手法治疗胸椎小关节错缝所致咔哒声响与即时镇痛疗效的相关性研究  

Exploration on correlation of cracking sounds caused by thoracic small joint disorder with manual reduction and immediate analgesic effect

作　　者：范志勇 查和萍 李义凯[2] 黄伟昌 关德斌 

机构地区：[1]广东省中西医结合医院康复科,广东南海528200 [2]南方医科大学中医药学院

出　　处：《中国骨伤》2011年第1期21-24,共4页China Journal of Orthopaedics and Traumatology

基　　金：广东省中医药局科研课题(编号:1040173)~~

摘　　要：目的:探讨手法整复胸椎小关节错缝所致咔哒声和即时镇痛疗效间的关系。方法:2008年6月至2009年10月采用手法治疗胸椎小关节错缝80例,其中采用拔伸下胸椎掌按法治疗40例(A组),男22例,女18例,年龄19～55岁,平均(38.75±11.08)岁;采用单纯胸椎掌按法治疗40例(B组),男24例,女16例,年龄19～56岁,平均(37.23±9.98)岁。采用棘突错缝改善和疼痛改善对即时镇痛疗效进行评定并分析咔哒声响与疗效的相关性。结果:按疗效标准治疗1次后即时镇痛疗效:A组治愈20例,好转16例,无效4例;B组治愈12例,好转16例,无效12例;两组疗效比校,差异有统计学意义(P<0.05)。A组40例均出现棘突错动,B组仅34例出现棘突错动,差异有统计学意义(P<0.05)。咔哒声响与疗效关系:A组有效36例中,34例有咔哒声响;B组有效28例中,23例有咔哒声响;两组声响的发出和即时疗效间均无相关性(P均>0.05)。结论:拔伸下胸椎掌按手法治疗胸椎小关节错缝的疗效优于胸椎掌按法治疗;咔哒声响与即时镇痛疗效无关,和棘突错动感有密切关系。Objective：To study correlation of cracking sounds caused by thoracic small joint disorder with manual reduction and immediate analgesic effect. Methods：From June 2008 to October 2009,80 patients with＂thoracic small joint disorder＂were treated with manual reduction. Of them,the method of traction-palm-pressing on thoracic vertebra was used in 40 patients（group A）,there were 22 males and 18 females with an average age of（38.75±11.08）years,ranged from 19 to 55 years;and the method of simple palm-pressing on thoracic vertebra was used in 40 patients（group B）,there were 24 males and 16 females with an average age of（37.23±9.98）years,ranged from 19 to 56 years. Immediate analgesic effect were evaluated with spinous process change and pain alleviation;correlation of cracking sounds caused by thoracic small joint disorder with manual reduction and immediate analgesic effect were analyzed. Results：Immediate analgesic effect at the 1st after treatment,36 cases had moderate improvement in group A（20 cases obtained healing well,16 improved and 4 ineffective） and 28 cases（12 cases obtained healing well,16 improved and 12 ineffective） had moderate improvement in group B,there were significant differences in the clinical effects between two groups（P0.05）. All patients of group A underwent spinous process changes and 34 patients of group B underwent spinous process changes;there were significant differences between two groups（P0.05）. Among effective 36 cases of group A,34 cases had cracking sounds;effective 28 cases of group B,23 cases had cracking sounds;there was no significant difference between cracking sounds and clinical effects（χ2=1.962,P0.05;χ2=0.440,P0.05）. Conclusion：The method of traction-palm-pressing on thoracic vertebra can significantly increase therapeutic effects compared with the method of simple palm-pressing on thoracic vertebra. Cracking sounds has nothing to do with immediate analgesic effect,but with spinous process change related.

关 键 词：手法 骨科 胸椎 关节 镇痛 

分 类 号：R274.94[医药卫生—中西医结合]