筋柔骨正理论指导下运用单纯疏筋手法治疗寰枢关节错缝30例  

Treatment of 30 Cases of Atlantoaxial Joint Dysfunction Syndrome with Sinew Dredging Manipulation

作　　者：李锐 刘洋 张世民[1] 杨灿 张琰朕 王毅[1] 黎作旭[1] 刘昱彰[1] 靳蛟 郝俊涛[1] 林海 张兆杰[1] LI Rui;LIU Yang;ZHANG Shimin;YANG Can;ZHANG Yanzhen;WANG Yi;LI Zuoxu;LIU Yuzhang;JIN Jiao;HAO Juntao;LIN Hai;ZHANG Zhaojie(Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing 100102,China;Beijing University of Chinese Medicine East Hospital,Beijing 100078,China)

机构地区：[1]中国中医科学院望京医院,北京100102 [2]北京中医药大学东方医院

出　　处：《中国中医骨伤科杂志》2024年第4期59-63,67,共6页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：中国中医科学院科技创新工程重大攻关项目(CI2021A02007)。

摘　　要：目的:回顾性分析单纯疏筋手法治疗30例寰枢关节错缝患者,观察其主要症状及影像学指标的改善情况。方法:选取2022年1月至2022年10月就诊的寰枢关节错缝患者30例,采用单纯疏筋手法进行治疗,每周3次,共治疗3周,分别于治疗前、首次治疗后3周、6周采用视觉模拟量表(VAS)评分和颈性眩晕症状和功能评估量表评估患者的主观症状,并于治疗前和首次治疗后3周测定颈椎CT片中的寰枢椎相对旋转角度、齿突侧块间距、寰齿前间距以及屈伸功能位X线片中的寰枢关节活动度。结果:30例患者均完成3周共9次手法治疗,首次治疗后3周和6周与治疗前相比,患者的颈痛VAS评分、颈性眩晕症状与功能量表评分均明显改善,差异有统计学意义(P<0.01)。治疗后3周与治疗前相比,颈椎CT片上寰枢椎相对旋转角度、齿突侧块间距及屈伸功能位X线片中的寰枢关节活动度均有明显改善,差异有统计学意义(P<0.01);寰齿前间距与治疗前相比减小,差异无统计学意义(P>0.05)。结论:筋柔骨正理论指导下运用单纯疏筋手法能够改善患者的临床症状及影像学表现,并且治疗过程中无颈椎扳动类操作,具有较好的安全性。Objective:To retrospectively analyze 30 cases of atlantoaxial joint dysfunction syndrome treated by sinew dredging manipulation,and observe the improvement of the main symptoms and imaging indicators.Methods:From January 2022 to October 2022,30 patients with atlantoaxial joint dysfunction syndrome were selected.They were treated with sinew dredging manipulation,3 times a week for a total of 3 weeks.The subjective symptoms of patients were evaluated by visual analogue scale(VAS)and cervical vertigo symptom and function assessment scale before treatment,3 weeks and 6 weeks after the first treatment.Before treatment and 3 weeks after the first treatment,the atlantoaxial relative rotation angle,the lateral mass distance of the odontal process,and the anterior atlantodental distance were measured in cervical CT and the range of motion of atlantoaxial joint were measured in the cervical flexion and extension position.Results:All the 30 patients completed the manual treatment for 9 times in 3 weeks.Compared with before treatment,the VAS scores of neck pain and the cervical vertigo symptom and function scale of the patients were significantly improved 3 weeks and 6 weeks after the first treatment,and the differences were statistically significant(P<0.01).Compared with before treat-ment,the relative rotation angle of the atlantoaxial,the distance of the lateral mass of the odontal process and the range of motion of atlantoaxial joint were significantly improved 2 weeks after treatment,and the differences were statistically significant(P<0.01).The anterior atlantodental distance was decreased compared with that before treatment,and the difference was not statistically significant(P>0.05).Conclusion:Under the guidance of the theory of tendon and bone alignment,the use of sinew dredging manipulation can effectively improve the clinical symptoms and imaging manifestations of patients,and there is no cervical spine wrenching operation in the treatment process,which has good safety.

关 键 词：寰枢关节错缝 手法 筋柔骨正 寰枢椎相对旋转角度 齿突侧块间距 

分 类 号：R681.5[医药卫生—骨科学]