颈椎特异性短杠杆微调手法治疗神经根型颈椎病的多中心临床研究  

A multicenter clinical study of cervical specific short-lever fine-regulation manipulation for treatment of cervical spondylotic radiculopathy

作　　者：孙武权[1] 房敏[1] 周楠[1] 沈国权[1] 詹红生[2] 钟力炜[3] 王勇[4] 龚利[1] 朱清广[5] 李建华[1] 文世梅[1] SUN Wuquan;FANG Min;ZHOU Nan;SHEN Guoquan;ZHAN Hongsheng;ZHONG Liwei;WANG Yong;GONG Li;ZHU Qingguang;LI Jianhua;WEN Shimei(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shantional Chinese Medicine, Shanghai 200437 , China;Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;The First People＇ s Hospital of Shanghai, Shanghai 200080 , China;Ruijin Hospital Affiliated to Shanghai Jiaotong University Medical College,Shanghai 200025,China;The Institute of Massaging Affiliated to Shanghai Academy of Traditional Chinese Medicine ,Shanghai 200437, China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437 [2]上海中医药大学附属曙光医院,上海201203 [3]上海市第一人民医院,上海200080 [4]上海交通大学医学院附属瑞金医院,上海200025 [5]上海市中医药研究院推拿研究所,上海200437

出　　处：《中医正骨》2018年第5期1-5,共5页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：上海市进一步加快中医药事业发展三年行动计划项目(2014-2016年)(ZY3-LCPT-1-1007)

摘　　要：目的:评价应用颈椎特异性短杠杆微调手法治疗神经根型颈椎病的价值。方法:从4家医院选取神经根型颈椎病患者120例,随机分期为3组,每组40例。宣教组通过健康教育指导患者纠正以往各种可能诱发颈椎病的不良习惯,长杠杆手法组按照《推拿学》中颈椎病推拿手法操作规范进行手法治疗,短杠杆手法组采用颈椎特异性短杠杆微调手法治疗。3组患者均治疗4周,然后分别采用颈椎功能障碍指数(the neck disability index,NDI)、颈椎病治疗成绩评分、简明健康状况调查表(short form 36health survey questionnaire,SF-36)评分评价临床疗效,并根据患者的颈椎病治疗成绩评分和治疗费用计算疗效费用比。结果:治疗前3组患者的NDI比较,差异无统计学意义[(39.80±4.31)%,(39.90±4.31)%,(39.45±4.53)%,F=0.122,P=0.885]。治疗结束后3组患者的NDI比较,差异有统计学意义[(32.40±5.62)%,(11.45±6.49)%,(7.75±4.94)%,F=216.088,P=0.000];短杠杆手法组的NDI低于宣教组和长杠杆手法组(P=0.000,P=0.013),长杠杆手法组的NDI低于宣教组(P=0.000)。3组患者治疗前后NDI差值比较,差异有统计学意义[(7.40±4.18)%,(28.45±4.16)%,(31.70±3.09)%,F=470.802,P=0.000];短杠杆手法组治疗前后NDI差值大于宣教组和长杠杆手法组(P=0.000,P=0.001),长杠杆手法组治疗前后NDI差值大于宣教组(P=0.000)。治疗前3组患者的治疗成绩评分比较,差异无统计学意义[(57.33±7.07)%,(57.50±8.32)%,(58.10±6.41)%,F=0.124,P=0.884]。治疗结束后3组患者的治疗成绩评分比较,差异有统计学意义[(66.47±5.95)%,(88.28±6.19)%,(91.03±8.90)%,F=142.267,P=0.000];短杠杆手法组和长杠杆手法组治疗结束后的治疗成绩评分均高于宣教组(P=0.000,P=0.000);短杠杆手法组和长杠杆手法组治疗结束后的治疗成绩评分比较,差异无统计学意义(P=0.199)。3组患者治疗前后治疗成绩评分差值比较,差异有统计学意义[(9.13±7.79)%,(30.78±8.98)%,(32.93�Objective： To evaluate the applied values of cervical specific short-lever fine-regulation manipulation in the treatment of cervical spondylotic radiculopathy（ CSR）. Methods： One hundred and twenty patients with CSR were selected out from four hospitals and were randomly divided into education group,long-lever manipulation group and short-lever manipulation group,40 cases in each group.The patients in education group got health education and were guided to correct all kinds of previous bad habits that might induce cervical spondylosis. The patients in long-lever manipulation group were treated with manipulation therapy according to the operation specification of TUINA manipulation of cervical spondylosis which was extracted from TUINA Science. The patients in short-lever manipulation group were treated with cervical specific short-lever fine-regulation manipulation. All patients in the 3 groups were treated for 4 weeks,and the clinical curative effects were evaluated and compared between the 3 groups by using neck disability index（ NDI）,treatment outcome score of cervical spondylosis and short form 36 health survey questionnaire（ SF-36） score respectively,and the effectiveness-cost ratio was calculated according to patients＇ treatment outcome scores of cervical spondylosis and cost of treatment. Results： There was no statistical difference in NDI between the 3 groups before the treatment（ 39. 80 ＋/-4. 31,39. 90 ＋/-4. 31,39. 45 ＋/-4. 53%,F = 0. 122,P = 0. 885）.There was statistical difference in NDI between the 3 groups after the end of the treatment（ 32. 40 ＋/-5. 62,11. 45 ＋/-6. 49,7. 75 ＋/-4. 94%,F = 216. 088,P = 0. 000）. The NDI was lower in short-lever manipulation group compared to education group and long-lever manipulation group（ P = 0. 000,P = 0. 013）,and was lower in long-lever manipulation group compared to education group（ P = 0. 000）.There was statistical difference between the 3 groups in the differences of NDI between pretreatment and posttreatment（ 7

关 键 词：颈椎病 神经根病 手法 整骨 特异性微调手法 临床试验 多中心研究 

分 类 号：R244.1[医药卫生—针灸推拿学]