低头摇正法联合桂枝加葛根汤治疗神经根型颈椎病的临床研究

Clinical Study of Head-Lowering Chiropractic Therapy Combined with Guizhi and Gegen Decoction in the Treatment of Cervical Spondylotic Radiculopathy

【目的】探讨龙氏治脊疗法之低头摇正法治疗神经根型颈椎病(CSR)的临床疗效。【方法】将60例CSR患者随机分为治疗组和对照组,每组各30例。对照组给予传统推拿手法治疗,治疗组给予龙氏治脊疗法之低头摇正法治疗,在此基础上,2组患者均给予桂枝加葛根汤加减治疗,10 d为1个疗程,共治疗2个疗程。观察2组患者治疗前后颈痛视觉模拟量表(VAS)评分、颈椎功能障碍指数(NDI)和田中靖久颈椎病症状量表(TTYS)评分的变化情况,并评价2组患者的临床疗效和安全性。【结果】(1)经2个疗程治疗后,治疗组的总有效率为96.7%(29/30),对照组为80.0%(24/30),组间比较,治疗组的疗效明显优于对照组(P<0.05)。(2)治疗后,2组患者的VAS评分和NDI指数均较治疗前明显下降(P<0.01),且治疗组对VAS评分和NDI指数的降低作用均明显优于对照组(P<0.01)。(3)治疗后,2组患者TTYS的症状评分、体征评分、工作和生活能力评分、手的功能评分及总分均较治疗前明显升高(P<0.01),且治疗组的升高作用均明显优于对照组(P<0.01)。(4)治疗过程中,2组患者均未出现疼痛加重、骨折等不良反应。【结论】对于神经根型颈椎病患者,采用低头摇正法联合桂枝加葛根汤或常规推拿手法联合桂枝加葛根汤治疗,均能缓解颈部疼痛,增大颈椎活动度的灵活性,促进颈椎功能的恢复,但低头摇正法联合桂枝加葛根汤治疗的总体疗效更为显著。

Objective To investigate the clinical effect of Long’s head-lowering chiropractic therapy combined with Guizhi and Gegen Decoction in the treatment of cervical spondylotic radiculopathy(CSR).Methods Sixty patients with CSR were randomly divided into treatment group and control group,30 patients in each group.The treatment group was treated with head-lowering chiropractic therapy,the control group was treated with traditional massage therapy,and then the patients in both groups were treated with modified Guizhi and Gegen Decoction.Ten days constituted one courses of treatment and the treatment lasted 2 courses.The changes of visual analogue scale(VAS)scores,neck dysfunction index(NDI)and the total Tanaka Yasuhisa 20-Score Scale(TTYS)scores for cervical spondylopathy in the two groups were observed before and after treatment,and the clinical efficacy and safety of two groups were evaluated after treatment.Results(1)After 2 courses of treatment,the total effective rate of the treatment group was 96.7%(29/30),and that of the control group was 80.0%(24/30).The intergroup comparison showed that the curative effect of the treatment group was superior to that of the control group(P<0.05).(2)After treatment,the VAS scores and NDI in the two groups were significantly decreased compared with those before treatment(P<0.01),and the effect on decreasing VAS scores and NDI in the treatment group was significantly superior to that in the control group(P<0.01).(3)After treatment,the symptom scores,sign scores,scores of working and ability of daily life,hand function score and overall TTYS scores in the two groups were significantly improved in comparison with those before treatment(P<0.01),and the effect on increasing the scores in the treatment group was significantly superior to that in the control group(P<0.01).(4)During the treatment,no adverse reaction such as aggravation of pain and fracture occurred in the two groups.Conclusion For the treatment of cervical spondylotic radiculopathy(CSR),both head-lowering chiropractic therapy combined with Guizhi and Gegen Decoction and conventional massage manipulation combined with Guizhi and Gegen Decoction are effective on relieving neck pain,increasing the range of motion of cervical vertebrate,and promoting the recovery of cervical vertebrate function for patients with CSR.However,the head-lowering chiropractic therapy combined with Guizhi and Gegen Decoction has performed a more significant therapeutic effect.