恢刺法结合改良颈椎扳法治疗寰枢关节错位所致颈源性头痛的临床疗效观察

Clinical efficacy observation on the treatment of cervicogenic headache caused by atlantoaxial joint dislocation by the method of reinjection combined with the modified method of cervical rotation

目的:比较恢刺法结合改良颈椎扳法(仰卧旋颈侧扳法)与改良颈椎扳法治疗寰枢关节错位所致颈源性头痛(CEH)的临床疗效,探寻更加有效的方法,验证针推相须治疗该病的必要性。方法:将64例寰枢关节错位所致CEH患者随机分为观察组和对照组,各32例。观察组运用恢刺法结合改良颈椎扳法治疗(仰卧旋颈侧扳法),对照组运用改良颈椎扳法治疗。采用视觉模拟量表(VAS)评分、伴随症状总积分、颈椎活动度(ROM)评分和寰枢轴线差值进行评价。结果:治疗后,两组患者VAS评分、伴随症状总积分、颈椎ROM评分、寰枢轴线差值均较治疗前改善(P<0.05),且观察组各评分均优于对照组(P<0.05)。结论:基于“筋骨并举”思想的恢刺法结合改良颈椎扳法(仰卧旋颈侧扳法)能更加有效改善寰枢关节错位所致CEH患者的头痛及伴随症状,能更加有效改善患者颈椎ROM及寰枢关节错位状态。针推相须为用,疗效更佳,值得临床扩广。

Objective:To compare the reinjection combined with the modified method of cervical rotation(supine cervical side pulling method)and the modified method of cervical rotation in the treatment of cervicogenic headache(CEH)caused by atlanto axial joint dislocation,to find the more effective method,validation needle push phase must be the necessity for treatment of the disease.Methods:A total of 64 cases of CEH caused by atlantoaxial dislocation were randomly divided into observation group and control group,with 32 cases in each group.The observation group was treated with reinjection combined with modified method of cervical rotation(supine cervical side pulling method),while the control group was treated with modified method of cervical rotation.Visual analogue scale(VAS)score,total score of accompanying symptoms,cervical ROM score and atlas axis difference were used to evaluate.Results:After treatment,VAS score,total score of associated symptoms,cervical range of ROM score and atlas pivot line difference in 2 groups were allimproved compared with before treatment(P<0.05),and scores in the observation group were better than those in the control group(P<0.05).Conclusion:Based on the guidance of‘simultaneous lifting of muscles and bones’,the combination of reinjection and modified method of cervical rotation(supine cervical side pulling method)can more effectively improve the headache and associated symptoms of patients with CEH caused by atlantoaxial dislocation.It can more effectively improve patients’cervical mobility and atlantoaxial dislocation.Needle push phase must be used,the effect is better,worthy of clinical adoption and attention.