平乐七珠展筋散配合牵复三步法治疗寰枢关节错缝对椎动脉血流动力学及血清炎症因子水平的影响  

Effects of Pingle Qizhu Zhanjin Powder Combined with Three-Step Traction on Vertebral Artery Hemodynamics and Serum Levels of Inflammatory Factors in Treatment of Atlantoaxial Joint Dislocation

作　　者：张馨心 毛晓艳 赵烨 史建云 毛书歌 ZHANG Xinxin;MAO Xiaoyan;ZHAO Ye;SHI Jianyun;MAO Shuge(Luoyang Orthopedic-Traumatological Hospital of Henan Province,Henan Provincial Orthopedic Hospital,Luoyang 471002,China)

机构地区：[1]河南省洛阳正骨医院,河南省骨科医院,河南洛阳471002

出　　处：《中医药信息》2022年第9期63-67,共5页Information on Traditional Chinese Medicine

基　　金：河南省中医药科学研究专项课题(20-21ZY2244)。

摘　　要：目的:探讨平乐七珠展筋散配合牵复三步法治疗寰枢关节错缝对椎动脉血流动力学及血清炎症因子水平的影响。方法:选取符合纳入标准的60例寰枢关节错缝患者,采用单双号法随机将60例患者分为对照组与观察组,每组各30例。对照组采用牵复三步法治疗,观察组在对照组基础上联合平乐七珠展筋散治疗,两组患者均治疗14 d。统计治疗后治疗总有效率,并比较治疗前后的颈枕部疼痛视觉模拟评分(VAS)、颈椎旋转主动关节活动度(AROM),检测患者血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平,椎动脉血流动力学指标平均血流速度(Vm)、收缩峰值血流速度(VP)、搏动指数(PI)、阻力指数(RI)以及颈部肌肉的平均杨氏模量值、实时剪切波平均速度。结果:观察组的治疗总有效率高于对照组(P<0.05)。治疗后,两组患者AROM、颈枕部疼痛评分、TNF-α、IL-6、Vm、Vp、平均杨氏模量值和实时剪切波平均速度均较治疗前改善明显(P<0.05),观察组颈枕部疼痛VAS评分、血清TNF-α和IL-6水平均低于对照组(P<0.05,P<0.01),AROM、Vm、Vp高于对照组(P<0.01,P<0.05),但两组治疗前后PI、RI指标无明显差异(P>0.05),颈部肌肉的平均杨氏模量值、实时剪切波平均速度均低于对照组(P<0.05,P<0.01)。结论:平乐七珠展筋散配合牵复三步法治疗寰枢关节错缝可明显减轻机体炎性反应状态和颈椎疼痛感,改善颈椎旋转受限、椎动脉血流动力学指标和颈部肌肉紧张等情况,临床疗效显著。Objective:To explore the effects of Pingle Qizhu Zhanjin Powder combined with three-step traction on the vertebral artery hemodynamics and the serum levels of inflammatory factors in the treatment of atlantoaxial joint dislocation.Methods:A total of 60 patients with atlantoaxial joint dislocation were randomly divided into the control group(n=30)and the observation group(n=30).The control group was treated with three-step traction;on which basis,the observation group was also treated with Pingle Qizhu Zhanjin Powder.Both groups were treated for 14 days.The total effective rate was compared between the two groups.VAS score around occipitocervical region,the cervical active range of motion(AROM),serum levels of tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6),mean flow velocity of vertebral artery(Vm),peak systolic velocity(Vp),pulsatility index(PI),resistance index(RI),average Young's modulus of neck muscles,as well as mean velocity of real-time shear wave were also compared between the two groups before and after the treatment.Results:The total effective rate was significantly higher in the observation group than that in the control group(P<0.05).After the treatment,VAS score around occipitocervical region,AROM,serum levels of TNF-αand IL-6,Vm,Vp,average Young's modulus and mean velocity of real-time shear wave were all improved in the two groups(P<0.05);among which,VAS score,serum levels of TNF-αand IL-6 were lower(P<0.05,P<0.01),whereas AROM,Vm and Vp were higher in the observation group than those in the control group(P<0.05,P<0.01);there were no statistical differences in PI and RI between the two groups before and after the treatment(P>0.05);the average Young's modulus of neck muscles and mean velocity of real-time shear wave were lower in the observation group than those in the control group(P<0.05,P<0.01).Conclusion:Pingle Qizhu Zhanjin Powder combined with three-step traction can significantly relieve inflammatory response and cervical pain,it can improve cervical rotation limitation,vertebral ar

关 键 词：寰枢关节错缝 平乐七珠展筋散 牵复三步法 椎动脉血流动力学 炎症因子 

分 类 号：R274.9[医药卫生—中西医结合]