基于颈部软组织张力探讨悬吊循经弹拨结合麦肯基疗法对颈型颈椎病的疗效及机制

Exploring the Effect and Mechanism of Suspension Transmenstrual Meridian Plucking Combined with McKenzie Therapy on Cervical Spondylotic Localization Based on the Soft Tissue Tension of the Neck

目的比较悬吊循经弹拨结合麦肯基疗法与两者分别单一治疗颈型颈椎病的临床疗效差异并探讨其疗效机制。方法将88例符合标准的患者按照随机数字表法分为综合组(29例)、对照1组(30例)、对照2组(29例)。对照1组采用悬吊循经弹拨法,对照2组采用麦肯基疗法,综合组将对照组的治疗方法相结合,5 d为1疗程,共观察2个疗程。应用颈椎病临床评价量表(clinical assessment scale for cervical spondylosis,CASCS)、利用表面肌电图比较2个疗程治疗前后颈椎功能情况以及胸锁乳突肌、斜方肌上部纤维平均功率频率(mean power frequency,MPF)和中位频率(median frequency,MF)数值变化(对应肌肉的疲劳度改变)。结果治疗结束后,综合组总有效率96.55%,优于对照1组总有效率80.00%和对照2组75.86%(P<0.05或P<0.01),且综合组颈椎功能情况及胸锁乳突肌、斜方肌上部纤维MPF、MF值的治疗效果均优于对照1组和对照2组,组间差异有统计学意义(P<0.05或P<0.01)。结论悬吊循经弹拨法结合麦肯基疗法能有效治疗颈型颈椎病,其效果优于单纯悬吊循经弹拨法和单纯麦肯基疗法,能更好地修复颈部软组织张力,实现生物力学平衡,恢复颈椎运动功能,因此临床上可推广此法治疗颈型颈椎病。

Objective To compare the difference in clinical efficacy between the suspension transmenstrual meridian plucking combined with McKenzie therapy and the two in the single treatment of cervical spondylotic localization,and to explore the mechanism of its curative effect.Methods A total of 88 patients meeting the standards were divided into a comprehensive group(29 cases),a control group 1(30 cases),and a control group 2(29 cases)according to the random number table method,and 5 days as a course of treatment,a total of 2 courses of observation.The control group 1 used suspension transmenstrual meridian plucking method.The control group 2 used McKenzie therapy.The comprehensive group combined the methods of the control groups.The clinical assessment scale for cervical spondylosis(CASCS)and surface electromyography were used to compare the cervical spine function,and the changes(corresponding to changes in muscle fatigue)of mean power frequency(MPF)and median frequency(MF)of the sternocleidomastoid muscle and trapezius muscle fibers before and after treatment of 2 courses.Results After the treatment,the total effective rate of the comprehensive group was 96.55%,which was better than the total effective rate of the control group 1(80.00%)and the control group 2(75.86%)(P<0.05 or P<0.01),and the cervical spine function and the treatment effect of MPF and MF value of sternocleidomastoid muscle and trapezius muscle fibers in the comprehensive group was better than that of control group 1 and control group 2.The difference between groups was statistically significant(P<0.05 or P<0.01).Conclusion Suspension transmenstrual meridian plucking combined with McKenzie therapy can effectively treat cervical spondylotic localization.Its effect is better than the simple suspension transmenstrual meridian plucking method and the simple McKenzie therapy.It can repair the soft tissue tension of the neck better,achieve the biomechanical balance,and restore cervical spine motor function.Therefore,this method can be promoted clinically to treat cervical spondylotic localization.