“调督通脉正脊法”分节段治疗颈心综合征的疗效观察  

Observation on the Curative Effect of“Tiaodu Tongmai Zhengji”on Cervical Cardiac Syndrome

作　　者：孙小慧[1] 李志远[1,2] 宋阳[1] Sun Xiaohui;Li Zhiyuan;Song Yang(Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,China;Innovative Institute of Chinese Medicine and Pharmacy,Shandong University of Traditional Chinese Medicine,Jinan 250355,China)

机构地区：[1]山东中医药大学附属医院,济南250014 [2]山东中医药大学中医药创新研究院,济南250355

出　　处：《世界科学技术-中医药现代化》2023年第9期3079-3086,共8页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：山东省卫生健康委员会山东省齐鲁卫生与健康杰出青年人才项目(鲁卫人字[2020]3号),负责人:孙小慧;济南市科学技术局济南市临床科技创新计划项目(20201915):基于循证医学的三阴性乳腺癌中医辨证治疗方案的临床规范化研究,负责人:孙小慧;山东中医药大学附属医院青年科研创新团队院级课题项目([2021]4号),负责人:孙小慧。

摘　　要：目的通过与常规针灸和常规推拿治疗颈心综合征相比,研究调督通脉正脊法治疗颈心综合征的安全性和有效性,为临床治疗颈心综合征提供选择方案。方法本文采用前瞻性的研究方法,收集2020年1月-2022年1月我院老年医学科门诊临床诊断为颈心综合征的患者45例,随机分为“调督通脉正脊”组、常规推拿组和常规针灸组,每组15例。“调督通脉正脊”组采用3种方法:针刺、推拿和整脊疗法。常规推拿组采用交感型颈椎病推拿治疗方案,常规针刺组采用颈椎病、心悸篇治疗方案。每周治疗3次,持续4周。1个月后,从主症、次症、后续随访症状及中医证候评分表评价治疗效果。结果在减轻颈心综合征患者包括心悸、胸闷与胸痛的主症方面,调督通脉正脊治疗优于常规推拿治疗(P<0.05),而常规推拿治疗优于常规针灸治疗(P<0.05)。针刺法、推拿法与调督通脉正脊治疗均能改善颈心综合征患者的次症即颈项肩胛疼痛,但在减轻患者颈项肩胛疼痛效果方面,调督通脉正脊治疗要显著优于常规针刺治疗与推拿治疗(P<0.01),而针刺治疗与推拿治疗无差别(P>0.05)。在改善颈心综合征的焦虑情绪方面,针刺法要优于调督通脉正脊,而调督通脉正脊要优于推拿(P<0.05)。针刺法与推拿治疗的总有效率相同,而调督通脉正脊治疗的总有效率要优于针刺法与推拿治疗(P<0.05)。结论调督通脉正脊法是在临床中总结经验得出一套可行的方法,突出以手法整复作用于脊椎及其小关节经络腧穴,以期达到平衡阴阳、疏经通络、理筋整复、调理气血,恢复肌肉力学平衡,恢复脏腑功能平衡。调督通脉正脊法在缓解颈心综合征患者心悸、胸闷、胸痛、颈肩痛等方面具有明显优势,总有效率也是要优于推拿法、针刺法,调督通脉正脊法是一种值得临床推广的治疗方法。Objective To study the safety and effectiveness of Tiaodu Tongmai Zhengji method in the treatment of cervical cardiac syndrome,and to provide a choice for the clinical treatment of cervical cardiac syndrome.Methods From January 2020 to January 2022,45 patients with cervical cardiac syndrome diagnosed clinically in the outpatient department of geriatrics of our hospital were randomly divided into"Tiaodu Tongmai Zhengji"group,routine massage group and routine acupuncture group,with 15 patients in each group.Three methods were used in the"Tiaodu Tongmai Zhengji"group:acupuncture,massage and chiropractic therapy.The routine massage group adopted the massage treatment scheme of sympathetic cervical spondylosis,while the routine acupuncture group adopted the treatment scheme of cervical spondylosis and palpitation.Three times a week for four weeks.One month later,the treatment effect was evaluated from the main symptoms,secondary symptoms,follow-up symptoms and TCM syndrome score.Results In alleviating the main symptoms of patients with cervical cardiac syndrome,including palpitation,chest tightness and chest pain,the treatment of regulating Du,Tongmai and Zhengji was superior to the conventional massage treatment(P<0.05),while the conventional massage treatment was superior to the conventional acupuncture treatment(P<0.05).Acupuncture,Tuina and Tiaodu Tongmai Zhengji treatment can improve the secondary symptom of cervical heart syndrome,that is,neck and scapular pain.However,in terms of alleviating neck and scapular pain,Tiaodu Tongmai Zhengji treatment is significantly better than conventional acupuncture and Tuina treatment(P<0.01),while there is no difference between acupuncture and Tuina treatment(P>0.05).In improving the anxiety of cervical heart syndrome,acupuncture is better than regulating Du Tongmai Zhengji,while regulating Du Tongmai Zhengji is better than massage(P<0.05).The total effective rate of acupuncture and massage treatment was the same,but the total effective rate of Tiaodu Tongmai Zhengji treatmen

关 键 词：颈心综合征 调督通脉正脊法 分节段治疗 疗效观察 

分 类 号：R24[医药卫生—中医临床基础]