中医整脊手法及牵引治疗187例青年颈椎失衡综合征前后X线分析

Analysis of X-rays of cervical imbalances syndrome before and after the treatment of osteopathy and traction intervention in 187 youth cases

目的:观察青年颈椎失衡综合征中医整脊治疗前后X线变化,论证中医整脊手法对早期青年颈椎疾病的临床疗效。方法:2009年3月至2011年2月,从北京中医药大学在校大学生中筛选出187例青年颈椎失衡综合症患者,年龄19～22岁,平均21岁。完全随机分为整脊组94例,男40例,女54例;牵引组93例,男42例,女51例。分别给予整脊和牵引治疗3周,每周3次。第3周治疗后,收集X线资料,比较治疗前后X线资料。结果:①整脊组治疗前曲度异常57例、棘突位置改变45例、角位移44例、椎体滑移15例、Ruth Jackson线交点前屈改变70例、后伸改变47例;治疗后曲度异常35例、棘突位置改变24例、角位移18例、椎体滑移3例、Ruth Jackson线交点前屈改变41例、后伸改变33例;X线测量指标:颈椎曲度由治疗前(7.070±4.629)°改善至治疗后(7.660±4.156)°、角位移由治疗前(13.790±2.590)°改善至治疗后(11.050±2.560)°、椎体滑移由治疗前(3.770±0.350)mm改善至治疗后(3.160±0.485)mm。整脊组治疗改善以椎体滑移及角位移变化明显,治疗前后差异有统计学意义(P<0.01)。②牵引组治疗前曲度异常60例、棘突位置改变39例、角位移39例、椎体滑移15例、Ruth Jackson线交点前屈改变70例、后伸改变47例;治疗后牵引组曲度异常50例、棘突位置改变29例、角位移17例、椎体滑移3例、Ruth Jackson线交点前屈改变41例、后伸改变33例;X线测量指标:颈椎曲度由治疗前(5.590±4.639)°改善至治疗后(5.990±4.330)°、角位移由治疗前(13.360±2.064)°改善至治疗后(11.210±1.872)°、椎体滑移由治疗前(3.790±0.339)mm改善至治疗后(3.480±0.332)mm。牵引组治疗改善以椎体滑移及角位移变化明显,治疗前后差异有统计学意义(P<0.01)。结论:①青年颈椎失衡综合征病名能反映青年颈椎问题病理变化。②X线上颈椎应力点、角位移、椎体滑移、曲度变直、棘突位置改变证实青年颈椎失稳是青年颈椎失衡后的主要影像学表现。③中医整脊手法和牵引均是治疗青年颈椎失衡综合征的有效方法。④青年颈椎失衡综合征是颈椎病的早期表现,是可逆的。

Objective： To observe X-ray features of before and after treatment of cervical imbalance syndrome with osteopathy and traction intervention in youth patients ,then to investigate the clinical effect of the treatment of the cervical imbalances syndrome in youth by osteopathy. Methods：From September 2007 to December 2010, one hundred and eighty-seven students of 19 to 22 years （means 21 years） with neck pain as the main symptom in Beijing university of Chinese medicine were selected and divide them into osteopathy group and traction groups randomly. In osteopathy group ,there were 94 patients including 40 males and 54 females; in traction group, there were 93 patients including 42 males and 51 females. The treatment of osteopathy group lasted for 3 weeks,three times per week; traction group by traction treatment three weeks,three times a week, too. X-ray before treatment and 3 weeks after treatment were collected. Results：The osteopathy group：94 cases, before treatment, abnormal curvature in 57 cases, spinous position change in 45 cases and angular displacement in 44 cases ,vertebral sliding in 15 cases, Ruth Jackson line intersect proneness change in 70 cases, stretch change in 47 cases;after treatment, ab- normal curvature in 35 cases, spinous position change in 24 cases and angular displacement in 18 cases, vertebral sliding in 3 cases ,Ruth Jackson line intersect proneness change in 41 cases ,extension change in 33 cases ;X-Ray measurement results： cervical curvature improved from （7.070±4.629） before treatment to （7.660±4.156）after treatment, angular displacementimproved from （ 13.790±2.590） before treatment to （ 11.050±2.560）after treatment; vertebral sliding improved from （3.770± 0.350） mm before treatment to （3.160±0.485） mm after treatment. The change of angular displacement and vertebral sliding were so significant before and after treatment in this group, there were statistical defferenees between before and after the treatment （P〈0.01） in osteopathy group. The traction group： 93 eases ,before treatment, abnormal eurvature in 60 eases, spinous position change in 39 eases and angular displacement in 39 eases ,vertebral sliding in 15 eases, Ruth Jackson line intersect proneness change in 70 eases, stretch in 47 cases ; after treatment, abnormal curvature in 50 eases, spinous position change in 29 eases and angular displacement in 17 cases;vertebral sliding in 3 eases, Ruth Jackson line intersect proneness change in 41 eases,stretch in 33 eases;X-Ray measurement results： eervical curvature improved from （5.590±4.639） before treatment to （5.990±4.330） after treatment, angular displacement improved from （13.360±2.064） before treatment to （ 11.210 ± 1.872） after treatment;vertebral sliding improved from （3.790±0.339） mm before treatment to （3.480±0.332） mm after treatment. The change of angular displacement and vertebral sliding were also so siguifieant in traction group before and after treatment ,there were statistical defferences between before and after the treatment （P〈0.01）. Conclusion： （1）Pathological changes can be called youth cervieal imbalance syndrome. Stress points, angular displacement, eervical vertebral slip, curvature straightened, spinous position change are main X-ray performanees. （3）Both osteopathy and traction intervention on are efficient in youth neck pain. （4）YoUths cervical vertebra imbalance is early but reversible performance.