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理筋正骨手法治疗颈型颈椎病临床观察

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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-contrac-tion 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.
Clinical Effect of Tendon-regulating and Bone-setting Manipulation in Treatment of Cervical-type Cervical Spondylosis
Objective To investigate the clinical effect of tendon-regulating and bone-setting manipulation combined with exer-cise in the treatment of cervical-type cervical spondylosis.Methods A total of 60 patients with cervical-type cervical spondylo-sis 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 meas-ure 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 calcu-late the co-contraction ratio(CCR)of the muscles in forward flexion,back extension,and lateral flexion of the neck;neck dys-function 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 reduc-tion 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.

Tendon-regulating and bone-setting manipulationCervical-type cervical spondylosisExercise trainingTraction

梁颖、陈朝晖、林永艳、张文娣、李冬静

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安徽中医药大学第一临床医学院,安徽合肥 230031

安徽中医药大学针灸推拿学院,安徽合肥 230012

理筋正骨 颈型颈椎病 运动锻炼 牵引

安徽省高校自然科学重大研究项目安徽中医药大学自然科学研究项目

KJ2021ZD0062ZH2020zryb03

2024

安徽中医药大学学报
安徽中医学院

安徽中医药大学学报

CSTPCD
影响因子:0.796
ISSN:2095-7246
年,卷(期):2024.43(1)
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