个体化牵引治疗椎动脉型颈椎病的临床研究

Clinical Research on Individualized Traction for Treating Cervical Spondylosis of Vertebral Artery Type

目的:以个体化牵引为核心治疗理念,通过自行研发的可调式颈椎固定牵引器对椎动脉型颈椎病患者行个体化牵引及制动,结合中药湿热敷治疗,观察临床治疗效果,进行疗效评价。方法:2015年1月至2015年12月共收集椎动脉型颈椎病住院患者180例,按住院日期单双数分为两组,可调式颈椎固定牵引器结合中药湿热敷(观察组)90例,充气式颈椎牵引器结合中药湿热敷(对照组)90例。通过彩色多普勒测量治疗前后左、右椎动脉和基底动脉的收缩期峰值血流速度、平均血流速度、搏动指数、阻力指数等血流参数,并进行比较分析。分别对患者治疗前后的颈椎活动度、颈部压痛、颈部疼痛等指标的评分、睡眠工作影响积分和总积分的改善指数和总的有效率进行观察,2周后观察疗效。结果:两组患者治疗后观察组痊愈76.1%、显效14.5%、好转6.3%、无效3.1%、总有效率96.9%;对照组痊愈55.7%、显效12.7%、好转10.9%、无效20.7%、总有效率80.3%。两组间治愈率和有效率比较差异均有统计学意义(P<0.05),观察组疗效明显优于对照组。结论:牵引是治疗椎动脉型颈椎病的有效方法,采用可调式颈椎牵引器进行个体化牵引,临床疗效优于采用充气式颈椎牵引器的伸直位或过伸位牵引。

Objective：With individualized traction as the core treatment concept,the goal of the study was to observe and evaluate the curative effect of adjustable cervical fixation tractor combined with traditional Chinese medicine sticking therapy of damp-heat for treating patients with cervical spondylosis of vertebral artery type.Methods：From January 2015 to December 2015,180 cases of inpatients with cervical spondylosis of vertebral artery type were enrolled.They were divided into 2 groups according to the odd or even dates of their hospitalization,90 cases in each group.The observation group patients were taken the adjustable cervical fixation tractor combined with traditional Chinese medicine sticking therapy of damp-heat;and the control group patients were taken the inflatable cervical fixation tractor combined with traditional Chinese medicine sticking therapy of damp-heat.The systolic peak velocity,the mean velocity of blood flow,pulsatility index,resistance index and other flow parameters in left and right of vertebral artery and basilar artery were measured by color Doppler before and after treatment.The scores of cervical motion,neck tenderness,neck pain and other indicators,the effects of work and sleep on integral,the improvement index of total integral,and the total effective rate were observed respectively before and after treatment.The efficacy was observed 2 weeks after treatment.Results：After treatment,the cure rate of the observation group was 76.1%,the explicit efficiency was 14.5%,the improvement rate was 6.3%,the inefficiency was 3.1%,and the total effective rate was 96.9%;while the cure rate of the control group was 55.7%,the explicit efficiency was 12.7%,the improvement rate was 10.9%,the inefficiency was 20.7%,and the total effective rate was 80.3%.The cure rate and the effective rate between two groups was statistical different（P〈0.05）,and the efficacy in observation group was superior to that ofcontrol group.ConclusionTraction is effective in the treatment of the cervical spondylosis of vertebral artery type.Adopting with individualized traction,the adjustable cervical fixation tractor is superior to the inflatable cervical fixation tractor with hyper extended in clinical efficacy.