[1]吴忌,王庆甫,张栋,等.北京地区在校大学生颈痛患者颈椎曲度特点的调查研究[J].中医正骨,2016,28(02):28-32.
　WU Ji,WANG Qingfu,ZHANG Dong,et al.A survey of cervical curvature characteristics of college students with neck pain in Beijing[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(02):28-32.
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北京地区在校大学生颈痛患者颈椎曲度特点的调查研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期数:
2016年02期
页码:
28-32
栏目:
调查研究
出版日期:
2016-02-20

文章信息/Info

Title:
A survey of cervical curvature characteristics of college students with neck pain in Beijing
作者:
吴忌1; 王庆甫2; 张栋2; 郑皓云3; 石鑫超2; 杨黎黎2;  时宗庭2
1.四川省骨科医院,四川 成都 610041;
2.北京中医药大学第三附属医院,北京 100029;
3.北京市中医院,北京 100029
Author(s):
WU Ji1; WANG Qingfu2; ZHANG Dong2; ZHENG Haoyun3; SHI Xinchao2; YANG Lili2; SHI Zongting2
1.Sichuan Orthopaedic Hospital,Chengdu 610041,Sichuan,China 2.The Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine,Beijing 100029,China 3.Beijing Hospital of Traditional Chinese Medicine,Beijing 100029,China
关键词:
颈痛;  颈椎;  曲度;  青年人;  健康调查
Keywords:
neck pain;  cervical vertebrae;  curvature;  young adult;  health surveys
摘要:
目的:探讨北京地区在校大学生颈痛患者的颈椎曲度特点。方法:采集北京地区5所高校216例在校大学生颈痛患者的一般 情况、发病信息、生活习惯、颈痛情况4个方面的临床信息,并拍摄颈椎中立位侧位X线片,采用Borden深度测量法、Harrison夹 角测量法及颈椎曲度指数法3种方法对颈椎曲度进行测量,分析临床信息与颈椎曲度的相关性。结果:①一般结果。共纳入颈痛 患者216例,主动退出18例,因信息不全剔除17例,因颈椎椎体融合剔除5例,最终观察样本数为176例。②临床信息采集结果。176 例颈痛患者,男36例、女140例,年龄(21.78±2.23)岁,身高(1.65±0.07)m,体质量指数20.60±2.70 kg·m2,病程(8.68±7.70)个月,Northwick Park颈痛量表评分(20.59±10.0)分。颈痛发生频率,大部分 每月≥1次,每月<1次者仅26例。大部分人每天伏案时间>6 h,每天睡眠时间均在6 h以上。③颈椎曲度测量结果。176例 颈痛患者,颈椎Borden深度(6.00±5.36)mm、Harrison夹角15.21°±12.48°、颈椎曲度指数8.0±11.5,与正常 参考值相比,异常例数分别为117例、134例、113例。Borden深度异常的117例中,曲度减小87例、反曲26例、曲度变大4例。④ 临床信息与颈椎曲度的相关性分析结果。经相关分析,性别、年龄、身高、体质量指数、病程、颈痛发生频率与颈椎曲度无相 关性。每天使用电脑时间、使用手机时间、伏案时间与颈椎Borden深度、Harrison夹角、颈椎曲度指数呈负相关; 每天伏案时 间越长,颈椎曲度的各项测量值越小(r=-0.237,P=0.000; r=-0.214,P=0.000; r=-0.202,P=0.000)。每天睡眠时间与颈椎曲度 各项测量值呈正相关,睡眠时间越充足颈椎曲度各项测量值减小的趋势越不明显(r=0.202,P=0.000; r=0.228,P=0.000; r=0.216,P=0.000)。颈痛评分与颈椎曲度各项测量值呈负相关,颈痛评分越高颈椎曲度测量值越小(r=-0.178,P=0.031; r=- 0.183,P=0.028; r=-0.165,P=0.047)。结论:北京地区大学生颈痛患者颈椎曲度异常率超过60%,且以颈椎曲度减小为主,伏案时 间越长颈椎曲度减小的趋势越明显,睡眠时间越充足颈椎曲度减小的趋势越不明显,颈椎曲度越小颈痛越明显。
Abstract:
Objective:To explore the cervical curvature characteristics of college students with neck pain in Beijing.Methods:Two hundred and sixteen students with neck pain were recruited from five colleges in Beijing and their clinical information were collected,including general state of health,frequency of neck pain,living habits and neck pain scores.Furthermore,neutral lateral radiographs of cervical vertebrae were taken and the cervical curvatures were measured by using 3 methods respectively including Borden depth measurement,Harrison angle measurement and cervical curvature index(CCI).At last,the correlations between clinical information and cervical curvature were analyzed.Results:Of 216 students with neck pain,18 students dropped out initiatively and 17 students were excluded for uncomplete information and 5 students were excluded for cervical interbody fusion.Finally,176 students(36 males and 140 females)were chosen as the observation samples.Their ages were 21.78+/-2.23 yrs,body heights were 1.65+/-0.07 meters,body mass indexs were 20.60+/-2.70 kg∕m(2),disease courses were 8.68+/-7.70 months and Northwick Park neck pain scale scores were 20.59+/-10.0 points.The monthly frequency of neck pain of≥1 were found in the majority of the students,and those of <1 were found in 26 students.The working time at desk exceeded 6 hrs every day in the majority of the students,and the hours of sleep exceeded 6 hrs every day in all of the students.The Borden depth of cervical vertebra of the 176 students was 6.00+/-5.36 mm and Harrison included angle was 15.21+/-12.48 degrees and CCI was 8.0+/-11.5.According to normal reference value,above outcome measures were abnormal in 117,134 and 113 students respectively; and decreased cervical curvature(87),contrary flexure(26)and increased cervical curvature(4)were found in the 117 students with abnormal Borden depth of cervical vertebra.The results of correlation analysis showed that gender,age,body height,body mass index,disease course and frequency of neck pain had no correlations with cervical curvature.The everyday working time on computer,mobile phone and desk had negatively correlated with Borden depth of cervical vertebra,Harrison included angle and CCI.The longer the everyday working time on desk was,the smaller the measured values of cervical curvature became(r=-0.237,P=0.000; r=-0.214,P=0.000; r=- 0.202,P=0.000).The everyday hours of sleep were positively correlated with the measured values of cervical curvature,in other words,the more sufficient the everyday hours of sleep were,the more unconspicuous the decreased tendency of the measured values of cervical curvature was(r=0.202,P=0.000; r=0.228,P=0.000; r=0.216,P=0.000).The neck pain scores were negatively correlated with the measured values of cervical curvature,in other words,the higher the neck pain scores was,the smaller the measured values of cervical curvature became(r=-0.178,P=0.031; r=-0.183,P=0.028; r=-0.165,P=0.047).Conclusion:The abnormal rate of cervical curvature of college students with neck pain in Beijing is more than 60%,and the abnormality of cervical curvature presents mainly with decreased cervical curvature.The longer the working time on desk is,the more obvious the decreased tenency of the cervical curvature is.The more sufficient the hours of sleep are,the more unconspicuous the decreased tendency of the cervical curvature is.The smaller the cervical curvature is,the more obvious the neck pain is.

