手法整复寰枢关节半脱位的前瞻性随机对照研究及应用  

Application and Prospective Randomized Control Study of Manipulative Reduction on Atlanta-axial Subluxation

作　　者：王常鸿[1] 高焕民[2] 郭成悦[3] 

机构地区：[1]青岛大学医学院第二附属医院康复科,山东266042 [2]青岛大学医学院第二附属医院神经内科,山东266042 [3]青岛大学医学院第二附属医院骨科,山东266042

出　　处：《国际中医中药杂志》2009年第4期314-316,共3页International Journal of Traditional Chinese Medicine

摘　　要：目的研究手法整复治疗侧向旋转型寰枢关节半脱位的疗效。方法经x线片证实的侧向旋转型寰枢关节半脱位患者128例，随机分为两组各64例，治疗组采用手法定位旋转复位法治疗，对照组采用常规牵引治疗，观察比较两组的临床疗效，并用X片证实。结果治疗后X片证实齿状突偏移调整情况，两组差异具有统计学意义（P〈0．01）。椎基底动脉的血流量改善两组差异具有统计学意义（P〈0．05）。治疗组总有效率95．3％，对照组总有效率78．1％，两组对比差异具有统计学意义（P〈0．01）：随访1年，治疗组复发6例，对照组复发13例，差异有统计学意义（P〈0．05）。结论手法整复治疗寰枢关节半脱位较牵引治疗更能针对病因、整复寰枢椎之间的位置关系，恢复颈椎的力学稳定性，改善患者的椎基底动脉血流量。Objective To observe the clinical effect of treating aflanto-axial subluxation by manipulative reduction therapy. Methods 128 patients with atlanto-axial subluxation confirmed by cervical plain X ray were randomized into two groups： 64 in the treatment group treated by manipulative reduction therapy, and 64 in the control group treated by the routine cervical traction. The clinical effect was evaluated by both clinical and X-ray confirmation. Results The X-ray study showed that after treatment the reconstruction of excursion in odontoid process in the treatment group was better than that in the control group significantly （P〈0.01）. The improvement of vertebra basal artery blood flow in the treatment group was also better than that in the control group significantly （P〈0.05）. The total effective rate of the treatment group was 95.3%, while the control group was 78.1%. Conclusion The technique of manipulative reduction on atlanto-axial subluxation acts more directly on the cause of the disease than the routine traction, and exerts better results in restoring proper atlanto-axial joint position and mechanics stability of cervical vertebra： Thus it is the effective shortcut way with high safety and low cost.

关 键 词：寰枢关节半脱位 手法整复 牵引 临床研究 前瞻性随机对照研究 

分 类 号：R687.3[医药卫生—骨科学]