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旋提手法配合颈痛颗粒及功能锻炼对神经根型颈椎病颈椎活动度改善的临床观察
Hits: 3171   Download times: 1917   Received:March 22, 2010    
作者Author单位UnitE-Mail
甄朋超 ZHEN Peng-chao 中国中医科学院望京医院脊柱二科, 北京 100102 Department of the Second Spine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China  
朱立国 ZHU Li-guo 中国中医科学院望京医院脊柱二科, 北京 100102 Department of the Second Spine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China zhlg95@yahoo.com.cn 
高景华 GAO Jing-hua 中国中医科学院望京医院脊柱二科, 北京 100102 Department of the Second Spine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China  
于杰 YU Jie 中国中医科学院望京医院脊柱二科, 北京 100102 Department of the Second Spine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China  
冯敏山 FENG Min-shan 中国中医科学院望京医院脊柱二科, 北京 100102 Department of the Second Spine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China  
魏戌 WEI-Xu 中国中医科学院望京医院脊柱二科, 北京 100102 Department of the Second Spine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China  
王尚全 WANG Shang-quan 中国中医科学院望京医院脊柱二科, 北京 100102 Department of the Second Spine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China  
期刊信息:《中国骨伤》2010年23卷,第10期,第750-753页
DOI:10.3969/j.issn.1003-0034.2010.10.009
基金项目:“十一五”国家科技支撑计划课题(编号:2006BAI04A09)


目的:观察采用旋提手法加颈痛颗粒加颈椎康复操疗法与颈椎牵引加双氯芬酸钠缓释片加佩戴颈围疗法对神经根型颈椎病的颈椎活动功能受限改善的效果。

方法:自2008年4月至2009年10月治疗神经根型颈椎病患者71例,男22例,女49例;年龄45~65岁,平均52.27岁;病程3 d~5年。其中36例采用旋提手法加颈痛颗粒加颈椎康复操治疗(A组),35例采用颈椎牵引加双氯芬酸钠缓释片加佩戴颈围治疗(B组),均持续治疗2周,应用头盔式颈椎活动仪于治疗前和治疗后第1 ,3 ,5 ,7 ,9 ,11 ,13天及治疗后1 个月测量颈椎前屈、后伸、左右侧屈、左右旋转的活动度。

结果:A、B两组颈椎前屈、后伸、左右屈、左右旋转的活动度治疗前无差异( P>0.05) ,治疗后组内比较,颈椎前屈、后伸活动度改善数值有统计学意义,A组均在治疗后第5天(P<0.01)开始出现,B组前屈活动度改善数值有统计学意义在治疗后第13天(P<0.05)出现,而治疗后1个月时与治疗前数值相比仍无统计学意义(P>0.05),后伸活动度在治疗后第7天(P<0.05)开始出现;颈椎左屈活动度改善数值有统计学意义,A组在治疗后第1天(P<0.05)开始出现,B组则在治疗后第5天(P<0.01)开始出现;颈椎右屈、左旋、右旋活动度改善数值有统计学意义,两组均在治疗后第3 天(P<0.05)或第5天(P<0.05)开始出现; 组间比较两组1个月随访时在颈椎前屈、左屈、右屈、左旋、右旋5个方向的活动度变化值均有统计学意义(P<0.05).

结论: 旋提手法加颈痛颗粒加颈椎康复操疗法在改善颈椎前屈、后伸、左侧屈活动受限情况起效较快;在改善颈椎各个方向活动受限疗效较为持久,不易反复。
[关键词]:颈椎病  活动范围,关节  手法,骨科  病例对照研究
 
Clinical observation on improvement of motion range of cervical spine of patients with cervical spondylotic radiculopathy treated with rotation-traction manipulation and neck pain particles and cervical neck pain rehabilitation exercises
Abstract:

Objective: To observe the effects of two different therapies on patients whose cervical function were restricted due to cervical spondylotic radiculopathy.

Methods: Form April 2008 to October 2009,71 cases with cervical spondylotic radiculopathy were divided into group A(36 cases) and group B(35 cases). Among them,22 cases were male and 49 cases were female,ranging in age form 45 to 65 years with an average of 52.27 years,course of disease was from 3 days to 5 years. The patients in group A were treated with rotation-traction manipulation,neck pain particles and cervical rehabilitation exercises;and the patients in group B were treated with cervical traction,Diclofenac sodium sustained release tablets and wearing neck collar. Theapeutic time was two weeks. The cervical anteflexion,extension,left and right lateral bending,left and right rotative activity were measured by helmet-style activities instrument before and after treatment(at the 1,3,5,7,9,11,13 days and 1 month after treatment respectively).

Results: There were no difference between two groups in cervical activity in all directions before treatment(P>0.05). Compared with the beginning,cervical anteflexion and extension showed significant difference at the 5th day after treatment in group A(P<0.01). In group B,cervical anteflexion showed significant difference at the 13th day after treatment(P<0.05),but at the 1 month after treatment,the significant difference disappeared(P>0.05);cervical extension showed significant difference at the 7th day after treatment compared with the beginning(P<0.05). Compared with the beginning,left lateral bending showed significant difference at the 1st day after treatment in group A(P<0.05)and at the 5th day after treatment in group B(P<0.01). Both in group A or B,right lateral bending,left and right rotative activity showed significant difference at the same time after treatment,either the 3rd day(P<0.05)or the 5th day(P<0.05). Compared between groups,cervical anteflexion,left and right lateral bending,left and right rotative activity showed significant difference at the 1 month after treatment(P<0.05).

Conclusion: The rotation-traction manipulation and neck pain particles and cervical rehabilitation exercises in treating cervicalspondylotic radiculopathy have quick effect to improve the activities of cervical anteflexion,extension,left lateral bending,and have durable effect to improve the activities of cervical spine in all directions.
KEYWORDS:Cervical spondylosis  Range of motion,articular  Manipulation,orthopedic  Case-control studies
 
引用本文,请按以下格式著录参考文献:
中文格式:甄朋超,朱立国,高景华,于杰,冯敏山,魏戌,王尚全.旋提手法配合颈痛颗粒及功能锻炼对神经根型颈椎病颈椎活动度改善的临床观察[J].中国骨伤,2010,23(10):750~753
英文格式:ZHEN Peng-chao,ZHU Li-guo,GAO Jing-hua,YU Jie,FENG Min-shan,WEI-Xu,WANG Shang-quan.Clinical observation on improvement of motion range of cervical spine of patients with cervical spondylotic radiculopathy treated with rotation-traction manipulation and neck pain particles and cervical neck pain rehabilitation exercises[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(10):750~753
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