调筋正脊法治疗椎动脉型颈椎病临床研究

Clinical Study on Tendon-Regulating and Spine-Adjusting Method in the Treatment of Cervical Spondylosis of Vertebral Artery Type

目的:观察调筋正脊法治疗椎动脉型颈椎病(cervical spondylosis of vertebral artery type,CSA)的临床疗效。方法:回顾性分析2020年5月至2022年5月在盐城市中医院诊治的CSA患者83例,根据治疗方式的不同分为调筋正脊组50例和常规治疗组33例。常规治疗组给予常规推拿手法治疗,调筋正脊组在常规治疗组的基础上加用调筋正脊法治疗。观察两组患者治疗前后颈椎活动程度评分、颈椎弯曲程度、改良颈性眩晕症状与功能评价量表(evaluation scale for cervical vertigo,ESCV)评分、颈肌磁共振成像(magnetic resonance imaging,MRI)影像学指标、症状改善情况及临床疗效。结果:调筋正脊组有效率为94.00%,常规治疗组有效率为75.76%,调筋正脊组有效率高于常规治疗组,差异有统计学意义(P<0.05)。调筋正脊组治疗后颈椎活动程度评分低于常规治疗组,颈椎弯曲程度大于常规治疗组,差异有统计学意义(P<0.05)。调筋正脊组治疗后ESCV评分高于常规治疗组,差异有统计学意义(P<0.05)。调筋正脊组治疗后胸锁乳突肌长径、胸锁乳突肌短径短于常规治疗组,斜方肌长径、斜方肌短径长于常规治疗组,差异有统计学意义(P<0.05)。调筋正脊组治疗后头痛、肩颈痛和眩晕评分均高于常规治疗组,差异有统计学意义(P<0.05)。结论:调筋正脊法治疗CSA,能改善患者眩晕症状、颈椎功能、颈椎活动程度、颈椎弯曲程度。

Objective:To observe the clinical efficacy of tendon-regulating and spine-adjusting method on cervical spondylosis of vertebral artery type(CSA).Methods:A retrospective analysis was performed on 83 patients with CSA who were treated in Yancheng Hospital of Traditional Chinese Medicine from May 2020 to May 2022.According to different treatment methods,they were divided into the tendon-regulating and spine-adjusting group(n=50)and the conventional treatment group(n=33).The conventional treatment group was given conventional massage treatment,while the tendon-regulating and spine-adjusting group was treated with tendon-regulating and spine-adjusting method on the basis of the conventional treatment group.The cervical activity score,cervical spine curvature degree,modified evaluation scale for cervical vertigo(ESCV)score,cervical muscle magnetic resonance imaging(MRI)imaging indexes,symptom improvement and clinical efficacy of the two groups were observed before and after treatment.Results:The effective rate of the tendon-regulating and spine-adjusting group was 94.00%,which was higher than that of the conventional treatment group:75.76%,and the difference was statistically significant(P<0.05).The cervical activity score of the tendon-regulating and spine-adjusting group was lower than that of the conventional treatment group,and the cervical spine curvature degree was greater than that of the conventional treatment group,with statistically significant differences(P<0.05).ESCV score of the tendon-regulating and spine-adjusting group was higher than that of the conventional treatment group after treatment,and the difference was statistically significant(P<0.05).The long diameter and short diameter of sternocleidomastoid muscle of the tendon-regulating and spine-adjusting group were shorter than those of the conventional treatment group,while the long diameter and short diameter of trapezius muscle were longer than those of the conven-tional treatment group,and all the differences were statistically significant(P<0.05).The scores of headache,shoulder and neck pain and vertigo of the tendon-regulating and spine-adjusting group were higher than those of the conventional treatment group after treat-ment,and all the differences were statistically significant(P<0.05).Conclusion:Tendon-regulating and spine-adjusting method for the treatment of CSA can improve the symptoms of vertigo,cervical function,cervical activity degree and cervical curvature degree.