手法整复结合等长抗阻训练治疗寰枢关节半脱位

Manipulative Reduction Combined with Isometric Exercise with Resistance in the Treatment of Atlantoaxial Subluxation

目的：观察手法整复结合等长抗阻训练治疗寰枢关节半脱位的效果。方法：64例寰枢关节半脱位患者随机分为试验组和对照组各32例。试验组以手法整复结合等长抗阻训练,对照组采用手法整复治疗。以临床症状、体征改善程度及X线张口位片评定疗效。结果：经过5～10次治疗后,总有效率2组相近（96.9%与93.8%）,治愈率试验组明显高于对照组（62.5%与43.8%,P〈0.05）。X线片示寰枢关节齿突与侧块间距差值2组比治疗前减小（P〈0.01）,且试验组小于对照组（P〈0.05）。结论：手法整复结合等长抗阻训练能有效纠正寰枢关节半脱位,提高治愈率。

Objective： To evaluate the effect of manipulative reduction combined with isometric exercise with resistance on the atlantoaxial subluxation. Methods： A total of 64 patients with atlantoaxial subluxation were divided into an experimental group （n： 32） and a control group （n= 32） randomly. The former received manipulative reduction combined with isometric exercise with resistance,and the latter only received manipulative reduction. Clinical symptoms, signs and X ray open-mouth view were observed, respectively, in the two groups before and after treatment. Results：In the experimental group, the total efficient rate was 96.9% and the curative rate was 62.5%. In the control group, the total efficient rate was 93.8% and the curative rate was 43.8%. There was no significant difference between the two group in the total efficient rate, but the curative rate in the experimental group was significantly higher than in the control group （P〈0.05）. Both the experimental and the control groups had significant difference in the distance between the odontoid process and the lateral mass of the atlantoaxial subluxation before and after the treatment （P〈0.05）. There was no significant difference in the distance between the odontoid process and the lateral mass of the atlantoaxial subluxation between the two groups before the treatment （P〈0.05）, while there was significant difference in the distance after the treatment （P〈0.05）. Conclusion： Manipulative reduction combined with isometric exercise with resistance is particularly effective for atlantoaxial subluxation with high curative rate.