“强筋束骨”手法在青年颈型颈椎病防治中的应用

Clinical Trial of Neck Manipulations for Strengthening Tendons and Bones in Preventing and Treating Youth Cervical Spondylosis

【目的】观察颈部强筋束骨手法为主治疗颈型颈椎病的疗效和安全性。【方法】将符合颈性颈椎病诊断的119例患者随机分为试验组60例和对照组59例。试验组给予颈部强筋束骨手法为主治疗(颈部强筋束骨手法+穴位自我按摩手法+颈椎功能保健操治疗),对照组给予西医常规保守治疗(双氯芬酸钠缓释片口服+颈椎牵引+颈部制动治疗),于治疗前后及随访期对2组患者进行视觉模拟量表法(VAS)疼痛评分、Vernon颈废用指数(NDI)评分,并于治疗1个疗程后评价2组病例的临床疗效。【结果】(1)治疗1个疗程后,试验组的治愈率和临床总体疗效均优于对照组,差异均有统计学意义(P<0.01);且随访期间,对照组的总有效率有下降趋势,而治疗组的总有效率未见明显下降。(2)治疗1周、治疗2周后,2组患者的VAS疼痛评分、NDI评分均较治疗前改善(P<0.01),且试验组的改善作用均优于对照组(P<0.01)。随访1个月、2个月和3个月,试验组的改善作用也均优于对照组(P<0.01)。(3)在本研究过程中,无1例出现颈痛加重、头晕、呕吐、胸闷等不良反应。【结论】以颈部强筋束骨手法为主治疗与西医常规保守治疗均能改善颈型颈椎病的症状及体征,但以颈部强筋束骨手法为主治疗的试验组的疗效更明显、更持久。

Objective To evaluate the effectiveness and safety of neck manipulations for strengthening tendons and bones for the prevention and treatment of youth cervical spondylosis. Methods A total of 119 youth cervical spondylosis patients were randomized into trial group（60 cases） and control group（59 cases）. The trial group was mainly given neck manipulations for strengthening tendons and bones,and also treated with acupoint selfmassage and cervical function exercise. The control group was given oral use of Diclofenac Sodium Sustained Release Tablets together with neck cervical traction therapy and neck immobilization. Visual analogue scale（VAS）pain scores and Vernon neck disability index（NDI）scores were observed before and after treatment and during the follow-up. After treatment for one treatment course, the clinical efficiency of the two groups was evaluated. Results（1）After treatment for one treatment course,the cure rate and overall therapeutic effect of the trial group were better than those of the control group,the differences being significant（P 0.01）. During the follow-up, the overall therapeutic effect of the trial group remained steady while that of the control group showed a decreasing trend.（2） After treatment for one and two week（s）,VAS scores and NDI scores of both groups were much improved（P 0.01 compared with those before treatment）,and the improvement of the trial group was superior to that of the control group（P 0.01）. The improvement of VAS scores and NDI scores of the trial group was still superior to that of the control group on follow-up month 1,2,and 3.（3）No adverse reaction of severe neck ache,vertigo,vomiting or chest distress occurred in both groups. Conclusion Therapy characterized by neck manipulations for strengthening tendons and bones is as effective as conventional western medicine therapy on relieving the symptoms and signs of cervical spondylosis, and the effectivenss of manipulations is more stronger and more lasting.