理筋正骨调颅三步法对颈源性头痛的疗效观察及机理分析

Therapeutic Effect and Mechanism of Three-step Method of “Soothing Soft Tissues,Setting Bone,and Manipulating Head” for Treatment of Cervicogenic Headache

【目的】观察理筋正骨调颅三步法治疗颈源性头痛(CEH)的疗效并探讨其机理。【方法】将50例CEH患者随机分为治疗组和对照组,每组各25例。治疗组采用理筋正骨调颅三步法治疗,对照组采用常规头痛循经推拿治疗,经2次治疗后,观察2组患者治疗前后的疼痛视觉模拟法(VAS)评分、颈部活动度和X光张口位片寰枢间隙及枢椎棘突偏歪变化情况,并评价2组疗效。【结果】(1)经2次治疗后,治疗组的总有效率为96.0%,对照组为80.0%,治疗组的总体疗效和总有效率均优于对照组(P<0.05)。(2)治疗后,2组患者的VAS评分和颈部患侧活动度均较治疗前改善(P<0.05),且治疗组对VAS评分和颈部患侧活动度的改善作用优于对照组(P<0.05)。(3)治疗后,治疗组患者X光的寰枢关节不对称情况及枢椎棘突偏歪情况均较治疗前明显减少(P<0.05),而对照组则无明显减少(P>0.05);治疗组在改善寰枢关节不对称情况和枢椎棘突偏歪情况方面效果更好(P<0.05)。【结论】理筋正骨调颅三步法与传统循经推拿相比,能快速有效地缓解CEH。

Objective To observe the curative effect of the three-step method of"soothing soft tissues,setting bone,and manipulating head"for the treatment of cervicogenic headache and to explore its mechanism.Methods Fifty patients with cervicogenic headache were randomly divided into treatment group and control group,25 cases in each group.The treatment group was treated with the three-step method of"soothing soft tissues,setting bone,and manipulating head",and the control group was treated with conventional massage therapy along the meridian.The treatment for the two groups covered two times.Before and after treatment,the Visual Analogue Scale(VAS)scores of headache,lateral cervical activity,the lateral atlantoaxial joint space on the X-ray mouth-openingposition radiography,and the deviation of spinous process of axis in the two groups were observed.After treatment,the clinical efficacy of the two groups was compared.Results(1)After treatment for two times,the total effective rate of in the treatment group was 96.0%,and that in the control group was 80.0%,the total effective rate and the overall efficacy of the treatment group being superior to those of the control group(P<0.05).(2)After treatment,headache VAS scores and lateral cervical activity in the two groups were much improved(P<0.05 compared with those before treatment),and the improvement in the treatment group was superior to that in the control group(P<0.05).(3)After treatment,the dissymmetry of atlantoaxial joint and the deviation of spinous process of axis in the treatment group were relieved(P<0.05 compared with those before treatment),but the changes of the two indexes in the control group were not significant(P>0.05).The effects on improving dissymmetry of atlantoaxial joint and the deviation of spinous process of axis in the treatment group were superior to those in the control group(P<0.05).Conclusion Compared with conventional massage therapy along the meridian,the three-step method of"soothing soft tissues,setting bone,and manipulating head"can effectively and rapidly relieve cervicogenic headache.