“上病下治”整脊法治疗神经根型颈椎病的疗效观察

Clinical Observation of the Chiropractic Therapy Based on the Principle of“Alleviating the Diseases in the Upper Part by Treating the Lower Part”for the Treatment of Cervical Spondylotic Radiculpathy

【目的】评价“上病下治”整脊法治疗神经根型颈椎病的临床疗效。【方法】采用回顾性分析方法,收集2020年10月至2022年5月在深圳市中医院推拿科住院治疗的神经根型颈椎病患者160例,根据治疗方法的不同,将患者分为治疗组和对照组,每组各80例。对照组给予常规推拿手法治疗,治疗组给予“上病下治”整脊法治疗,每周4次,4次为1个疗程,共治疗2个疗程。观察2组患者治疗前后疼痛视觉模拟量表(VAS)评分和颈椎活动度指标的变化情况,并评价2组患者的临床疗效。【结果】(1)经过2个疗程治疗后,治疗组的总有效率为92.50%(74/80),对照组为77.50%(62/80),组间比较,治疗组的疗效明显优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的疼痛VAS评分均较治疗前明显降低(P<0.05),且治疗组的降低作用明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗后,2组患者的颈椎前屈、后伸、左侧屈、右侧屈、左旋转、右旋转等颈椎活动度指标均较治疗前改善(P<0.05),且治疗组的改善作用均明显优于对照组,差异均有统计学意义(P<0.05)。【结论】“上病下治”整脊法治疗神经根型颈椎病疗效显著,可有效减轻患者疼痛症状,提高患者颈椎活动度,改善患者生活质量,其疗效优于常规推拿手法治疗。

Objective To evaluate the clinical efficacy of chiropractic therapy based on the principle of“alleviating the diseases in the upper part by treating the lower part”(Shangbing Xiazhi)in treating cervical spondylotic radiculpathy(CSR).Methods A retrospective analysis was conducted in 160 patients with CSR who were hospitalized in the Department of Massage of Shenzhen Traditional Chinese Medicine Hospital from October 2020 to May 2022.The patients were divided into a treatment group and a control group according to the treatment method,with 80 cases in each group.The control group was treated with conventional massage manipulations,while the treatment group was treated with the Shangbing Xiazhi chiropractic therapy.Both groups were treated for 4 times a week,4 times constituting a course of treatment,and the treatment lasted for 2 courses.The changes in pain visual analogue scale(VAS)scores and cervical motion indicators of the two groups were observed before and after treatment,and then the clinical efficacy of the two groups was evaluated.Results(1)After 2 courses of treatment,the overall effective rate of the treatment group was 92.50%(74/80)and that of the control group was 77.50%(62/80),and the intergroup comparison showed that the efficacy of the treatment group was significantly superior to that of the control group,and the difference was statistically significant(P<0.05).(2)After treatment,the pain VAS scores of patients in both groups were significantly decreased compared with those before treatment(P<0.05),and the effect on lowering the VAS scores of the treatment group was significantly superior to that of the control group,the difference being statistically significant(P<0.05).(3)After treatment,the cervical motion indicators of anterior flexion,posterior extension,left lateral flexion,right lateral flexion,left rotation and right rotation in both groups were improved compared with those before treatment(P<0.05),and the effect on improving the cervical motion indicators of the treatment group was significantly superior to that of the control group,the difference being statistically significant(P<0.05).Conclusion The Shangbing Xiazhi chiropractic therapy for CSR exerts certain effect on alleviating pain symptoms,increasing the cervical range of motion and improving the quality of life of patients,and its efficacy is superior to conventional massage manipulations.