头颈部手法牵引旋转治疗颈椎小关节紊乱症疼痛的疗效

Manual traction and rotation therapy for the treatment of patients with cervical facet joint disorder

目的比较手法牵引旋转疗法和传统手法旋转疗法对颈椎小关节紊乱症的治疗效果。方法收集2012年1月至2017年1月南阳市第二人民医院骨一科门诊收治的颈椎小关节紊乱症患者132例,性别不限,年龄20~50岁,采用随机数字表法随机分为牵引旋转组和传统旋转组,每组66例。前者给予手法牵引旋转疗法,后者给予传统的手法旋转疗法。对患者治疗前及疗程结束后3d时进行视觉模拟评分(VAS)。根据疼痛缓解度的四级评估法评价疗效并比较两组的疗效。治疗后半年随访,观察复发情况。结果疗程结束后3d时,牵引旋转组66例中优效65例,无效者仅1例,有效率与优效率均为98.5%(65/66例);传统旋转组66例中54例有效,有效率为81.8%(54/66例),其中优效者47例,优效率为71.2%(47/66例)。两组有效率与优效率相比,差异均有统计学意义(P均<0.05)。结论手法牵引旋转治疗颈椎小关节紊乱症,方法简单疗效显著,优于传统手法旋转疗法。

Objective To investigate the therapeutic effect of manual traction and rotation therapy on patients with cervical facet joint disorder. Methods One hundred and thirty-two patients with cervical facet joint disorder, both sexes, 20-50 years old, were randomly divided into traction and rotation group (n=66) and traditional rotation group (n=66) from January 2012 to January 2017 in the First Department of Orthopedics of Nanyang Second General Hospital. The patients were given manual traction and rotation therapy in the traction and rotation group, and given traditional rotation therapy in the traditional rotation group. The VAS and efficacy of patients in the two groups were evaluated before and at the third day after the treatment. The pain relief rate and efficacy were evaluated by the four levels of pain score. The patients were followed up for six months to observe the recurrence. Results Sixty-five cases got excellent effect in the traction and rotation group with the effective rate and excellent rate of 98.5%(65/66 cases). Only one case was ineffective in this group. While fifty-four cases were of excellent effect in the traditional rotation group with the effective rate 81.8%(54/66 cases), and the excellent rate 71.2%(47/66 cases). The different of effective rate and excellent rate between the two groups was statistic significantly (all P<0.05). Conclusion The manual traction and rotation therapy is effective for the treatment of cervical facet joint disorder, and is superior to the traditional rotation therapy.