针刀联合端提旋转手法治疗神经根型颈椎病的病例对照研究

Randomized controlled trials of needle-knife therapy combined with rotation-traction manipulation for the treatment of cervical spondylotic radiculopathy

目的 :比较针刀联合旋提手法与单纯旋提手法治疗神经根型颈椎病患者的临床疗效,探讨针刀治疗神经根型颈椎病的作用机制,为临床治疗提供依据。方法:2013年11月至2015年6月,将符合纳入标准的神经根型颈椎病80例患者随机分为治疗组和对照组,对照组39例,单纯采用旋提手法,每日1次,2周为1个疗程,连续治疗1个疗程;治疗组41例,采用针刀联合旋提手法治疗,1周1次,针刀治疗后观察30 min,如患者无特殊不适则开始进行手法治疗,手法同对照组,每日1次,2周为1个疗程,连续治疗1个疗程,观察两组治疗前后症状、体征积分变化及临床综合疗效。结果:两组患者治疗后,各症状体征积分均较治疗前明显下降(P<0.05),且治疗组优于对照组(P<0.05)。治疗组痊愈19例,显效16例,有效5例,无效1例;对照组痊愈10例,显效10例,有效16例,无效3例;两组比较差异有统计学意义(P<0.01),治疗组优于对照组。结论:针刀联合旋提手法治疗神经根型颈椎病优于单纯手法治疗,可改善局部血液循环,降低局部致痛物质的含量,增加体内生成的抗痛物质,疏通经络,可使机体在新的基础上达到新的静态和动态平衡。

Objective：To compare the therapeutic effects between needle-knife therapy combined with rotation- traction manipulation and rotation-traction manipulation for the treatment of cervical spondylotic radiculopathy.Methods：From November 2013 to June 2015,80 patients with cervical spondylotic radiculopathy meeting the inclusion criteria were divided into two groups randomly：the control group in which 39 patients were treated with rotation- traction manipulation,and the treatment group in which 41 patients were treated with needle-knife combined with rotation-traction manipulation.The patients in the control group were treated once dayly for 2 weeks,which was 1 course.The patients in the treatment group were treated with needle-knife firstly once a week for 2 weeks,which was 1 course;then were treated with the same methods as the patients in the control group.The symptoms,signs score and the therapeutic effects of the two groups before and after treatment were observed.Results：After treatment,symptoms and signs scores declined in both groups（P〈0.05）.The results of the treatment group were better than effects in the control group（P〈0.05）.In the treatment group,19 patients got an excellent result,16 good,5 fair and1 bad;while in the control group,10 patients got an excellent result,10 good,16 fair and 3 bad;the results of the treatment group were better than the results of the control group（P〈0.01）.Conclusion：Needle-knife combined with rotation-traction manipulation is an effective method for the treatment of cervical spondylotic radiculopathy,which is better than using manipulation method simply.Needle-knife therapy has follow advantages：improving local blood circulation,reducing local content of pain substance,increasing production of substances resisting pain,opening channels and collaterals,and make body reaching new static and dynamic balance on the new foundation.