石氏定位旋扳法治疗神经根型颈椎病的疗效观察  

Therapeutic Effect of Shi’s Rotation Manipulation Treatment for Cervical Spondylotic Radiculopathy

作　　者：邓真 沈知彼 詹红生[2,3] 陈蓓 廉由之[1,2] 商海滨 李国中 王辉昊 DENG Zhen;SHEN Zhibi;ZHAN Hongsheng;CHEN Bei;LIAN Youzhi;SHANG Haibin;LI Guozhong;WANG Huihao(Shanghai Baoshan Hosptial of Intergated Traditional Chinese and Western Medicine,Shanghai 201999,China;Zhan Hongsheng Studio of Academic Experience of Shanghai Famous Doctors in Traditional Chinese Medicine,Shanghai 201203,China;Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海市宝山区中西医结合医院,上海中医药大学附属曙光医院宝山分院,上海201999 [2]詹红生上海市名老中医学术经验研究工作室 [3]上海中医药大学附属曙光医院

出　　处：《中国中医骨伤科杂志》2020年第5期5-9,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：国家自然科学基金项目(81804114,81973871);上海市卫计委临床行业专项(201840004);上海市卫计委詹红生上海市名老中医学术经验研究工作室建设项目(SHGS-2017025,SZYMYGZS4013)。

摘　　要：目的:观察石氏颈椎定位旋扳法治疗神经根型颈椎病的临床疗效。方法:将符合纳入标准的120例患者随机分为观察组和对照组(每组60例),观察组采用石氏颈椎定位旋扳法治疗,每周2次,共2周;对照组采用常规颈部理筋牵引手法治疗,每周2次,共2周。分别在治疗前、治疗第1周及第2周后和治疗结束后3个月对患者进行VAS量表、NPQ量表及临床症状评估,观察比较两组患者治疗前后和3个月后的临床疗效。结果:第1周治疗结束后,观察组VAS评分(41.21±10.41)、NPQ量表评分(27.21±7.34)明显低于对照组(59.57±13.49,33.65±11.37),差异有统计学意义(t=2.713,P<0.01;t=3.511,P<0.05)。第2个疗程结束后,观察组VAS量表(29.28±13.87)、NPQ量表评分(16.14±5.26)明显低于对照组(40.37±15.79,26.37±9.76),差异有统计学意义(t=3.072,P<0.01;t=2.027,P<0.01)。第2周治疗结束后,观察组总有效率94.74%,对照组总有效率70.91%,两组差异有统计学意义(P<0.05)。治疗结束3个月后随访,VAS评分观察组(20.02±9.52)与对照组(24.12±10.61)差异无统计学意义(t=2.812,P>0.05),NPQ评分观察组(12.74±6.33)明显低于对照组(19.88±7.26),差异有统计学意义(t=2.366,P<0.05)。3个月后随访,观察组复发率5.56%,最终有效率89.47%,对照组复发率23.08%,最终有效率54.55%,两者差异有统计学意义(P<0.01)。结论:石氏定位旋扳法治疗神经根型颈椎病疗效显著,复发率低,操作简单、规范、安全,值得临床推广应用。Objective:To observe the efficacy of Shi’s rotation manipulation treatment for cervical spondylotic radiculopathy.Methods:120 patients were randomly divided into the observation group(n=60)and control group(n=60).The observation group was treated with Shi’s rotation manipulation treatment twice per week for 2 weeks.The control group was treated with ordinary tendon combined with traction manipulation treatment.All patients were assessed with VAS scale and NPQ scale before and after treatment as well as 3 months later to observe and compare the clinical efficacy between two groups.Results:At the end of the first week,the VAS score(41.21±10.41)and NPQ score(27.21±7.34)in the observation group were significantly lower than those in the control group(59.57±13.49,33.65±11.37)(P<0.05).After the second course of treatment,the VAS(29.28±13.87)and NPQ(16.14±5.26)in the observation group were significantly lower than those in the control group(40.37±15.79,26.37±9.76)(P<0.01).At the end of the second week,the total effective rate was 94.74%in the observation group and 70.91%in the control group(P<0.05).After 3 months follow-up,there was no significant difference in VAS between the observation group(20.02±9.52)and the control group(24.12±10.61)(t=2.812,P>0.05),NPQ score in the observation group(12.74±6.33)was significantly lower than the control group(19.88±7.26),the difference was statistically significant(t=2.366,P<0.05).After 3 months follow-up,the recurrence rate of the observation group was 5.56%,the final effective rate was 89.47%,the recurrence rate of the control group was 23.08%,the final effective rate was 54.55%,the difference was statistically significant(P<0.01).Conclusion:The Shi’s rotation manipulation treatment on cervical spondylotic radiculopathy is effective,with low recurrence rate,simple,standardized and safe operation.It is worthy of clinical application.

关 键 词：神经根型颈椎病 定位旋扳法 理筋手法 牵引手法 

分 类 号：R681.5[医药卫生—骨科学]