仰卧位旋转扳法联合针刺治疗寰枢关节半脱位的临床观察

Clinical observation on the treatment of Atlanto-axial joint subluxation with supine rotating manipulation combined with acupuncture

目的 运用仰卧位旋转扳法联合针刺治疗寰枢关节半脱位,观察临床疗效,探讨其治疗机制。方法 将60例确诊为寰枢关节半脱位的患者按随机数字表分成对照组和观察组各30例,对照组采用颈部推拿松解与仰卧位旋转扳法治疗,观察组在其基础上加用针刺天柱穴治疗,两组均隔日治疗1次,共3次。比较治疗前后视觉模拟评分法(VAS)评分、颈性眩晕症状与功能评估量表(ESCV)评分和复发率。结果 治疗后两组VAS与ESCV评分均较治疗前有显著下降(P<0.05),且观察组优于对照组(P<0.05)。治疗后,观察组总复发率低于对照组(P<0.05)。观察组总有效率100%高于对照组的93.3%,差异具有统计学意义(P<0.05)。结论 仰卧位旋转扳法联合针刺治疗寰枢关节半脱位可针对病因,柔筋正骨,恢复颈椎正常的解剖位置,取得良好疗效。

Objective To observe the clinical effect and explore the therapeutic mechanism of supine rotating manipulation combined with acupuncture in the treatment of Atlanto-axial joint subluxation.Methods 60 patients diagnosed as Atlanto-axial joint subluxation were divided into a control group and an observation group according to the random number table,30 cases in each group.The control group was treated with neck massage relaxation and supine rotation manipulation method,and the observation group was treated with acupuncture at Tianzhu acupoint on the basis of that.Both groups were treated once every other day,three times in total.The visual analogue scale(VAS)score,the evaluation scale for cervical vertigo(ESCV)score,and the recurrence rate before and after treatment were compared.Results After treatment,the VAS and ESCV scores of both groups showed a significant decrease compared with before treatment(P<0.05),and the observation group was better than the control group(P<0.05).After treatment,the total recurrence rate of the observation group was lower than that of the control group(P<0.05).The total effective rate of the observation group was 100%,higher than 93.3%of the control group,and the difference was statistically significant(P<0.05).Conclusion The treatment of Atlanto-axial joint subluxation by supine rotating manipulation combined with acupuncture can aim at the cause,soften tendons and set bones,restore the normal anatomical position of cervical spine,and achieve good results.