参考文献/References:

[1] Ståhl MK,El-Metwally AAS,Rimpelä AH.Time trends in single versus concomitant neck and back pain in finnish adolescents:results from national cross-sectional surveys from 1991 to 2011[J].BMC Musculoskeletal Disorders,2014,15:296.
[2] 时宗庭,王庆甫,黄沪,等.青少年颈痛患者功能位X线分析[J].北京中医药大学学报(中医临床版),2010,17(6):32-35.
[3] 国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:189-190.
[4] Hoy D,Protani MR,De R.Buchbinder.The epidemiology of neck pain[J].Best Practice&Research Clinical Rheumatology,2010,24(6):783-792.
[5] Leak AM,Cooper J,Dyer S,et al.The Northwick Park Neck Pain Questionnaire,devised to measure neck pain and disability[J].Br J Rheumatol,1994,33(5):469-474.
[6] Adam Greenspan,唐光建.骨放射学[M].3版.北京:中国医药科技出版社,2003:334-338.
[7] 贾连顺.现代脊柱外科学[M].北京:人民军医出版社,2007:881.
[8] 程黎明,贾连顺,陈雄生,等.计算机测量脊柱颈曲的临床意义[J].第二军医大学学报,1997,18(6):544-546.
[9] Katsushi Takeshita,Motoaki Murakami,Akira Kobayashi,et a1.Relationship between cervical curvature index (Ishihara)and cervical spine angle(C2-7)[J].Journal of Orthopaedic Science,2001,6(3):223-226.
[10] 张明才,石印玉,王翔,等.颈椎生理曲度异常对颈椎病发病作用的病例对照研究[J].中国骨伤,2010,23(10):746-750.
[11] 韦坚,韦贵康.颈椎曲度变化与退变关系的生物力学分析[J].中医正骨,1999,11(3):9-10.
[12] 张栋,王庆甫,吴忌,等.青少年颈痛的中医证候分型研究[J].中国骨伤,2015,28(7):628-632.
[13] 朱清广,房敏,洪水棕.“经筋病”和“骨错缝”在颈椎病中的生物力学作用[J].北京中医药,2010,29(1):34-36.
[14] 黄德尤,陆玉敏,李清锋,等.青少年颈椎病X线平片诊断价值探讨[J].中国临床医学影像杂志,2009,20(10):788-790.
[15] 薛艺东,刘广忠.青少年颈椎病的影像学特点与早期诊断[J].陕西医学杂志,2008,37(4):497-499.
[16] 董蔚青,李镇中.青年颈椎病的生物力学探讨[J].现代医用影像学,2009,18(3):136-138.
[17] Diepenmaat AC,van der Wal MF,de Vet HC,et al.Neck/shoulder,low back,and arm pain in relation to computer use,physical activity,stress,and depression among Dutch adolescents[J].Pediatrics,2006,117(2):412–416.
[18] 徐江,孙立军,由世浩.青少年颈椎亚健康中医病因病机研究[J].长春中医药大学学报,2011,27(2):232-233.
[19] 刘洪涛,申宝忠,卜丽红.青少年颈椎病X线征象分析及病因与防治探讨[J].现代生物医学进展,2012,12(33):6466-6469.
[20] 任龙喜,何玉宝,郭函,等. 颈部疼痛程度与颈推曲度相关性的临床观察[J].中国脊柱脊髓杂志,2011,21(9):750-754.

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备注/Memo

备注/Memo:
基金项目:教育部高等学校博士学科点专项科研基金项目(20110013110013); 首都医学发展基金项目(SF-2007-III-05); 国家 级临床重点专科“十二五”建设项目; 国家中医药管理局“十二五”重点学科建设项目
通讯作者:王庆甫 E-mail:qingpu-wang@sohu.com
更新日期/Last Update: 2016-04-30