定点旋颈法结合颈椎牵引治疗神经根型颈椎病的疗效观察

Observation on the curative effects of fixed-point cervical rotatory manipulation combined with cervical traction in the treatment of cervical spondylotic radiculopathy

目的:观察定点旋颈法结合颈椎牵引治疗神经根型颈椎病的临床疗效。方法:将纳入研究的54例神经根型颈椎病患者随机分为2组,每组27例。治疗组采用定点旋颈法结合颈椎牵引治疗,每周3次2,周为1个疗程;对照组采用颈椎牵引结合推拿手法治疗,每周3次,2周为1个疗程。治疗1个疗程后参照国家中医药管理局《中医病证诊断疗效标准》中颈椎病的疗效标准评定2组患者的临床疗效,并于治疗前及治疗1个疗程结束后采用美国颈椎多功能测试训练系统测定患者的颈椎活动度。结果:①临床疗效。治疗组疗效优于对照组(χ2=4.601,P=0.032)。②颈椎活动度。治疗前2组患者的颈椎前屈、后伸、左右侧屈及左右旋转活动度比较,差异无统计学意义(t=0.176,P=0.861;t=0.309,P=0.758;t=0.178,P=0.859;t=0.203,P=0.839;t=0.119,P=0.906;t=0.464,P=0.645),有可比性;治疗1个疗程后2组患者的颈椎前屈、后伸、左右侧屈及左右旋转活动度均有改善(治疗组:t=6.936,P=0.000;t=4.511,P=0.000;t=2.409,P=0.020;t=2.464,P=0.017;t=2.492,P=0.016;t=4.403,P=0.000。对照组:t=4.366,P=0.000;t=2.726,P=0.008;t=2.675,P=0.010;t=2.372,P=0.021;t=3.392,P=0.001;t=3.870,P=0.000),其中治疗组患者的前屈、后伸活动度的改善程度大于对照组(t=2.059,P=0.044;t=2.061,P=0.044),2组患者的左右侧屈及左右旋转活动度改善程度比较,差异无统计学意义(t=0.268,P=0.790;t=0.313,P=0.756;t=0.394,P=0.695;t=0.303,P=0.763)。结论:定点旋颈法结合颈椎牵引治疗能明显改善神经根型颈椎病患者的颈椎活动度,缓解临床症状。

Objective：To observe the clinical curative effects of fixed-point cervical rotatory manipulation combined with cervical traction in the treatment of cervical spondylotic radiculopathy（CSR）.Methods：Fifty-four CSR patients enrolled in the study were randomly divided into 2 groups,27 cases in each group.Patients in the treatment group were administrated with fixed-point cervical rotatory manipulation combined with cervical traction,3 times a week with 2 weeks for a course of treatment;while the others in the control group were administrated with cervical traction combined with massage manipulation,3 times a week with 2 weeks for a course of treatment.After a course of treatment,the clinical curative effects of the patients in the 2 groups were evaluated according to Criteria of diagnosis and therapeutic effect of diseases and syndromes in traditional Chinese medicine publish ed by State Administration of Traditional Chinese Medicine,and the cervical activity of the patients was evaluated before the treatment and after a course of treatment.Results：①Clinical curative effect：the clinical curative effect of treatment group was better than that of control group（χ2=4.601,P=0.032）.②Cervical activity：Before the treatment,there was no statistical difference in such cervical activities as proneness,extension,left/right lateral bending and rotation of the patients between the 2 groups（t=0.176,P=0.861;t=0.309,P=0.758;t=0.178,P=0.859;t=0.203,P=0.839;t=0.119,P=0.906;t=0.464,P=0.645）,and there was comparability between the 2 groups.After a course of treatment,the cervical activities as proneness,extension,left/right lateral bending and rotation of the patients in the 2 groups improved（Treatment group：t=6.936,P=0.000;t=4.511,P=0.000;t=2.409,P=0.020;t=2.464,P=0.017;t=2.492,P=0.016;t=4.403,P=0.000.Control group：t=4.366,P=0.000;t=2.726,P=0.008;t=2.675,P=0.010;t=2.372,P=0.021;t=3.392,P=0.001;t=3.870,P=0.000）,and the cervical proneness and extension of treatment group improved to a greater extent than those of control group（t=2.059,P=0.044;t=2.061,P=0.044）,and there was no statistical difference in the improvement of left/right lateral bending and rotation of the cervical vertebra for the patients between the 2 groups（t=0.268,P=0.790;t=0.313,P=0.756;t=0.394,P=0.695;t=0.303,P=0.763）.Conclusion：The therapy of fixed-point cervical rotatory manipulation combined with cervical traction can significantly improve the cervical activity for the CSR patients and relieve the clinical symptoms.