硬膜外腔注药配合仰卧牵引旋转整复法治疗颈椎病的临床研究

CERVICAL SPONDYLOSIS TREATED BY EPIDURAL BLOCK ASSISTED WITH CERVICAL SPINE MANIPULATION

目的：观察硬膜外腔注药配合仰卧牵引旋转整复法治疗颈椎病的疗效。方法：将１９６ 例颈椎病患者分为三组， Ａ 组１１０ 例， Ｂ 组７６ 例， Ｃ 组１０ 例。 Ａ、 Ｂ 组用中药制剂脉络宁、注射液内加２ ％ 利多卡因和５ ％ 碳酸氢钠配制的注射液１０ ～１５ 毫升做硬膜外腔注射。 Ａ 组注药后５ 分钟术者在助手的帮助下行仰卧牵引旋转整复法。 Ｃ 组硬膜外腔注射利多卡因与生理盐水的混合液１０ ～１５ ｍｌ 。一般每周治疗一次，三次为一疗程。结果：１９６ 例患者经过一疗程的治疗， Ａ 组显效７５ 例（６８ ．２ ％ ） ，有效２８ 例，无效７ 例，总有效率９３ ．６ ％ ； Ｂ 组显效３６ 例（４７ ．４ ％ ） ，有效２９ 例，无效１１ 例，总有效率８５ ．５３ ％ ； Ｃ 组有效５ 例（５０ ．００ ％ ） ，无效５ 例，总有效率５０ ．００ ％ 。经统计学处理显效率 Ａ 组与 Ｂ 组比较，差异非常显著（ Ｐ ＜ ０ ．０１） ；总有效率 Ａ、 Ｂ 两组间差异不显著 Ｐ ＞ ０ ．０５ ， Ｂ 组与 Ｃ 组比较差异显著 Ｐ ＜ ０ ．０５ 。结论：脉络宁、利多卡因与碳酸氢钠的混合液做硬膜外腔注射治疗颈椎病是一种有效的药物。硬膜外腔注药后进行仰卧牵引旋转整复法能使显效率明显提高。

Objective: To evaluate the therapeutic effect of epidural injection and cervical spine manipulation for cervical spondylosis. Method: 196 cases of cervical spondylosis were divided randomly into 2 groups. Epidural block was used in 76 patient as control group, receiving epidural injection of 10～15ml containing Mai Luo Ning, 2% Lidocaine in 5% NaHCO 3. The treatment group consisted of 110 cases. 5 minute after epidural injection the patient lying on back was given traction and rotation of cervical vertebra. Result: A total of 196 patients of cervical spondylosis were given treatment once a week for 3 weeks. The excellent rate in the control group and in treatment group was found to be 47.4% and 68.2%, respectively (P<0.01). Total effective rate was not significant different between the two groups (P>0.05). Conclusion: Epidural block is an effective method for the treatment of cervical spondylosis. Epidural block assisted with cervical spine manipulation increases the clinical efficacy for the treatment of cervical spondylosis.