旋提手法改善椎动脉型颈椎病颈椎活动度的临床观察

Clinical observation for the improvement of motion of range of cervical spine on rotation-traction manipulation treating cervical spongdylosis of the vertebral artery type

目的:通过观察颈椎活动度治疗前后的变化,评价旋提手法治疗椎动脉型颈椎病的疗效。方法:共计纳入椎动脉型颈椎病患者195例,随机分配到试验组和对照组,试验组采用旋提手法,对照组采用牵引疗法。应用头盔式颈椎活动仪于治疗前和治疗后第1、3、5、7、9、11、13天及治疗后1、3个月共9个时间点观测颈椎的前屈、后伸、左右侧屈、左右旋转的活动度。结果:颈椎活动度的程度比较,第3次访视起,试验组颈椎活动度计分改善较对照组明显(P<0.05);颈椎活动度的数值比较,前屈活动度改善两组无显著统计学差异,后伸活动度从第1个月随访起,左右侧屈活动度从第3次访视起,左右侧旋活动度从第7次访视起,试验组均优于对照组(P<0.05);两组疗效及与时间交互作用比较,试验组优于对照组(P<0.05),随着治疗次数增加,试验组、对照组的颈椎活动度均有显著改善(P<0.001)。结论:旋提手法对于改善椎动脉型颈椎病患者的颈椎活动度有效,颈椎活动度程度、数值是量化颈椎功能和评价手法疗效的重要指标。

Objective： To observe the range of motion（ROM） of cervical spine pre and post treatment,and evalulate the effect on rotation-traction manipulation treating cervical spongdylosis of the vertebral artery type.Methods： 195 patients with cervical spongdylosis of the vertebral artery type were randomly allocated to testing group（treated by rotation-traction manipulation） and control group（treated by traction）.ROM of cervical spine in both groups were measured before and on the 1st,3rd,5th,7th,9th,11th,13th day and 1st,3st month after the treatment.Results： For the comparison of ROM degree,from the 3rd visiting point on,the testing group which improved the score of ROM was better than the control group（P0.05）.As far as the comparison of ROM numerical value is concerned,there was no difference in anteflexion.However,there were differences among posterior extension,lateral flexion and lateral rotation（P0.05）,the time were respectively from the 1st month follow-up,the 3rd visiting point,the 7th visiting point on.Contrasting the effect and interaction with the time between the groups,the testing group was more effective（P0.05）,With the increase of treatment times,ROM became better and better in both groups（P0.001）.Conclusion： Rotation-traction manipulation is effective in improving ROM with cervical spongdylosis of the vertebral artery type,ROM degree and numerical value are important indexes for quantizing function of cervical spine and curative effect.