg pain, Oswestry Disability Index (ODI) scores, anxiety levels measured by the Self-Rating Anxiety Scale (SAS), depression levels measured by the Self-Rating Depression Scale (SDS), mood states assessed by the Profile of Mood States (POMS), quality of life evaluated by the General Quality of Life Assessment Schedule-74 items (GQOL-74), and adherence to rehabilitation between the two groups. Statistical analysis was conducted using SPSS version 27.0. Results: After a 12-week intervention period, all assessment indicators showed significantly better outcomes in the observation group compared to the control group (P < 0.05). Specifically: 1) Pain relief and functional improvement: VAS scores decreased by 26.9% in the observation group compared to the control group [3.8 ± 1.2 vs. 5.2 ± 1.5], while ODI scores improved by 28.7% [32.5 ± 7.5 vs. 45.6 ± 8.2]. 2) Psychological state improvement: SAS scores decreased by 9.0% [38.5 ± 5.9 vs. 42.3 ± 6.7], SDS scores decreased by 10.5% [39.2 ± 6.3 vs. 43.8 ± 7.1], and POMS scores improved by 25.5% [10.8 ± 2.8 vs. 14.5 ± 3.2]. 3) In terms of quality of life: The GQOL-74 score of the observation group (78.6 ± 10.2) increased by 20.4% compared with that of the control group (65.3 ± 9.1). 4) In terms of rehabilitation compliance: The total compliance rate of the observation group was 90.00%, which was significantly higher than 78.75% of the control group (χ² = 4.456, P = 0.023). Conclusion: Combined rehabilitation exercises with psychological interventions can significantly alleviate pain symptoms, improve lumbar function, effectively regulate negative emotions such as anxiety and depression, comprehensively enhance quality of life, and markedly increase adherence to rehabilitation treatments among LDH patients through dual physiological-psychological regulatory mechanisms with notable clinical benefits; this approach is worthy of broader application in clinical settings for LDH management; further research should employ multi-center prospective randomized controlled trials with larger sample sizes to validate long-term efficacy and explore underlying mechanisms more deeply.