上段颈胸椎快速、小幅度松动手法结合常规松动术治疗机械性颈肩痛的疗效观察

The efficacy of combined treatment of upper segments of cervical and thoracic high-velocity low-amplitude thrust manipulation and conventional mobilization in treating patients with mechanical neck pain/

目的:研究上段颈胸椎快速、小幅度松动手法结合常规松动术治疗机械性颈肩痛的短期疗效。方法:将60例患者随机分为HVLA手法组(30例)和对照组(30例)两组。HVLA手法组除了接受常规松动术治疗以外,还针对C1-2、T1-2关节实施快速、小幅度松动手法,对照组仅接受常规松动术治疗。在治疗前和治疗后48h分别使用颈部功能障碍指数(NDI)、视觉模拟疼痛评分(VAS)和C1-2旋转活动范围来评估患者。结果:治疗后,HVLA手法组和对照组都明显好于治疗前,有显著性差异(P<0.01);HVLA手法组(30例)NDI指数下降57.5%,VAS评分下降50.4%,对照组(30例)NDI指数下降16.7%,VAS评分下降12.8%,两组比较有显著性差异(P<0.01);HVLA组治疗后C1-2旋转活动范围均显著高于对照组(P<0.01)。结论:治疗机械性颈肩痛综合运用上段颈椎和胸椎HVLA手法治疗的短期疗效明显好于常规松动术。

Objective：To observe the short-term effects of combined treatment of upper segments of cervical and thoracic high-velocity low-amplitude （HVLA） thrust manipulation and conventional mobilization in patients with mechani- cal neck-shoulder pain. Method：Sixty patients were randomized into HVLA group（n=30） and control group（n=30）.The HVLA group re- ceived HVLA thrust manipulation targeted on C1-2 and T1-2 without conventional mobilization.The control group received conventional mobilization only.Patients of both groups completed the assessments of neck disabil- ity index（NDI） and visual analogue scale（VAS） piror to treatment and 48h after treatment.The range of rotation of C1-2 was assessed. Result：All patients of both groups ameliorated after treatment（P〈 0.01）. And patients of HVLA group improved more significantly（P〈 0.01） in NDI（57.5%） and VAS （50.4%） than those of control group （16.7% and 12.8%, respectively） following treatment. In addition, the HVLA group had significant（P〈0.01） improvement in passive rotation range of C1-2. Conclusion：The short term effect of combination of upper segments of cervical and upper thoracic HVLA thrust manipulation is more significant than conventional mobilization in patients with mechanical neck pain.