脊柱微调手法治疗神经根型颈椎病的临床推广应用研究

Clinical application of the spine fine-tuning manipulation in the treatment of cervical spondylotic radiculopathy

目的评价不同类型医院不同医生使用脊柱微调手法治疗神经根型颈椎病的临床疗效。方法从10家不同类型医院推拿科挑选20名医生进行脊柱微调手法培训,考核合格后用本手法治疗神经根型颈椎病患者,每周3次,共4周,共收集了273例病例,然后分析不同医院医生治疗前后患者疼痛评分(VAS)、颈椎功能障碍指数评分(NDI)、健康调查简表(SF-36)评分变化情况,以及治疗后临床疗效和组间VAS、NDI、SF-36的差异。结果各医院患者治疗前比较,三个观察指标VAS、NDI、SF-36等评分差异均没有统计学意义;而治疗后三个指标VAS、NDI、SF-36等评分均明显低于治疗前,差异有统计学意义(P<0.05)。岳阳医院(A组)与4家三、二级中医院(B组)、5家社区医院(C组)治疗后相比,VAS、NDI、SF-36等评分差异及各组之间临床疗效结果差异均无统计学意义(P>0.05)。结论脊柱微调手法治疗神经根型颈椎病安全有效,手法简便快捷,操作流程标准规范,经过培训,手法操作者的临床使用具有同质性,值得广泛推广。

Objective To evaluate the clinical effects of the spine fine-tuning manipulation in the treatment of cervical spondylotic radiculopathy by different doctors in different hospitals.Methods Twenty doctors were selected from the Tuina department of 10 different types of hospitals for the training of spine fine-tuning manipulation.After passing the examination,patients with cervical spondylotic radiculopathy were treated with this technique,three times a week for a total of 4 weeks.A total of 273 cases were collected.Then,the scores changes in the Visual Analogue Scales(VAS),Neck Disability Index(NDI)and Health Survey Short Form(SF-36)before and after treatment were analyzed,and the clinical efficacy and differences of the VAS,NDI,SF-36 were compared between the various groups after treatment.Results There was no significant difference in the VAS,NDI and SF-36 scores before treatment,while the three observation indicators after treatment were significantly lower than those before treatment,and the differences were statistically significant(P<0.05).There was no significant difference in the VAS,NDI and SF-36 scores between the Yueyang Hospital(Group A),4 tertiary and secondary TCM hospitals(Group B)and 5 community hospitals(Group C)after treatment(P>0.05).There was no significant difference in clinical efficacy between the groups(P>0.05).Conclusion The spine fine-tuning manipulation is safe and effective in the treatment of cervical spondylotic radiculopathy,characterized by its simple and fast manipulations,standardized operation procedure,and homogeneous clinical use by trained manipulation operators,which is worthy of wide promotion.