练功十八法联合推拿治疗颈型颈椎病的临床随机对照研究  

Combination of Kongfu and tuina for the treatment of cervical spondylosis: a randomized controlled trial

作　　者：王琼[1] 朱国苗[2] 姚斐[1] 王建伟 孙武权[4] 房敏[4] 

机构地区：[1]上海中医药大学针灸推拿学院,上海201203 [2]上海市第七人民医院康复科,上海200137 [3]上海中药大学附属曙光医院推拿科,上海201203 [4]上海中医药大学附属岳阳中西医结合医院推拿科,上海200437

出　　处：《上海中医药杂志》2015年第4期61-64,67,共5页Shanghai Journal of Traditional Chinese Medicine

基　　金：上海市卫生局"中医药事业发展三年行动计划"-海派中医流派(丁氏推拿)传承工程项目(ZYSNXD-CC-HPGCJD-011)

摘　　要：目的观察练功十八法联合推拿治疗颈型颈椎病的临床疗效,并进行半年临床疗效随访。方法将162例颈型颈椎病患者随机分为治疗组与对照组,每组81例。对照组予单纯推拿手法治疗2周,随访半年期间不做任何干预;治疗组在对照组治疗措施基础上加用练功十八法锻炼2周,并在随访期间继续进行锻炼。观察比较数字疼痛分级(NPRS)、颈部残障指数(NDI)、生活质量评分SF-36(PCS、MCS)及颈椎活动度的变化情况,并随访半年。结果 1week0与week2、week26组内分别比较,两组NPRS、NDI水平差异均有统计学意义(P<0.05);治疗组PCS在week0-2、week0-26两时点间比较,差异均有统计学意义(P<0.05),而对照组仅在week0-2时点间比较,差异均有统计学意义(P<0.05);治疗组MCS在week0-26时点间比较,差异有统计学意义(P<0.05),而对照组在week0-2时点间比较,差异有统计学意义(P<0.05)。组间比较,NPRS、NDI在week2时的水平差异有统计学意义(P<0.05);PCS、MCS在week26时的水平差异有统计学意义(P<0.05)。2week0与week2组内比较,两组前屈、后伸、左旋转、右旋转活动度差异均有统计学意义(P<0.05);组间week2时比较,前屈、后伸、左旋转、右旋转活动度差异有统计学意义(P<0.05)。3两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论练功十八法联合推拿治疗颈型颈椎病,可显著缓解颈部疼痛及功能障碍,且疗效稳定。Objective To observe the clinical efficacy of Kongfu and tuina in treating cervical spondylosis and to conduct 6-month follow-up. Methods One hundred and sixty-two cases with cervical spondylosis were randomized into treatment group and control group,with 81 cases in each group. Control group was treated by tuina for two weeks,without any intervention during the 6-month follow-up; treatment group was treated by Kongfu for two weeks in addition,and did exercises during the follow-up. The numeric pain rating scale（ NPRS）,neck disability index（ NDI）,physical component score（ PCS） and mental component score（ MCS） in the short form 36 health survey scale（ SF-36） and cervical flexibility were evaluated and 6-month follow-up. Results 1 In each group,there was significant difference in the levels of NPRS and NDI at week 0,week 2 and week 26（ P 〈 0. 05）; in the treatment group,there was a significant difference during the two periods： week 0-2 and week0-26（ P 〈 0. 05）,but only significant difference was found in the control group during week0-2（ P 〈 0. 05）; in the treatment group,there was a significant difference in MCS during the week0-26（ P 〈 0. 05）,while with significant difference in the control group during week 0-2（ P 〈 0. 05）. There were significant differences in the levels of NPRS and NDI at week 2 between the two groups（ P 〈 0. 05）; with significant differences in the levels of PCS and MCS at week 26（ P 〈 0. 05）. 2 In each group,there was significant differences in the range of motion between week 0 and week 2（ P 〈 0. 05）;at week 2,there was significant differences in the range of motion between the two groups（ P 〈 0. 05）. 3 No significant difference was found in adverse reaction between the two groups（ P 〉 0. 05）. Conclusion Combined Kongfu and tuina can alleviate neck pain and relieve dysfunction of neck in treating cervical spondylosis.

关 键 词：颈型颈椎病 练功十八法 推拿 临床疗效 随访 

分 类 号：R274.9[医药卫生—中西医结合]