理筋正骨手法治疗颈型颈椎病临床观察  

Clinical Effect of Tendon-regulating and Bone-setting Manipulation in Treatment of Cervical-type Cervical Spondylosis

作　　者：梁颖 陈朝晖[2] 林永艳 张文娣[2] 李冬静 LIANG Ying;CHEN Zhaohui;LIN Yongyan;ZHANG Wendi;LI Dongjing(The First Clinical Medical College of Anhui University of Chinese Medicine,Anhui Hefei 230031,China;College of Acupuncture and Moxibustion,Anhui University of Chinese Medicine,Anhui Hefei 230012,China)

机构地区：[1]安徽中医药大学第一临床医学院,安徽合肥230031 [2]安徽中医药大学针灸推拿学院,安徽合肥230012

出　　处：《安徽中医药大学学报》2024年第1期27-31,共5页Journal of Anhui University of Chinese Medicine

基　　金：安徽省高校自然科学重大研究项目(KJ2021ZD0062ZH);安徽中医药大学自然科学研究项目(2020zryb03)。

摘　　要：目的观察理筋正骨手法结合运动锻炼治疗颈型颈椎病的临床疗效。方法将60名颈型颈椎病患者随机分为治疗组和对照组,每组30例;治疗组采用理筋正骨手法结合运动锻炼,对照组采用牵引疗法联合运动锻炼;分别于治疗前后采用手持式压痛仪检测患者颈部疼痛部位压痛阈值,关节角度尺测量颈椎关节活动度,采集颈部肌肉表面肌电积分肌电值(integral electromyogram,iEMG),计算颈椎前屈、后伸、侧屈的肌肉协同收缩率(co-contraction ratio,CCR),采用颈部功能障碍指数(neck disability index,NDI)评价功能改善程度,并进行疗效评价。结果与治疗前比较,两组患者治疗后疼痛减轻,颈椎活动度增加,颈部肌肉CCR下降,NDI降低(P<0.05);治疗组疼痛、颈椎关节活动度、颈部肌肉CCR、NDI改善程度均优于对照组(P<0.05)。治疗组临床疗效优于对照组(P<0.05)。结论理筋正骨手法结合运动锻炼可有效减轻颈型颈椎病患者的疼痛,改善关节活动度,提高颈部肌肉协调性,改善患者颈椎功能,其疗效优于牵引疗法结合运动锻炼。Objective To investigate the clinical effect of tendon-regulating and bone-setting manipulation combined with exercise in the treatment of cervical-type cervical spondylosis.Methods A total of 60 patients with cervical-type cervical spondylosis were randomly divided into treatment group and control group,with 30 patients in each group.The patients in the treatment group were given tendon-regulation and bone-setting manipulation combined with exercise,and those in the control group were given traction therapy combined with exercise.Before and after treatment,a hand-held tenderness instrument was used to measure the tenderness threshold at the site of neck pain;a joint angle ruler was used to measure the joint range of motion of the cervical vertebra;the integrated electromyogram(iEMG)of surface electromyography was collected for neck muscles to calculate the co-contraction ratio(CCR)of the muscles in forward flexion,back extension,and lateral flexion of the neck;neck dysfunction index(NDI)was used to evaluate the degree of functional improvement;clinical outcome was evaluated finally.Results After treatment,both groups had alleviation of pain,an increase in the range of motion of cervical vertebra,a reduction in the CCR of neck muscles,and a reduction in NDI(P<0.05),and compared with the control group,the treatment group had significantly greater improvements in pain,the range of motion of cervical vertebra,the CCR of neck muscles,and NDI(P<0.05).The treatment group had a significantly better clinical outcome than the control group(P<0.05).Conclusion For patients with cervical-type cervical spondylosis,tendon-regulating and bone-setting manipulation combined with exercise can effectively alleviate pain and improve joint activity,neck muscle coordination,and dysfunction,with a better clinical effect than traction therapy combined with exercise.

关 键 词：理筋正骨 颈型颈椎病 运动锻炼 牵引 

分 类 号：R681.55[医药卫生—骨科学]