三种手法治疗寰枢关节紊乱症的近期疗效及对胸锁乳突肌表面肌电图的影响  

The Short-term Effectiveness of Three Manipulations for Atlantoaxial Joint Disorders and the Effects on Surface Electromyography of Sternocleidomastoid Muscle

作　　者：杨灿 李锐 张琰朕 张世民[1] 刘劲松[1] 黎作旭[1] 王朝鲁[1] 种涛 张兆杰[1] YANG Can;LI Rui;ZHANG yanzhen;ZHANG Shimin;LIU Jinsong;LI Zuoxu;WANG Chaolu;CHONG Tao;ZHANG Zhaojie(Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing,100102)

机构地区：[1]中国中医科学院望京医院,北京市100102

出　　处：《中医杂志》2023年第24期2532-2537,共6页Journal of Traditional Chinese Medicine

基　　金：中国中医科学院科技创新工程(CI2021A02007)。

摘　　要：目的比较三种不同手法治疗寰枢关节紊乱症的近期疗效及对胸锁乳突肌表面肌电图的影响。方法将90例寰枢关节紊乱症患者随机分为疏筋手法组、疏筋整复手法组、常规手法组,每组30例,各组患者均给予相应手法治疗2周。观察各组患者治疗前后枕颈部疼痛视觉模拟(VAS)评分、颈性眩晕症状与功能评估量表(ESCV)评分及双侧胸锁乳突肌表面肌电图平均肌电振幅值(AEMG)的变化,并比较各组患者治疗后的临床疗效及安全性。结果与本组治疗前比较,治疗后各组患者VAS评分均降低,ESCV评分均升高(P<0.01),且疏筋手法组、疏筋整复手法组均显著优于常规手法组(P<0.01)。表面肌电图AEMG组内同侧比较,各组治疗后双侧胸锁乳突肌AEMG较本组治疗前均增大(P<0.01);治疗后各组患者组间比较,疏筋整复手法组双侧胸锁乳突肌AEMG高于疏筋手法组、疏筋手法组高于常规手法组(P<0.05或P<0.01)。治疗后疏筋手法组、疏筋整复手法组、常规手法组的愈显率分别为56.67%、86.67%、36.67%,各组患者疗效比较差异有统计学意义(K=10.21,P<0.01)。结论疏筋手法及疏筋整复手法可有效改善寰枢关节紊乱症患者眩晕、头痛及颈枕部疼痛症状,改善胸锁乳突肌收缩功能,疗效优于常规手法治疗。Objective To compare the short-term effectiveness of the three different manipulations for atlantoaxial joint disorders and their effects on surface electromyography of sternocleidomastoid muscle.Methods Ninty patients with atlantoaxial joint disorders were randomly divided into the tendon relaxing manipulation group,the tendon relax⁃ing plus rehabilitation manipulation group,and the conventional manipulation group,with 30 cases in each group,and each group of patients received the corresponding manipulation treatment for 2 weeks.The changes of visual ana⁃logue score(VAS)of occipital neck pain,evaluation scale for cervical vertigo(ESCV),and averaged electromyogra⁃phy(AEMG)of surface electromyography of bilateral sternocleidomastoid muscles before and after the treatment were observed,and the clinical effectiveness and safety of the patients were compared among groups.Results The VAS scores of patients in each group decreased,and the ESCV scores increased after treatment(P<0.01),and the tendon relaxing manipulation group and the tendon relaxing plus rehabilitation manipulation group were significantly better than the conventional manipulation group(P<0.01).The AEMG of the bilateral sternocleidomastoid muscles of the three groups increased after treatment(P<0.01);when compared among the three groups,the AEMG of the bilateral sternocleidomastoid muscles of the tendon relaxing plus rehabilitation manipulation group was higher than that of the tendon relaxing manipulation group,and the tendon relaxing manipulation group was higher than that of the conventional manipulation group(P<0.05 or P<0.01).The cure and markedly effective rates of the tendon relax⁃ing manipulation group,the tendon relaxing plus rehabilitation manipulation group,and the conventional manipula⁃tion group were 56.67%,86.67%,and 36.67%respectively,showing statistically difference(K=10.21,P<0.01).Conclusion The tendon relaxing manipulation and tendon relaxing plus rehabilitation manipulation can effectively improve the symptoms of vertigo,he

关 键 词：寰枢关节紊乱症 眩晕 推拿 疏筋手法 整复手法 胸锁乳突肌 表面肌电图 

分 类 号：R244.1[医药卫生—针灸推拿学]