柔式正骨治疗寰枢椎半脱位临床研究

Clinical Study on Flexible Bone Setting for Atlanto-Axial Subluxation

目的:观察柔式正骨治疗寰枢椎半脱位临床效果。方法:将80例寰枢椎半脱位的患者随机分为2组。对照组予常规的治疗方法解痉松肌法、整复错位法、理筋顺络法三步法治疗;治疗组予柔式正骨四步法治疗。观察比较2组临床疗效、日本骨科协会(JOA)颈椎评分、DR寰齿前间隙差值、DR寰齿侧间隙差值、临床症状、体征积分以及随访6个月后复发率情况。结果:临床疗效总有效率治疗组97.5%,对照组87.5%,2组总有效率比较,差异有统计学意义(P<0.05)。治疗后,2组JOA颈椎评分、DR寰齿前间隙差值、DR寰齿侧间隙差值与本组治疗前比较,差异均有统计学意义(P<0.05),2组间上述各项指标比较,差异均有统计学意义(P<0.05)。治疗后,2组临床症状积分比较,差异均有统计学意义(P<0.05)。治疗后,2组体征积分比较,差异均有统计学意义(P<0.05)。随访6个月后,2组复发率比较,差异有统计学意义(P<0.05)。结论:柔式正骨治疗寰枢椎半脱位有良好的临床疗效,能改善JOA颈椎评分、DR寰齿前间隙差值、DR寰齿侧间隙差值,效果优于普通治疗的三步法。

Objective:To observe the clinical effect of flexible bone setting on atlanto-axial subluxation. Methods:A total of 80 cases with atlanto-axial subluxation were randomly divided into two group. The control group was adopted with conventional three-step treatment including spasmolytic and muscle-loosing method,reconstructive dislocation method,sinew-reinforcing and collaterals-normalizing method. The treatment group was adopted with four-step treatment of flexible bone setting. The clinical effect, cervical spine score of JOA, difference of DR atlanto-dental interval, difference of DR variance of bilateral lateral atlanto dental space,score of clinical symptoms and signs,and the recurrence rate after half a year of follow-up were all observed and compared between the two groups. Results:The total effective rate was 97.5% in the treatment group and 87.5% in the control group,the difference being significant(P<0.05). After treatment,there were significant differences in the comparison of JOA score, difference of DR atlanto-dental interval, and difference of DR variance of bilateral lateral atlanto dental space when compared with those in the same group before treatment(P<0.05). After treatment,there were significant differences in the comparison of the above indexes between the two groups(P<0.05). After treatment,there were significant differences in the comparison of scores of clinical symptoms between the two groups(P<0.05). After treatment,there were significant differences in the comparison of scores of body signs between the two groups(P<0.05). After six-month follow-up,there was significant difference in the comparison of the recurrence rate between the two groups(P<0.05). Conclusion:Flexible bone-setting has great clinical effect in treating atlanto-axial subluxation,which can improve JOA score,difference of DR atlanto-dental interval,and difference of DR variance of bilateral lateral atlanto dental space,whose effect is better than the common three-step treatment.