刘寿山整颈法治疗慢性非特异性颈痛的随机对照研究  

Randomized Controlled Study of Liu Shoushan Manipulation in Treating of Non-Specific Chronic Neck Pain

作　　者：张超 李嘉玮[1] 马增斌 覃昌龙[1] 白春晓 翟俊修[1] 张帆[1] 李忠泽[1] 许萌 陈江 ZHANG Chao;LI Jiawei;MA Zengbin;QIN Changlong;BAI Chunxiao;ZHAI Junxiu;ZHANG Fan;LI Zhongze;XU Meng;CHEN Jiang(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;Beijing University of Chinese Medicine;Beijing Hospital)

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]北京中医药大学 [3]北京医院

出　　处：《中国中医骨伤科杂志》2024年第10期19-25,共7页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：国家自然科学基金面上项目(82374492);北京中医药大学新教师启动基金项目(2023-BUCMXJSY015)。

摘　　要：目的:观察刘寿山整颈法治疗慢性非特异性颈痛的疗效及安全性。方法:纳入慢性非特异性颈痛患者40例,随机分为观察组(20例)和对照组(20例);观察组患者接受刘寿山整颈法治疗,对照组接受牵引治疗;评估两组患者治疗前后肌肉弹性模量、疼痛程度及颈椎功能障碍程度的差异。结果:治疗后两组患者的剪切波弹性模量(SWE)值均下降,观察组患者左侧胸锁乳突肌(L-SCM)、双侧头夹肌(SPCAP)及双侧上斜方肌(Trapezius)的剪切波弹性模量值显著低于牵引组(P<0.001),两组患者右侧胸锁乳突肌(R-SCM)相比差异无统计学意义(P=0.243);治疗后两组患者疼痛视觉模拟量表(VAS)评分及颈椎功能障碍指数(NDI)评分均下降,观察组患者VAS评分及NDI评分显著低于对照组,差异有统计学意义(P<0.05)。相关性分析表明VAS评分差异绝对值与上斜方肌、头夹肌剪切波弹性模量差异显著负相关(-1.0<r<-0.5,P<0.001),与左胸锁乳突肌负相关(P=0.0021),与右胸锁乳突肌相关性无统计学意义(P=0.2891)。结论:刘寿山整颈法治疗可显著改善慢性非特异性颈痛患者上斜方肌、头夹肌的僵硬度,较好地缓解疼痛程度,改善颈椎功能,且在短期内保持疗效。Objective:To assess the efficacy and safety of Liu Shoushan manipulation therapy in treating non-specific chronic neck pain(NCNP).Methods:40 patients with NCNP were randomly assigned to either an observation group(20 cases)receiving Liu Shoushan manipulation therapy and a control group(20 cases)receiving traction therapy.The differences of elastic modulus,pain degree and cervical dysfunction of different muscles between the two groups were evaluated before and after treatment.Results:After treatment,the shear wave elastography(SWE)value of the two groups decreased.The observation group demonstrated significantly lower SWE values in the left sternocleidomastoid muscle(L-SCM),trapezius(TRAP)and splenius capitis(SPCAP)compared to the control group(P<0.001),and there was no statistically difference in right sternocleidomastoid muscle(R-SCM)between the two groups(P=0.243).Additionally,visual analogue scale(VAS)and neck disability index(NDI)scores decreased significantly in both groups post-treatment,with the observation group showing greater reductions compared to the control group(P<0.05).Correlation analysis revealed significant negative correlations between VAS score differences and elasticity modulus differences of the trapezius and SPCAP(-1.0<r<-0.5,P<0.001),and negative correlation with the L-SCM(P=0.0021),while correlations with the R-SCM were not significant statistically(P=0.2891).Conclusion:Liu Shoushan manipulation therapy can significantly improve the stiffness of the trapezius and SPCAP in patients with chronic non-specific neck pain,effectively alleviate pain,improve cervical spine function,and maintain efficacy in the short-term follow-up.

关 键 词：慢性非特异性颈痛 刘寿山 正骨疗法 剪切波弹性模量成像 随机对照研究 

分 类 号：R681.5[医药卫生—骨科学]