摘要
目的:观察卧位偏向牵引联合中药薰蒸治疗神经根型颈椎病的临床疗效。方法:将120例神经根型颈椎病患者随机分为卧位偏向牵引组、卧位常规牵引组、坐位牵引组,每组40例。卧位牵引治疗包括前屈位牵引8d、中立位牵引2d、背伸位牵引4d;卧位偏向牵引组在前屈位牵引时采用卧位偏向牵引,中立位、背伸位牵引时采用常规卧位牵引;卧位常规牵引组全程采用常规卧位牵引法牵引;坐位牵引组采用传统坐位间歇牵引法。3组患者均采用中药薰蒸治疗。牵引和中药薰蒸均每日2次,连续治疗14d。分别于治疗前和治疗结束后,采用视觉模拟量表(visual analogue scale,VAS)评价患者颈部疼痛情况,测量患者颈椎旋转、前屈活动度,采用田中靖久神经根型颈椎病症状量表20分法和颈椎功能障碍指数(neck disability index,NDI)评价临床疗效,采用剪切波弹性成像技术测量斜方肌的杨氏模量值。结果:①颈部疼痛VAS评分。治疗结束后,3组患者颈部疼痛VAS评分均小于治疗前[(5.70±0.82)分,(1.43±0.68)分,t=37.779,P=0.000;(5.43±0.81)分,(2.53±0.93)分,t=15.945,P=0.000;(5.43±0.98)分,(3.00±1.13)分,t=16.013,P=0.000],卧位偏向牵引组患者颈部疼痛VAS评分小于卧位常规牵引组和坐位牵引组(LSD-t=6.040,P=0.000;LSD-t=7.562,P=0.000),卧位常规牵引组患者颈部疼痛VAS评分小于坐位牵引组(LSD-t=2.051,P=0.044)。②颈椎旋转活动度。治疗结束后,3组患者颈椎旋转活动度均大于治疗前(46.60°±10.45°,63.65°±7.79°,t=-9.379,P=0.000;45.95°±9.24°,57.58°±7.54°,t=-6.694,P=0.000;48.22°±9.96°,53.72°±9.39°,t=-2.298,P=0.000),卧位偏向牵引组患者颈椎旋转活动度大于卧位常规牵引组和坐位牵引组(LSD-t=-3.280,P=0.001;LSD-t=-5.371,P=0.000),卧位常规牵引组患者颈椎旋转活动度大于坐位牵引组(LSD-t=-2.083,P=0.040)。③颈椎前屈活动度。治疗结束后,3组患者颈椎前屈活动度均大于治疗前(28.45°
Objective:To observe the clinical efficacy of deflected supine traction combined with Chinese herbal steaming in the treatment of cervical spondylotic radiculopathy(CSR).Methods:A total of 120 CSR patients were randomly divided into a deflected supine traction(DST)group,a conventional supine traction(CST)group,and a sitting traction(ST)group,with 40 cases in each group.The supine traction consisted of traction in the forward flexion position for 8 days,in the neutral position for 2 days,and in the back flexion position for 4 days.In the DST group,DST was adopted in the traction in the forward flexion position,and CST was adopted in the traction in the neutral position and back flexion position.In the CST group,CST was employed throughout the whole treatment cycle.In the ST group,conventional intermittent ST was employed.All patients were treated with Chinese herbal steaming.Traction and Chinese herbal steaming were performed twice a day for 14 days.Before and after treatment,the visual analogue scale(VAS)was used to evaluate the cervical pain of patients,and ranges of motion in cervical rotation and cervical flexion were measured.The clinical efficacy was evaluated by the Yasuhisa Tanaka 20 Score Scale and neck disability index(NDI).Young's modulus of trapezius muscle was measured by shear wave elasticity imaging(SWEI).Results:①Cervical pain VAS score.After treatment,cervical pain VAS scores in all groups were lower than those before treatment(5.70±0.82 vs 1.43±0.68 points,t=37.779,P=0.000;5.43±0.81 vs 2.53±0.93 points,t=15.945,P=0.000;5.43±0.98 vs 3.00±1.13 points,t=16.013,P=0.000).The cervical pain VAS score in the DST group was lower than those in the CST group and the ST group(LSD-t=6.040,P=0.000;LSD-t=7.562,P=0.000).The cervical pain VAS score in the CST group was lower than that in the ST group(LSD-t=2.051,P=0.044).②Range of motion in cervical rotation.After treatment,ranges of motion in cervical rotation in all groups were greater than those before treatment(46.60°±10.45°vs 63.65°±7.79°,t=-
作者
宋永伟
范华雨
樊金辉
曹向阳
鲍铁周
蔡尚欢
张杰
海渊
SONG Yongwei;FAN Huayu;FAN Jinhui;CAO Xiangyang;BAO Tiezhou;CAI Shanghuan;ZHANG Jie;HAI Yuan(Luoyang Orthopedic-Traumatological Hospital of Henan Province/Henan Provincial Orthopedic Hospital,Luoyang 471002,Henan,China)
出处
《中医正骨》
2023年第3期31-36,共6页
The Journal of Traditional Chinese Orthopedics and Traumatology
关键词
颈椎病
神经根病
牵引术
熏洗疗法
临床试验
cervical spondy losis
radiculopathy
traction
steaming washing therapy
clinical trial
