| 椎动脉型颈椎病的手法治疗 |
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投稿时间：2010-01-10
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| 作者 | Author | 单位 | Address | E-Mail |
| 高辉 |
GAO Hui |
赣南医学院第一附属医院骨科,江西 赣州 341000 |
Department of Orthopaedics,the 1st Affiliated Hospital of Gannan Medical College,Ganzhou 341000,Jiangxi,China |
gaohui3721@163.com |
| 叶勇军 |
YE Yong-jun |
赣南医学院第一附属医院骨科,江西 赣州 341000 |
Department of Orthopaedics,the 1st Affiliated Hospital of Gannan Medical College,Ganzhou 341000,Jiangxi,China |
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| 期刊信息：《中国骨伤》2010年，第23卷，第4期，第257-260页 |
| DOI：10.3969/j.issn.1003-0034.2010.04.007 |
| 基金项目:江西省卫生厅中医药科研基金(编号：2007A140) |
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中文摘要:
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、C 3组，每组100例，分别采用旋牵手法(每周1次，每次30 min,4次为1个疗程)、旋转扳法(每周1次，每次30 min,4次为1个疗程)和颈椎牵引法(每日1次，每次30 min,重量5～10 kg,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-C7 Cobb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(P<0.01和P<0.05),B组与C组比较无统计学差异(P>0.05),3组比较有统计学差异(P<0.05).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(P<0.01);A组与C组相比，LVA、RVA、BA血流也均有改善(P<0.05);B组与C组相比，LVA、RVA、BA血流改善均无统计学差异(P>0.05);3组相比LVA、RVA、BA均有统计学差异(P<0.05).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(P<0.05).
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。 |
| 【关键词】椎动脉型颈椎病 手法,骨科 超声检查,多普勒,经颅 |
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| Manipulative treatment of vertebral artery type of cervical spondylosis |
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ABSTRACT
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 per time,4 times a course of treatment;patients in group C were treated with traction(one time per day,30 min per time,10 times a course of treatment). Therapic time was a course of treatment in all groups. At 6 months after treatment,the clinical effects,cervical curvature,change of blood flow were respectively observed according sympotoms,X-ray,transcranial doppler sonography(TCD).
Results: All patients were followed up more than 6 months. The improving average of cervical curvature(C2-C7 Cobb angle):group A,B,C was respectively 1.82±0.88,0.12±0.06,0.56±0.22;group A was better than group B(P<0.01) and group C(P<0.05). There was no significantly difference between group B and C(P>0.05);and there was significantly difference in three groups(P<0.05). TCD detection:LVA,RVA,BA improving significantly in group A than group B(P<0.01) and group C(P<0.05);there was no significantly difference between group B and C(P>0.05) and there was significantly difference among three groups(P<0.05). Clinical effects:in group A,36 cases obtained curing results,36 excellent,20 utility,8 ineffective,the rate of excellent and good was 92%;in group B:6 cases obtained curing results,20 excellent,10 utility,64 ineffective,the rate of excellent and good was 36%;in group C,10 cases obtained curing results,26 excellent,8 utility,56 ineffective,the rate of excellent and good was 44%;there was significantly difference in three groups(P<0.05).
Conclusion: All three methods can significantly relieve headache and vertigo through improving cervical curvature and VA、BA blood flow,but its long-term effect should be observed. |
| KEY WORDS Vertebral artery type of cervical spondylosis Manipulation,orthopedic Ultrasonograply,doppler,transcranial |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 高辉,叶勇军.椎动脉型颈椎病的手法治疗[J].中国骨伤,2010,23(4):257~260 |
| 英文格式: | GAO Hui,YE Yong-jun.Manipulative treatment of vertebral artery type of cervical spondylosis[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(4):257~260 |
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