摘要
目的:探讨“三步五法”推拿结合稳定肌训练应用于神经根型颈椎病(CSR)的临床疗效和可能机制。方法:选取2018年10月-2021年10月我院收治的60例CSR患者作为研究对象,按照随机数字法分为对照组和观察组各30例,对照组给予稳定肌训练治疗,观察组在对照组基础上给予“三步五法”推拿治疗,连续治疗2周。比较两组临床疗效、症状评分、疼痛程度(VAS)评分、颈椎功能障碍指数(NDI)、颈椎关节活动度及椎动脉血流动力学指标[时间平均流速(TMFV)、收缩期血流速度(PSV)、搏动指数(PI)、阻力指数(RI)]。结果:观察组治疗有效率高于对照组(93.33%vs70.00%)(P<0.05)。治疗后,两组肩颈背痛、颈肌肉痛、上肢麻木评分和VAS、NDI评分及PI、RI均降低,后伸度、前屈度、旋转度、TMFV、PSV均升高(P<0.05);且观察组肩颈背痛、颈肌肉痛、上肢麻木评分和VAS、NDI评分及PI、RI均显著低于对照组,后伸度、前屈度、旋转度、TMFV、PSV均显著高于对照组(P<0.05)。结论:“三步五法”推拿结合稳定肌训练治疗CSR患者疗效显著,可能通过提高痛阀缓解了肩颈部疼痛、力量训练增加了颈椎稳定性以及椎动脉血液循环改善而起到疏通经络、调理气血的临床作用。
Objective To explore the clinical effect and possible mechanism of “three steps and five methods” massage combined with stabilizing muscle training in cervical spondylotic radiculopathy (CSR).Methods Sixty patients with CSR admitted to the hospital from October 2018 to October 2021 were selected as the research subjects.They were divided into control group and observation group by random number table method,with 30 cases in each group.Patients in control group were given stable muscle training,and those in observation group were given three-step five-method manipulation on this basis.Both groups were given 2 weeks of treatment.Clinical effects,symptom scores,the Visual Analogue Scale (VAS)scores,neck disability index (NDI),cervical range of motion and vertebral artery hemodynamic indexes 【time mean flow velocity (TMFV),peak systolic blood flow velocity (PSV),pulsatility index (PI)and resistance index (RI)】 were compared between the two groups.Results The treatment response rate in observation group was higher than that in control group (93.33% vs 70.00%)(P<0.05).After treatment,the scores of shoulder,neck and back pain,neck muscle pain,upper extremity numbness,VAS and NDI,PI and RI were reduced in the two groups.The ranges of posterior extension,anteflexion and rotation,TMFV and PSV were increased in the two groups (P<0.05).Meanwhile,the scores of shoulder,neck and back pain,neck muscle pain,upper extremity numbness,VAS and NDI,PI and RI in observation group were significantly lower than those in control group.The ranges of posterior extension,anteflexion and rotation,TMFV and PSV in observation group were significantly larger/higher than those in control group (P<0.05).Conclusion The significant efficacy of Three-step five-method manipulation combined with stabilizing muscles training in the treatment of CSR patients may be due to the relief of shoulder and neck pain by raising the pain valve,the increased stability of the cervical spine through strength training,and the clinical effect of unblocking the meridians and regulating qi and blood by improving blood circulation in the vertebral arteries.
作者
陈德生
沈杰
柯丽
宣以道
陈和木
CHEN Desheng;SHEN Jie;KE Li;XUAN Yidao;CHEN Hemu(The 901 Hospital of the Joint Logistics Support Force PLA,Anhui Hefei 230031,China;The First Affiliated Hospital of Anhui Medical Universty,Anhui Hefei 230022,China)
出处
《中医药临床杂志》
2022年第11期2141-2145,共5页
Clinical Journal of Traditional Chinese Medicine
基金
安徽省高校省级质量工程项目(编号:2020SJJXSFK1370)
安徽省高校自然科学研究项目(编号:KJ2020ZD18)。
关键词
神经根型颈椎病
三步五法推拿
稳定肌训练
颈椎功能障碍指数
血流动力学指标
Cervical spondylotic radiculopathy
Three-step five-method manipulation
Stable muscle training
Neck disability index
Hemodynamic index
