多方法评价仰卧位屈颈牵引治疗神经根型颈椎病的随机对照研究  

Randomized Controlled study on Multi-method Evaluation of the Clinical Value of Supine Cervical Vertebra Traction with Neck Flexion in the Treatment of Cervical Spondylotic Radiculopathy

作　　者：王一[1] 蔚浩 周睿[1] 

机构地区：[1]四川省骨科医院颈肩腰腿痛2科,成都610041

出　　处：《华西医学》2016年第1期37-42,共6页West China Medical Journal

摘　　要：目的观察仰卧位屈颈牵引治疗神经根型颈椎病(CSR)的疗效。方法将2011年8月-2013年12月住院治疗的71例单一节段CSR患者随机分为2组,试验组36例采用仰卧位屈颈牵引配合电针、艾灸、推拿、中频脉冲治疗,对照组35例采用坐位颈椎牵引配合电针、艾灸、推拿、中频脉冲治疗,观察期15 d。通过颈椎侧位X线片测量颈椎曲度并采用视觉模拟评分(VAS)、颈椎功能障碍指数量表(NDI)、中医病证诊断疗效标准、颈椎临床评价量表(CASCS)评分对照观察两组患者的临床疗效。结果治疗前试验组与对照组颈椎弧弦距分别为(4.07±3.63)、(4.13±3.02)mm,治疗后两组颈椎弧弦距分别为(9.03±4.31)、(8.87±3.97)mm,较治疗前均明显增加(P<0.01),两组治疗后颈椎弧弦距及弦弧距增加值差异无统计学意义(P>0.05);试验组与对照组总有效率分别为100.00%和97.14%,愈显率分别80.56%和51.43%,差异均有统计学意义(P<0.05)。治疗前试验组与对照组VAS评分分别为(8.43±0.75)、(8.35±0.78)分,治疗后两组分别为(1.40±0.61)、(2.55±0.59)分,两组治疗后的VAS评分均明显降低(P<0.01),试验组明显低于对照组(P<0.01);治疗前试验组与对照组NDI评分分别为(54.13±7.44)、(55.85±8.72)分,治疗后分别为(10.78±4.55)、(12.66±5.48)分,两组治疗后NDI均明显降低(P<0.01),试验组和对照组差异无统计学意义(P>0.05);治疗前试验组与对照组CACSC评分分别为(34.88±5.39)、(34.77±4.89)分,治疗后分别为(74.65±6.73)、(69.03±6.21)分,治疗后两组比较差异有统计学意义(P<0.01),治疗后两组CASCS评分增加值差异无统计学意义(P>0.05)。结论颈椎牵引配合电针、艾灸、推拿、中频脉冲是治疗CSR的有效方法,仰卧位屈颈牵引效果更优。Objective To probe into the clinical value of supine cervical vertebra traction with neck flexion in treating cervical spondylotic radiculopathy.Methods From August 2011 to December 2013,71 patients were divided randomly into a treatment group of 36 cases and a control group of 35 cases.They were treated respectively with supine cervical vertebra traction with neck flexion,and cervical vertebra traction on a sitting position.Both groups had acupuncture,moxibustion,massage and medium frequency electrotherapy.The period of observation was 15 days.We evaluated the results by surveying physiological curvature of the cervical spine on lateral radiograph,and visual analogue scale（VAS）,neck disability index（NDI）,criteria of diagnosis and therapeutic effect of syndromes in traditional Chinese medicine syndrome and clinical assessment scale for cervical spondylosis（CASCS） were also used.Results Physiological curvature of cervical spine was much improved in both groups after treatment（P〈0.05）.The distance of cervical vertebra arc between vertebral anterior edge sequences in treatment group before treating was（4.07 ± 3.63） mm and it was（9.03 ±4.31） mm after treatment For the control group,those two numbers were respectively（4.13 ± 3.02） and（8.87 ± 3.97）mm.There was no significant difference in the distance of cervical vertebra arc and its increase between vertebral anterior edge between the two groups after treatment.There was significant difference in the efficiency rate between the two groups（P〈0.05）（treatment group 100.00%,control group 97.14%）.When cured rate and cured-markedly effective rate were added,the treatment group（80.56%） was much better than the control group（51.43%）（P〈0.01）.As to VAS score,NDI and CASCS scores,both groups got much better after treatment（P〈0.01）.For VAS,the treatment group decreased from 8.43 ± 0.75 before treatment to 1.40 ± 0.61 after treatment,while the control group from 8.35 ± 0.78 before treatment to2.55 ± 0.59 after

关 键 词：神经根型颈椎病 仰卧位屈颈牵引 多方法测评 随机对照研究 

分 类 号：R681.55[医药卫生—骨科学]