[1]陈立,张明月,兰秀芳,等.仰卧拔伸手法结合颈肌等长收缩锻炼治疗 颈型颈椎病的临床研究[J].中医正骨,2013,25(10):17-20.
　Chen Li*,Zhang Mingyue,Lan Xiufang,et al.Clinical study on the curative effect of pulling-extending manipulation in supine position combined with isometric contraction exercise of neck muscles in the treatment of cervical spondylosis of cervical type[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2013,25(10):17-20.
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仰卧拔伸手法结合颈肌等长收缩锻炼治疗 颈型颈椎病的临床研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第25卷
期数:
2013年10期
页码:
17-20
栏目:
临床研究
出版日期:
2013-10-30

文章信息/Info

Title:
Clinical study on the curative effect of pulling-extending manipulation in supine position combined with isometric contraction exercise of neck muscles in the treatment of cervical spondylosis of cervical type
作者:
陈立; 张明月; 兰秀芳; 叶文雄; 蒋静
中国人民解放军南京军区海军杭州疗养院,浙江 杭州 310002
Author(s):
Chen Li*; Zhang Mingyue; Lan Xiufang; Ye Wenxiong; Jiang Jing.*
PLA. Naval Hangzhou Sanatorium of Nanjing Military Region,Hangzhou 310002,Zhejiang,China
关键词:
颈椎病 推拿; 脊柱 颈肌 等长收缩 治疗; 临床研究性
Keywords:
Cervical spondylosis;  Manipulation; spinal;  Neck muscles;  Isometric contraction;  Therapies; investigational
摘要:
目的:观察仰卧拔伸手法结合颈肌等长收缩锻炼治疗颈型颈椎病的临床疗效。方法:将符合要求的90例颈型颈椎病患者随机分为3组,每组30例。Ⅰ组采用仰卧拔伸手法结合颈肌等长收缩锻炼治疗,Ⅱ组采用仰卧拔伸手法治疗,Ⅲ组采用电脑中频治疗仪结合颈肌等长收缩锻炼治疗,共治疗20 d。分别采用VAS评分法、颈椎功能障碍指数问卷调查表、关节活动度测定尺及Borden氏法,从颈部疼痛、颈椎功能障碍、颈椎活动范围及颈椎曲度4个方面评价各组患者的治疗效果。结果:①颈部疼痛。治疗前3组患者颈部疼痛VAS评分比较,差异无统计学意义(F=0.133,P=0.878); 治疗后3组患者的颈部疼痛VAS评分均较治疗前下降(t=16.185,P=0.001; t=12.665,P=0.001; t=8.358,P=0.003),Ⅰ组下降程度大于Ⅱ组和Ⅲ组(P=0.001,P=0.001),Ⅱ组下降程度大于Ⅲ组(P=0.034)。②颈椎功能障碍。治疗前3组患者的颈椎功能障碍指数比较,差异无统计学意义(F=1.082,P=0.351); 治疗后3组患者颈椎功能障碍指数均下降(t=7.837,P=0.001; t=6.085,P=0.001; t=2.623,P=0.014),Ⅰ组下降程度大于Ⅱ组和Ⅲ组(P=0.001,P=0.002),Ⅱ组下降程度与Ⅲ组相比差异无统计学意义(P=0.265)。③颈椎活动范围。治疗前3组患者在颈椎屈伸、侧弯和旋转活动方面比较,差异均无统计学意义(F=0.919,P=0.401; F=1.263,P=0.301; F=0.092,P=0.911)。治疗后3组患者的颈椎屈伸活动度均较治疗前增加(t=7.565,P=0.001; t=2.086,P=0.012; t=3.166,P=0.004),Ⅰ组的增加值大于Ⅱ组和Ⅲ组(P=0.001,P=0.001),Ⅱ组的增加值大于Ⅲ组(P=0.043); 治疗后Ⅰ组患者颈椎侧弯活动度较治疗前增加(t=5.298,P=0.001),其余2组患者无改善(t=0.626,P=0.536; t=0.140,P=0.401); 治疗后3组患者颈椎旋转活动度较治疗前均无改善(t=1.222,P=0.232; t=1.399,P=0.172; t=0.154,P=0.879)。④颈椎曲度。治疗前3组患者颈椎曲度比较,差异无统计学意义(F=1.174,P=0.322); 治疗后3组患者颈椎曲度较治疗前均无改善(t=1.811,P=0.081; t=0.670,P=0.508; t=2.147,P=0.060)。结论:仰卧拔伸手法结合颈肌等长收缩锻炼能有效缓解颈型颈椎病患者的颈部疼痛症状,改善颈椎活动功能,是治疗该病的有效方法。
Abstract:
Objective:To observe the clinical curative effect of pulling-extending manipulation in supine position combined with isometric contraction exercise of neck muscles in the treatment of cervical type cervical spondylosis(CTCS).Methods:Ninety CTCS patients met the requirements were randomly divided into 3 groups,30 cases in each group.Patients in groupⅠwere administrated with pulling-extending manipulation in supine position combined with isometric contraction exercise of neck muscles,patients in groupⅡwere administrated with pulling-extending manipulation in supine position,while the rest in group Ⅲ were administrated