神经松动术结合牵引治疗神经根型颈椎病的临床观察

Clinical Observation of Neural Mobilization Combined with Traction on the Treatment of Cervical Spondylosis of Nerve Root Type

目的:探讨徒手神经松动术结合颈肩同步牵引对神经根型颈椎病患者的有效性及安全性。方法:选取神经根型颈椎病患者122例,采用随机数字表法随机分为牵引组(61例,仅接受颈肩同步牵引)和联合组(61例,在牵引基础上加徒手神经松动术)。评估两组患者治疗前后的颈椎功能、疼痛程度、炎症指标、生活质量及复发情况。结果:治疗后联合组的右侧屈、右旋转、左侧屈、左旋转角度均高于牵引组,差异有统计学意义(P<0.05);联合组的血浆黏度、全血低切黏度、全血高切黏度、颈痛量表(NPQ)评分、颈椎功能障碍指数(NDI)评分均低于牵引组,差异有统计学意义(P<0.05)。炎症指标方面,联合组IL-1β、TNF-α、IL-6和PGE2水平均低于牵引组;联合组世界卫生组织生存质量测定问卷(WHOQOL-BREF)各维度评分高于牵引组(P<0.05)。联合组复发率显著低于牵引组,差异有统计学意义(χ^(2)=3.921,P=0.048)。结论:徒手神经松动术结合颈肩同步牵引可以降低疼痛程度,改善颈椎功能障碍,优化血液流变和炎症指标,从而提高患者的生活质量,治疗安全,适合临床应用。

Objective:This study was to explore unarmed neural mobilization combined with neck and shoulder synchronous traction in patients with cervical spondylosis of nerve root type efficacy and safety.Methods:A total of 122 patients with cervical spondylosis radiculopathy were randomly divided into traction group(61 cases)and combined group(61 cases).Evaluation of two groups of patients before and after treatment of cervical spine function and the degree of pain,inflammation index,the quality of life,and relapse.Results:After treatment,the angles of right flexion,right rotation,left flexion,and left rotation in the combined group were higher than those in the traction group(P<0.05).The plasma viscosity,whole blood low-shear viscosity,whole blood high-shear viscosity,Neck Pain Questionnaire(NPQ)and Neck Disability Index(NDI)scores in the combined group were lower than those in the traction group(P<0.05).Inflammatory indicators,the combined group of IL-1β,TNF-α,IL-6 and PGE2 levels are lower than traction group,combined group WHOQOL-BREF each dimension score higher than traction group(P<0.05).The recurrence rate of the combined group was significantly lower than that of the traction group(χ~2=3.921,P=0.048).Conclusion:Manual nerve mobilization combined with neck and shoulder synchronous traction can effectively reduce the degree of pain,improve cervical spine dysfunction,optimize blood rheology and inflammatory indicators,so as to improve the quality of life of patients,treatment safety,suitable for clinical application.