推拿联合易筋经治疗神经根型颈椎病临床观察  

Clinical Effect of Massage Combined with Muscle-Bone Strengthening Exercise in Treatment of Cervical Spondylotic Radiculopathy

作　　者：侯敏 陈亚锋[1] 贺杰 陈翠 母佳鑫 赵永华[1] HOU Min;CHEN Yafeng;HE Jie;CHEN Cui;MU Jiaxin;ZHAO Yonghua(The First Affiliated Hospital of Anhui University of Chinese Medicine,Anhui Hefei 230031,China)

机构地区：[1]安徽中医药大学第一附属医院,安徽合肥230031

出　　处：《安徽中医药大学学报》2022年第6期14-18,共5页Journal of Anhui University of Chinese Medicine

基　　金：安徽高校自然科学研究重点项目(KJ2020A0407);安徽省重点研究和开发计划项目(1804h08020255)。

摘　　要：目的基于国医大师李业甫“治养并重”理论,观察推拿联合易筋经治疗神经根型颈椎病(cervical spondylotic radiculopathy,CSR)的临床疗效。方法前瞻性收集60例CSR患者,依据其是否愿意接受易筋经习练分别纳入治疗组和对照组,两组各30例。治疗组患者在院接受推拿联合易筋经治疗,出院后1个月继续习练易筋经;对照组在院接受推拿治疗,出院后1个月无任何干预。分别于治疗前、治疗后、出院1个月后观察两组患者颈部肌肉弥散张量成像(diffusion tensor imaging,DTI)参数、疼痛视觉模拟量表(visual analogue scale,VAS)评分、颈椎功能障碍指数(neck disability index,NDI)量表评分,并于出院1个月后评定疗效。结果与治疗前比较,治疗后两组患者DTI参数中患侧胸锁乳突肌、头夹肌表观弥散系数(apparent diffusion cofficient,ADC)值,VAS评分,NDI评分均明显降低,患侧胸锁乳突肌、头夹肌各向异性分数(fractional anisotropy,FA)值均明显升高,差异均有统计学意义(P<0.05);治疗组胸锁乳突肌、头夹肌ADC值,头夹肌FA值,NDI评分改善程度均明显优于对照组(P<0.05)。与治疗后比较,出院1个月后除对照组患者患侧胸锁乳突肌、头夹肌FA值差异无统计学意义(P>0.05)外,两组患者胸锁乳突肌、头夹肌ADC值,VAS评分,NDI评分均明显改善,差异有统计学意义(P<0.05);且治疗组DTI参数、VAS评分、NDI评分改善程度均明显优于对照组(P<0.05)。治疗组临床疗效优于对照组(P<0.05)。结论“治养并重”理论指导下推拿联合易筋经治疗CSR可修复颈肌纤维、减轻疼痛、提高颈椎功能及临床疗效,较单纯推拿疗效更佳。Objective To investigate the clinical effect of massage combined with muscle-bone strengthening exercise in the treatment of cervical spondylotic radiculopathy(CSR)based on the theory of"paying equal attention to treatment and nourishing"proposed by National Chinese Medicine Master Li Yefu.Methods A total of 60 patients with CSR were prospectively enrolled in this study,and according to whether they were willing to accept muscle-bone strengthening exercise,they were divided into treatment group and control group,with 30 patients in each group.The patients in the treatment group received massage combined with muscle-bone strengthening exercise in the hospital and continued to practice this exercise for one month after discharge,and those in the control group received massage in the hospital and did not receive any intervention within one month after discharge.The two groups were observed in terms of neck muscle diffusion tensor imaging(DTI),Visual Analogue Scale(VAS)score,and Neck Dysfunction Index(NDI)score before treatment,after treatment,and at 1 month after discharge,and treatment outcome was evaluated at 1 month after discharge.Results After treatment,both groups had significant reductions in apparent diffusion coefficient(ADC)values of ipsilateral sternocleidomastoid muscle and splenius capitis muscle,VAS score,and NDI score and significant increases in fractional anisotropy(FA)values of ipsilateral sternocleidomastoid muscle and splenius capitis muscle(P<0.05);compared with the control group,the treatment group had significantly greater improvements in ADC values of sternocleidomastoid muscle and splenius capitis muscle,FA value of splenius capitis muscle,and NDI score(P<0.05).From after treatment to 1 month after discharge,both groups had significant improvements in ADC values of sternocleidomastoid muscle and splenius capitis muscle,VAS score,and NDI score(P<0.05),while the control group had no significant changes in FA values of ipsilateral sternocleidomastoid muscle and splenius capitis muscle(P>0.05);c

关 键 词：李业甫 治养并重 神经根型颈椎病 弥散张量成像 易筋经 推拿 

分 类 号：R681.55[医药卫生—骨科学]