传统针灸推拿基础上联用McKenzie疗法对神经根型颈椎病患者颈椎功能及电生理指标的影响

Effects of Mc Kenzie on the basis of traditional acupuncture and massage therapy on functional and electrophysiological index in patients with cervical nerve root type cervical spondylosis

目的探讨神经根型颈椎病(Cervical Spondylotic Radiculopathy,CSR)在传统针灸、推拿治疗的基础上,联合采用Mc Kenzie疗法的临床价值。方法自2014-03-2016-03随机纳入了129例CSR患者,采用随机数字表法分为联合组60例与对照组69例。其中,对照组单纯采用传统的针灸、推拿治疗,联合组在传统针灸、推拿的基础上联用Mc Kenzie疗法。治疗2个疗程后,对两组患者的颈椎功能、电生理指标和疗效进行对比。结果 129例中,脱落3例(未完成2个疗程1例,擅自联合其他疗法2例),均为对照组患者;最终纳入126例,其中联合组60例,对照组66例。颈椎功能评分:联合组治疗后评分及治疗前后差值,均显著高于对照组(P<0.05);且改善指数也明显大于对照组(P<0.05)。电生理指标:两组治疗后,强度-时间曲线的最短反应时和时值均有明显改善(P<0.05);组间对比,联合组的时值在治疗后显著低于对照组(P<0.05)。疗效对比:联合组治疗后,总有效率为93.3%,显著高于对照组的81.8%,差异有统计学意义(P<0.05)。结论在传统针灸、推拿的基础上,联用Mc Kenzie疗法治疗CSR患者,其颈椎功能与电生理指标均有明显改善,可显著提高疗效,值得推广应用。

Objective To investigate the clinical value of McKenzie therapy in the treatment of cervical spondylotic radiculopathy （CSR） on the basis of traditional acupuncture and massage. Methods From March 2014 to March 2016, 129 patients with CSR were randomly divided into combined group （n=60） and control group （n=69）. The control group was treated with acupuncture and massage therapy, the combined group was given McKenzie therapy on the basis of traditional acupuncture and massage. After 2 courses of treatment, the function of the cervical spine in the two groups was compared. Results Of 129 cases, there were 3 cases lost （no completion of the course of treatment of 1 case, combined with other therapies in 2 cases）, all of them were in the control group, and finally 126 cases were included in the study, there were 60 patients in the combined group and 60 patients in the control group. Cervical spine function score： the score of the combined group and the difference between before and after treatment were significantly higher than those in the control group （P〈0.05）, and the improvement index was significantly higher than that of the control group （P〈0.05）. Electrophysiological index： after treatment, the shortest reaction intensity time curve and duration in two groups were significantly improved （P〈0.05）; those in the combination group were significantly lower than the control group after treatment （P〈0.05）. Comparison of curative effect： the total effective rate of the combined group was 93.3%, which was significantly higher than 81.8% of the control group, and the difference was statistically significant （P〈0.05）. Conclusion On the basis of traditional acupuncture and massage, combined with McKenzie therapy in the treatment of patients with CSR can significantly improve the function of the cervical spine and electrophysiological index.