椎动脉型颈椎病的手法治疗

目的:比较3种方法治疗椎动脉型颈椎病的临床疗效。方法:自2006年12月至2008年12月,将300例椎动脉型颈椎病患者(男138例,女162例,年龄18～76岁,平均38.6岁)按完全随机方法分为A、B、C3组,每组100例,分别采用旋牵手法(每周1次,每次30min,4次为1个疗程)、旋转扳法(每周1次,每次30min,4次为1个疗程)和颈椎牵引法(每日1次,每次30min,重量5～10kg,10次为1个疗程)治疗,3组均治疗1个疗程,治疗6个月后采用疗效评定标准对疗效进行评定,并观察颈椎曲度和经颅多普勒超声(TCD)检测血流变化。结果:所有患者均获得随访,时间在6个月以上。颈椎曲度(C2-C7Cobb角)改变:A、B、C组分别改善(1.82±0.88)°、(0.12±0.06)°、(0.56±0.22)°,A组优于B、C组(P0.01和P0.05),B组与C组比较无统计学差异(P0.05),3组比较有统计学差异(P0.05)。TCD检测:A组与B组相比,左侧椎动脉(LVA)、右侧椎动脉(RVA)、基底动脉(BA)血流均明显改善(P0.01);A组与C组相比,LVA、RVA、BA血流也均有改善(P0.05);B组与C组相比,LVA、RVA、BA血流改善均无统计学差异(P0.05);3组相比LVA、RVA、BA均有统计学差异(P0.05)。临床疗效:A组治愈36例,显效36例,有效20例,无效8例,优良率92%;B组治愈6例,显效20例,有效10例,无效64例,优良率36%;C组治愈10例,显效26例,有效8例,无效56例,优良率44%,3组优良率有统计学差异(P0.05)。结论:3种治疗方法均能通过改善椎动脉、基底动脉的血流量,颈椎曲度而减轻椎动脉型颈椎病临床症状,但旋牵手法优于旋转扳法、颈椎牵引法,其远期疗效还需更长时间随访观察。

Manipulative treatment of vertebral artery type of cervical spondylosis

Objective:To compare the effects of the three manipulative methods in treating vertebral artery type of cervical spondylosis. Methods:From December 2006 to December 2008,300 patients (male 138 and female 162,the age from 18 to 76 years with an average of 38.6 years) with vertebral artery type of cervical spondylosis were randomly divided into group A,B,C (100 cases each group). Patients in group A,B were respectively treated with rotation traction and rotation turn manual reduction (one time per week,30 min...