摩腹捏脊手法治疗椎动脉型颈椎病临床研究

Clinical Study on the Therapy of Rubbing Abdomen and Pinching along the Spine for Cervical Spondylosis of Vertebral Artery Type

目的:观察摩腹捏脊手法治疗椎动脉型颈椎病(CSA)的临床疗效。方法:将40例CSA患者随机分为对照组和治疗组,每组20例。对照组以枕颌带牵引治疗,治疗组以摩腹捏脊手法治疗。2组均每天治疗1次,连续治疗20天。对比2组临床疗效,观察2组治疗前后颈性眩晕症状与功能评估量表(ESCV)、颈椎功能障碍指数量表(NDI)评分及肠道菌群比例的变化。结果:对照组总有效率65.00%,治疗组总有效率95.00%,2组比较,差异有统计学意义(P <0.05)。治疗后,2组ESCV评分均较治疗前提升,NDI评分均较治疗前下降,差异均有统计学意义(P <0.05);治疗组ESCV评分高于对照组,NDI评分低于对照组,差异均有统计学意义(P <0.05)。治疗后,治疗组双歧杆菌/拟杆菌与乳酸杆菌/拟杆菌比值均较治疗前升高(P <0.05),且均高于同期对照组(P <0.05)。对照组双歧杆菌/拟杆菌及乳酸杆菌/拟杆菌比值治疗前后比较,差异均无统计学意义(P> 0.05)。结论:摩腹捏脊手法可有效治疗CSA,效果优于颈椎牵引疗法,其作用机理可能通过调整肠道菌群比例实现。

Objective:To observe the clinical effect of the therapy of rubbing abdomen and pinching along the spine for cervical spondylosis of vertebral artery type(CSA). Methods:Divided 40 cases of patients with CSA randomly into the control group and the treatment group,20 cases in each group. The control group was treated with intermaxillary traction,and the treatment group was treated with the therapy of rubbing abdomen and pinching along the spine. Both groups were treated once a day for 20 days. Compared the clinical effect in the two groups, and observed the scores of evaluation scale for cervical vertigo(ESCV) and neck disability index(NDI) and the changes of intestinal flora ratio before and after treatment.Results: The total effective rate was 65.00% in the control group and 95.00% in the treatment group, difference being significant(P < 0.05). After treatment,the ESCV scores of the two groups were higher than those before treatment,and the NDI scores were lower than those before treatment, differences being significant(P < 0.05): the ESCV scores of the treatment group were higher than those of the control group,and the NDI scores were lower than those of the control group,differences being significant(P < 0.05). After treatment,the ratios of bifidobacterium/bacteroides to lactobacillus/bacteroides in the treatment group were higher than those before treatment(P < 0.05),and higher than those in the control group(P < 0.05).There were no significant differences being found in the ratios of bifidobacterium/bacteroides to lactobacillus/bacteroides in the control group before and after treatment(P > 0.05). Conclusion: The application of the therapy of rubbing abdomen and pinching along the spine can effectively treating CSA. Its effect is superior to cervical traction therapy. The mechanism may be achieved by adjusting the proportion of intestinal flora.