应用三维动静态平衡康复模式治疗非脊髓型颈椎病的临床研究

Clinical study on three-dimensional dynamic and static equilibrium rehabilitation modality in the treatment of non-myelopathy type cervical spondylosis

目的:观察应用三维动静态平衡康复模式治疗非脊髓型颈椎病的临床疗效。方法:将符合要求的98例非脊髓型颈椎病患者随机分为三维康复组和传统治疗组,每组49例。三维康复组采用三维颈椎康复垫结合三维颈肌抗阻静力锻炼治疗,传统治疗组采用枕颌带牵引、药物治疗和颈肩锻炼治疗,共治疗3周。比较2组患者的颈部疼痛视觉模拟评分(visual analogue scale,VAS)、颈部功能残障指数(neck disability index,NDI)、颈椎前缘序列线弧弦距及临床疗效。结果:治疗前2组患者的颈部疼痛VAS评分、NDI及颈椎前缘序列线弧弦距比较,组间差异均无统计学意义[(5.16±1.21)分,(5.21±1.17)分,t=0.168,P=0.829;(28.63±5.07),(28.56±5.11),t=0.131,P=0.896;(7.15±5.68)mm,(7.08±5.77)mm,t=0.156,P=0.863];治疗3周后三维康复组的颈部疼痛VAS评分和NDI低于传统治疗组,颈椎前缘序列线弧弦距大于传统治疗组[(2.53±1.05)分,(3.79±1.71)分,t=1.680,P=0.012;(17.21±4.75),(24.15±5.82),t=1.132,P=0.023;(9.83±5.98)mm,(7.69±6.03)mm,t=-3.265,P=0.002]。治疗3周后三维康复组的颈部疼痛VAS评分和NDI均较治疗前降低,颈椎前缘序列线弧弦距较治疗前增加(t=2.946,P=0.004;t=2.685,P=0.013;t=-3.496,P=0.001);传统治疗组的VAS评分、NDI及颈椎前缘序列线弧弦距与治疗前相比,差异均无统计学意义(t=0.489,P=0.617;t=0.632,P=0.582;t=0.182,P=0.632)。治疗3周后,三维康复组治愈39例、有效8例、无效2例,传统治疗组治愈18例、有效20例、无效11例,三维康复组的临床疗效优于传统治疗组(R_(三维康复组)=38.51,R_(传统治疗组)=60.49,Z=-4.339,P=0.000)。结论:应用三维动静态平衡康复模式可有效减轻非脊髓型颈椎病患者的疼痛症状,促进颈椎生理曲度和功能恢复,值得临床推广应用。

Objective：To observe the clinical curative effects of three-dimensional dynamic and static equilibrium rehabilitation modali-ty in the treatment of non-myelopathy type cervical spondylosis.Methods：Ninety-eight patients with non-myelopathy type cervical spondylo-sis enrolled in the study were randomly divided into three-dimensional rehabilitation group and traditional therapy group,49 cases in each group.The patients in three-dimensional rehabilitation group were treated with three-dimensional cervical vertebra rehabilitation cushion combined with three-dimensional neck muscle resistance isometric exercises,while the others in traditional therapy group were treated with jaw-occiput traction combined with drug therapy and neck-shoulder functional exercises.After 3-week treatment,the neck pain visual ana-logue scale（VAS）scores,neck disability index（NDI）,horizontal distance between C2 and C7 plumb lines and clinical curative effects were compared between the 2 groups.Results：There was no statistical difference in neck pain VAS scores,NDI and horizontal distance between C2 and C7 plumb lines between the 2 groups before the treatment（5.16 ±1.21 vs 5.21 ±1.17 points,t =0.168,P =0.829;28.63 ±5.07 vs 28.56 ±5.11,t =0.131,P =0.896;7.15 ±5.68 vs 7.08 ±5.77 mm,t =0.156,P =0.863）.The neck pain VAS scores and NDI were lower and the horizontal distance between C2 and C7 plumb lines was greater in the three-dimensional rehabilitation group compared to the traditional therapy group after 3-week treatment（2.53 ±1.05 vs 3.79 ±1.71 points,t =1.680, P =0.012;17.21 ±4.75 vs 24.15 ±5.82,t =1.132,P =0.023;9.83 ±5.98 vs 7.69 ±6.03 mm,t =-3.265,P =0.002）.The neck pain VAS scores and NDI decreased while the horizontal distance between C2 and C7 plumb lines increased after 3-week treatment in three-dimensional rehabilitation group（t =2.946,P =0.004;t =2.685,P =0.013;t =-3.496,P =0.001）.However,no statistical differ-ence was found between pretreatment and post-treatment in above parameters in traditional therapy group（t =0.489,P =0.617;t =0.632, P =0.582;t =0.182,P =0.632）.After 3-week treatment,39 patients were cured,8 fair and 2 poor in the three -dimensional rehabilitation group;while 18 patients were cured,20 fair and 11 poor in traditional therapy group.The three-dimensional rehabilitation group surpassed the traditional therapy group in the clinical curative effect（Rthree-dimensional rehabilitation group =38.51,Rtraditional therapy group =60.49,Z =-4.339,P =0.000）.Conclusion：The three-dimensional dynamic and static equilibrium rehabilitation modality can effectively relieve the neck pain and improve the cervical curve and promote the cervical function recovery in patients with non-myelopathy type cervical spondylosis,so it is wor-thy of popularizing in clinic.