整脊推拿配合导引治疗神经根型颈椎病的临床研究

目的:观察整脊推拿配合导引治疗神经根型颈椎病的临床疗效。方法:将120例神经根型颈椎病患者随机分为2组,每组60例。其中男68例,女52例。年龄35～60岁,中位数47.5岁。病程2～49周,中位数14.5周。治疗组采用整脊推拿配合导引治疗,对照组单纯采用整脊推拿治疗。治疗结束后分别采用《中医病证诊断疗效标准》、神经根型颈椎病疗效评分方法及Bobor’s法比较2组患者的总体疗效、疗效评分及颈椎生理曲度。结果:①总体疗效。治疗组治愈47例,好转13例;对照组治愈31例,好转29例;治疗组患者总体疗效优于对照组(U=3.050,P=0.002)。②疗效评分。治疗前治疗组疗效评分(13.93±2.14)分,对照组疗效评分(14.07±2.19)分;治疗后治疗组疗效评分(28.44±1.52)分,对照组疗效评分(24.34±2.20)分;治疗前2组患者疗效评分比较,差异无统计学意义(t=0.354,P=0.723);治疗后2组患者的疗效评分均增加(t=42.819,P=0.000;t=25.627,P=0.000),治疗组增加更明显(t=15.898,P=0.000)。③颈椎生理曲度。治疗前治疗组颈椎生理曲度(2.72±1.60)mm,对照组颈椎生理曲度(2.64±1.34)mm;治疗后治疗组颈椎生理曲度(4.30±1.23)mm,对照组颈椎生理曲度(3.55±1.82)mm;治疗前2组患者颈椎生理曲度比较,差异无统计学意义(t=0.297,P=0.767);治疗后2组患者颈椎生理曲度均改善(t=6.064,P=0.000;t=3.119,P=0.002),治疗组改善更明显(t=15.041,P=0.000)。结论:整脊推拿配合导引能有效改善神经根型颈椎病患者的临床症状和颈椎生理曲度,是治疗该病的有效方法,值得临床推广应用。

Clinical study on the effect of chiropractic manipulation combined with physical and breathing exercises on cervical spondylotic radiculopathy

Objective：To observe the clinical curative effect of chiropractic manipulation combined with physical and breathing exercises on cervical spondylotic radiculopathy.Methods：One hundred and twenty patients with cervical spondylotic radiculopathy were randomly divided into 2 groups,60 cases in each group;male 68 cases,while female 52 cases;ranging in age from 35 to 60 years with a median of 47.5 years;ranging in courses of disease from 2 to 49 weeks with a median of 14.5 weeks.Patients in the treatment group were administrated with chiropractic manipulation combined with physical and breathing exercises,while the others in the control group were administrated with chiropractic manipulation only.The total curative effect,curative effect scores and cervical curvature of the patients were compared between the 2 groups under the adoption of Standard for diagnosis and therapeutic effectiveness evaluation of traditional Chinese medicine syndromes,scoring method of curative effect of cervical spondylotic radiculopathy and Bobor＇s method respectively after the treatment.Results：Forty-seven patients had excellent outcomes and 13 cases had good outcomes in the treatment group,while 31 cases had excellent outcomes and 29 cases had good outcomes in the control group.The total curative effect was better in the treatment group than in the control group（U=3.050,P=0.002）.The curative effect scores of treatment group and control group were（13.93±2.14）points and（14.07±2.19）points respectively before the treatment.The curative effect scores of treatment group and control group were（28.44±1.52）points and（24.34±2.20）points respectively after the treatment.There was no statistical difference in curative effect scores between the 2 groups before the treatment（t=0.354,P=0.723）.The curative effect scores of all of the 2 groups increased after the treatment（t=42.819,P=0.000;t=25.627,P=0.000）,and scores of treatment group increased much more significantly（t=15.898,P=0.000）.The cervical curvature of patients in the treatment group and in the control group were（2.72±1.60）mm and（2.64±1.34）mm respectively before the treatment.The cervical curvature of patients in the treatment group and in the control group were（4.30±1.23）mm and（3.55±1.82）mm respectively after the treatment.There were no statistical differences in cervical curvature between the 2 groups before the treatment（t= 0.297,P=0.767）.The cervical curvature of patients in the 2 groups were all improved after the treatment（t=6.064,P=0.000;t=3.119,P=0.002）,and patients in the treatment group got much more improvement（t=15.041,P=0.000）.Conclusion：The therapy of chiropractic manipulation combined with physical and breathing exercises can effectively improve the clinical symptoms and cervical curvature for the patients with cervical spondylotic radiculopathy,therefore it is an effective method in the treatment of this disease and it is worthy of popularizing in clinic.