拇指施力点对颈椎定点旋转手法疗效的影响

Effect of Thumb Application Force Point on Curative Effect of Cervical Spine Fixed-Point Rotation Technique

目的 探究定点旋转手法中拇指施力点对临床疗效的影响,从而对操作规范提供指引。方法 采取前瞻性随机对照,在一家三甲医院门诊筛选出60例颈痛患者,随机分成a、b、c三组,每组均由同一名医生实施手法,只是拇指施力点不同,a组是关节突,b组是棘突,c组是横突,记录分析患者治疗前后的疼痛数字评分(NRS)、颈椎功能障碍指数(NDI)、总体变化评分(PGIC)。结果 治疗后三组NRS即时值、第4周随访值以及差值相比较,差异均无统计学意义(P>0.05);治疗后三组NDI随访值及差值相比较,差异均无统计学意义(P>0.05);三组PGIC值相比较差异无统计学意义(P>0.05)。结论 颈椎定点旋转手法中术者的拇指施力点对治疗效果影响不明显,有待进一步研究拇指施力点对颈椎定点旋转手法安全性的影响。

Objective To explore effect of thumb force application point on clinical effect of fixed-point rotation technique,and provide guidance for standardized operation.Methods The paper chose 60 patients with neck pain in an outpatient department of a tertiary hospital with prospective randomized controlled trial,and divided them into three groups randomly:a,b,and c.Each group was operated by the same doctor,with different thumb force points.Group a had articular processes,group b had spinous processes,and group c had transverse processes.Pain numerical scores(NRS),cervical dysfunction index(NDI),and overall change scores(PGIC)of patients were recorded and analyzed before and after treatment.Results After treatment,there was no statistically significant difference in immediate NRS values,4th week follow-up values among three groups.After treatment,there was no statistically significant difference in NDI follow-up values among three groups,there was no statistically significant difference in PGIC values among three groups.Conclusion Application point of thumb does not have significant effect on treatment effect on cervical spine fixed-point rotation technique,and further research is needed to investigate effect of thumb force application point on safety of cervical spine fixed-point rotation technique.