推拿联合药物治疗颈型颈椎病的疗效及其对患者颈椎前凸角影响的回顾性分析

Therapeutic Effects of Tuina and Medicine in the Treatment of Cervical Spondylosis and Retrospective Analysis of Its Influnece on Cervical Lordosis Angle

目的:观察推拿手法联合药物治疗颈型颈椎病的临床疗效及其对患者颈椎前凸角的影响。方法:回顾性分析辽宁中医药大学附属第二医院2018年1月至2020年1月68例颈型颈椎病患者诊治资料,其中接受单纯药物治疗者34例纳入药物(颈痛颗粒与乙哌立松片)组,接受药物(颈痛颗粒与乙哌立松片)和推拿联合治疗者34例纳入联合治疗组。采用视觉模拟量表(visual analog scale,VAS)评分评估患者疼痛情况;采用影像学方法评价患者颈椎曲度改变情况;采用多功能颈椎测试训练系统比较治疗前后患者颈椎活动度(包括前屈、后伸、左旋及右旋)。结果:联合治疗组有效率高于药物组(P<0.05)。治疗1月后药物组VAS评分降低(P<0.05),治疗1周后联合治疗组VAS评分降低(P<0.01);治疗3月后联合治疗组患者颈椎前凸角增加(P<0.05)。治疗1周、1月及3月联合治疗组VAS评分均低于药物组(分别P<0.05)。治疗后两组患者颈椎前屈、后伸、左旋及右旋活动度均较治疗前增加(P<0.05),联合治疗组优于药物组(P<0.05)。结论:推拿联合药物治疗可有效减轻颈型颈椎病患者疼痛症状,增加颈椎前凸角,改善颈椎活动度,效果优于药物治疗。

Objective:To observe clinical effects of Tuina and medicine in the treatment of cervical spondylosis,and discuss its influnece on cervical lordosis angle.Methods:The data of the diagnosis and treatment of 68 patients with cervical spondylosis in our hospital between January,2018 and January,2020 were retrospectively analyzed,among them,34 patients who accepted single therapy of medicine Jingtong granules and eperisone tablets were included in the medicine group,34 ones who accepted medicine Jingtong granules and eperisone tablets and Tuina were chosen as the combined treatment group.VAS scores were used to assess pain improvements the patients;imaging method was adopted to assess the changes of cervical curvature between both groups;multifunctional cervical spine testing and training system was used to compare cervical spine range of motion(ROM)(including antexion,rear protraction,left and right rotation) before and after the treatment.Results:The effective rate of the combined treatment group was higher than that of the medicine group(P<0.05).VAS of the medicine group decreased after one month of the treatment(P<0.05),VAS of the combined treatment group lowered after one week of treatment(P<0.01);the patients’ cervical lordosis angle of the combined treatment group increased after three months of the therapy(P<0.05).VAS of the combined treatment group was lower than that of the medicine group after one week,one month and three months of the treatment(respectively P<0.05).After the treatment,cervical flexion,extension,left and right rotation ROM of both groups incnreased than these before the treatment(P<0.05),the combined treatment group was better than the medicine group(P<0.05).Conclusion:Tuina and medicine could effectively relieve pain in patients with cervical spondylosis,increase cervical lordosis angle,improve ROM,and its effects are superior to medicine therapy.