with computerized intermediate frequency therapy apparatus combined with isometric contraction exercise of neck muscles,for 20 days.The curative effects were evaluated from the 4 aspects of pain,dysfunction,range of motion(ROM)and curvature of cervical vertebra,using VAS scores,cervical dysfunction index questionnaires,and ROM measurement scale and Borden's method respectively.Results:①Cervical pain:There was no statistical difference in VAS scores of cervical pain among the 3 groups before the treatment(F=0.133,P=0.878).VAS scores of cervical pain decreased in all of the 3 groups after the treatment(t=16.185,P=0.001; t=12.665,P=0.001; t=8.358,P=0.003),and decline degree of groupⅠwas greater than that of groupⅡand group Ⅲ respectively(P=0.001,P=0.001),while decline degree of groupⅡwas greater than that of groupⅢ(P=0.034).②Cervical dysfunction:There was no statistical difference in cervical dysfunction index among the 3 groups before the treatment(F=1.082,P=0.351).The cervical dysfunction indexes of patients in the 3 groups decreased after the treatment(t=7.837,P=0.001; t=6.085,P=0.001; t=2.623,P=0.014),and decline degree of groupⅠwas greater than that of groupⅡand groupⅢrespectively(P=0.001,P=0.002),while there was no statistical difference in decline degree between groupⅡand groupⅢ(P=0.265).③ROM:There was no statistical difference in the ROM of flexion-extention,lateral bending and rotation of cervital vetebrae among the 3 groups before the treatment(F=0.919,P=0.401; F=1.263,P=0.301; F=0.092,P=0.911).After the treatment,the ROM of flexion-extention of cervital vertebrae increased in all of the 3 groups(t=7.565,P=0.001; t=2.086,P=0.012; t=3.166,P=0.004),and the increased value of groupⅠwas greater than that of groupⅡand group Ⅲ respectively(P=0.001,P=0.001),while increased value of groupⅡwas greater than that of group Ⅲ(P=0.043).After the treatment,the ROM of cervical lateral bending of groupⅠincreased compared with that before the treatment(t=5.298,P=0.001),while no improvements were found in the rest 2 groups(t=0.626,P=0.536; t=0.140,P=0.401).After the treatment,no improvements were found in the ROM of cervical rotation in the 3 groups(t=1.222,P=0.232; t=1.399,P=0.172; t=0.154,P=0.879).④Cervical vertebra curvature:There was no statistical difference in cervical vertebra curvature among the 3 groups before the treatment(F=1.174,P=0.322).After the treatment,no improvement were found in cervical vertebra curve for the 3 groups(t=1.811,P=0.081; t=0.670,P=0.508; t=2.147,P=0.060).Conclusion:The therapy of pulling-extending manipulation in supine position combined with isometric contraction exercise of neck muscles can effectively relieve cervical pain and improve cervical ROM,so it is an effective method in the treatment of cervical spondylosis of cervical type.

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备注/Memo

备注/Memo:
2012-06-13收稿 2012-10-19修回
基金项目:中国人民解放军总后卫生部中医药专项课题(10ZYZ215)
更新日期/Last Update: 2013-10-30