应用拔伸旋转手法治疗神经根型颈椎病患者的体位分析

The Clinical Effects of Cervical Spinal Manipulation Therapy with Different Cervical Spine Positions on Cervical Spondylopathy of Nerve-root Type

目的:观察患者颈椎处于不同体位下应用拔伸旋转手法治疗神经根型颈椎病的治疗效果。方法:将276例神经根型颈椎病患者随机分成三组,分别在颈椎保持前屈位、中立位、后伸位体位下采用拔伸旋转手法治疗。观察三组患者颈椎病的症状体征、临床疗效、主观疼痛及颈部残障指数(NDI)评分。结果:治疗2周后,各组患者症状体征量表各项目评分及总分较治疗前均有所提高(P<0.05);治疗后,后伸位组症状体征量表总积分优于中立位组,中立位组症状体征量表总积优于前屈位组。治疗后,三组患者间总有效率及主观疼痛评分比较差异均存在显著性,后伸位组优于中立位组和前屈位组(P<0.05);NDI评分后伸位组(0.18±0.07)显著低于中立位组(0.24±0.05)和前屈位组(0.29±0.06)(P<0.05)。结论:对于神经根型颈椎病患者采用拔伸旋转手法治疗时,在20度范围内,患者后伸位的临床疗效优于中立位和前屈位。

Objective： To observe the clinical effects of cervical spinal manipulation therapy on cervical spondylopathy of nerve-root type with different cervical spine positions（ extension,neutrality or flexion position of cervical spine）. Method： A total of 276 patients with cervical spondylopathy of nerve-root type treated in our clinic were randomly and medially divided into three groups ： extension position group,neutrality position group and flexion position group. Every patient received cervical spinal manipulation therapy with extension,neutrality or flexion positions of cervical spine. The signs and symptoms of cervical disease,clinical effect,subjective pain and neck disability index（ NDI） score of three groups were calculated and compared.Result： After two weeks of treatment,the symptoms and signs Scale and total score of patients in the three groups were impoved（ P〈0.05）; the symptoms and signs scale and total score of extension group was better than that of the other twogroups after treatment（ P〈0.05）. There were significant differences among three groups in total effective rate and subjective pain score（ P〈0.05）,and the effect of extension group was better than other two groups. The NDI score of extension group（ 0.18 ± 0.07） was less than that of the other two groups（ 0.24 ± 0.05,0. 29 ± 0. 06）（ P〈0. 05）. Conclusion： When cervical spondylopathy of nerve-root type patients treated with cervical spinal manipulative therapy within 20 angles of cervical spine,the clinical effect of cervical spinal manipulation therapy with extension position of cervical spine was better than that of the neutrality and flexion positions.