旋提手法治疗颈型颈椎病的临床疗效观察

Clinical Efficacy Observation on Neck-type Cervical Spondylopathy Treated with Rotating and Lifting Manipulations

【目的】观察旋提手法治疗颈型颈椎病(NTCS)患者的临床疗效及其对颈椎曲度的影响。【方法】将36例NTCS患者随机分为治疗组和对照组,每组各18例。治疗组给予旋提手法治疗,对照组给予颈椎牵引治疗,疗程为2周。观察2组患者治疗前后颈部疼痛视觉模拟量表(VAS)评分、症状体征总评分(包括颈部疼痛评分、颈部压痛评分、颈椎活动度评分)及颈椎曲度测量值的变化情况,并评价2组患者的临床疗效。【结果】(1)脱落情况:研究过程中,治疗组脱落1例,对照组无脱落病例,最终治疗组和对照组分别有17例和18例患者完成全部疗程的治疗。(2)疗效情况:治疗2周后,治疗组的总有效率为100.0%(17/17),对照组为72.2%(13/18);组间比较,治疗组的总有效率(Fisher确切概率法)和总体疗效(秩和检验)均明显优于对照组,差异均有统计学意义(P<0.05)。(3)症状体征评分情况:治疗后,2组患者的颈部疼痛VAS评分、症状体征总评分均较治疗前明显降低(P<0.05),且治疗组的降低作用均明显优于对照组,差异均有统计学意义(P<0.05)。(4)颈椎曲度情况:治疗后,2组患者的颈椎曲度均较治疗前明显改善(P<0.05),且治疗组的改善作用略优于对照组,组间治疗前后差值比较,差异有统计学意义(P<0.05)。【结论】旋提手法治疗NTCS患者疗效确切,能有效缓解颈部疼痛、活动不利症状,恢复颈椎生理曲度,其疗效明显优于颈椎牵引治疗。

Objective To investigate the clinical effect of rotating and lifting manipulations in treating neck-type cervical spondylopathy(NTCS)and to observe the influence on cervical curvature of the patients.Methods Thirtysix NTCS patients were randomly divided into treatment group and control group,with 18 patients in each group.The treatment group was treated with rotating and lifting manipulations and the control group was treated with cervical traction for 2 weeks.The changes in visual analogue scale(VAS)scores of neck pain,total symptom and sign scores(including neck pain scores,neck tenderness scores and the scores of cervical range of motion)and cervical spine curvature measurements in the two groups before and after treatment were observed,and the clinical efficacy of the two groups was evaluated after treatment.Results(1)During the trial,there was one case falling off in the treatment group and no case falling off in the control group.A total of 17 patients in the treatment group and 18 patients control group completed the full course of treatment.(2)After 2 weeks of treatment,the overall effective rate of the treatment group was 100.0%(17/17)and that of the control group was 72.2%(13/18).The intergroup comparison showed that the overall effective rate(by Fisher’s precision probability test)and the overall efficacy(by rank sum test)of the treatment group were significantly superior to those of the control group,and the differences were statistically significant(P<0.05).(3)After treatment,the VAS scores of neck pain and the overall scores of symptoms and signs in the two groups were significantly decreased compared with those before treatment(P<0.05),and the effect on reducing the above scores in the treatment group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(4)After treatment,the cervical curvature of both groups was significantly improved compared with that before treatment(P<0.05),and the effect on improving cervical curvature in the treatment group was slightly superior to that in the control group.The difference of the pre-and post-treatment difference value between the two groups was statistically significant(P<0.05).Conclusion Rotating and lifting manipulations exert certain effect in treating NTCS patients by effectively relieving neck pain and dysfunction of the neck and restoring the physiological curvature of the cervical spine.Its efficacy is superior to that of the cervical traction therapy.