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[1]孫武權(quán),房敏,周楠,等.頸椎特異性短杠桿微調(diào)手法治療神經(jīng)根型頸椎病的多中心臨床研究[J].中醫(yī)正骨,2018,30(05):1-5.
　SUN Wuquan,FANG Min,ZHOU Nan,et al.A multicenter clinical study of cervical specific short-lever fine-regulation manipulation for treatment of cervical spondylotic radiculopathy[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(05):1-5.
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頸椎特異性短杠桿微調(diào)手法治療神經(jīng)根型頸椎病的多中心臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期數(shù):
2018年05期
頁(yè)碼:
1-5
欄目:
臨床研究
出版日期:
2018-05-20

文章信息/Info

Title:
A multicenter clinical study of cervical specific short-lever fine-regulation manipulation for treatment of cervical spondylotic radiculopathy
作者:
孫武權(quán)1; 房敏1; 周楠1; 沈國(guó)權(quán)1; 詹紅生2; 鐘力煒3; 王勇4; 龔利1; 朱清廣5; 李建華1; 文世梅1
1.上海中醫(yī)藥大學(xué)附屬岳陽(yáng)中西醫(yī)結(jié)合醫(yī)院,上海 200437; 2.上海中醫(yī)藥大學(xué)附屬曙光醫(yī)院, 上海 201203; 3.上海市第一人民醫(yī)院,上海 200080; 4.上海交通大學(xué)醫(yī)學(xué)院附屬瑞金醫(yī)院, 上海 200025; 5.上海市中醫(yī)藥研究院推拿研究所,上海 200437
Author(s):
SUN Wuquan1; FANG Min1; ZHOU Nan1; SHEN Guoquan1; ZHAN Hongsheng2; ZHONG Liwei3; WANG Yong4; GONG Li1; ZHU Qingguang5; LI Jianhua1; WEN Shimei1
1.Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China 2.Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China 3.The First People's Hospital of Shanghai,Shanghai 200080,China 4.Ruijin Hospital Affiliated to Shanghai Jiaotong University Medical College,Shanghai 200025,China 5.The Institute of Massaging Affiliated to Shanghai Academy of Traditional Chinese Medicine,Shanghai 200437,China
關(guān)鍵詞:
頸椎病;  神經(jīng)根病;  手法; 整骨;  特異性微調(diào)手法;  臨床試驗(yàn);  多中心研究
Keywords:
cervical spondylosis;  radiculopathy;  manipulation; osteopathic;  specific spine adjustment technique;  clinical trial;  multicenter study
文獻(xiàn)標(biāo)志碼:
A
摘要:
目的:評(píng)價(jià)應(yīng)用頸椎特異性短杠桿微調(diào)手法治療神經(jīng)根型頸椎病的價(jià)值。方法:從4家醫(yī)院選取神經(jīng)根型頸椎病患者120例,隨機(jī)分期為3組,每組40例。宣教組通過(guò)健康教育指導(dǎo)患者糾正以往各種可能誘發(fā)頸椎病的不良習(xí)慣,長(zhǎng)杠桿手法組按照《推拿學(xué)》中頸椎病推拿手法操作規(guī)范進(jìn)行手法治療,短杠桿手法組采用頸椎特異性短杠桿微調(diào)手法治療。3組患者均治療4周,然后分別采用頸椎功能障礙指數(shù)(the neck disability index,NDI)、頸椎病治療成績(jī)?cè)u(píng)分、簡(jiǎn)明健康狀況調(diào)查表(short form 36 health survey questionnaire,SF-36)評(píng)分評(píng)價(jià)臨床療效,并根據(jù)患者的頸椎病治療成績(jī)?cè)u(píng)分和治療費(fèi)用計(jì)算療效費(fèi)用比。結(jié)果:治療前3組患者的NDI比較,差異無(wú)統(tǒng)計(jì)學(xué)意義[(39.80±4.31)%,(39.90±4.31)%,(39.45±4.53)%,F=0.122,P=0.885]。治療結(jié)束后3組患者的NDI比較,差異有統(tǒng)計(jì)學(xué)意義[(32.40±5.62)%,(11.45±6.49)%,(7.75±4.94)%,F=216.088,P=0.000]; 短杠桿手法組的NDI低于宣教組和長(zhǎng)杠桿手法組(P=0.000,P=0.013),長(zhǎng)杠桿手法組的NDI低于宣教組(P=0.000)。3組患者治療前后NDI差值比較,差異有統(tǒng)計(jì)學(xué)意義[(7.40±4.18)%,(28.45±4.16)%,(31.70±3.09)%,F=470.802,P=0.000]; 短杠桿手法組治療前后NDI差值大于宣教組和長(zhǎng)杠桿手法組(P=0.000,P=0.001),長(zhǎng)杠桿手法組治療前后NDI差值大于宣教組(P=0.000)。治療前3組患者的治療成績(jī)?cè)u(píng)分比較,差異無(wú)統(tǒng)計(jì)學(xué)意義[(57.33±7.07)%,(57.50±8.32)%,(58.10±6.41)%,F=0.124,P=0.884]。治療結(jié)束后3組患者的治療成績(jī)?cè)u(píng)分比較,差異有統(tǒng)計(jì)學(xué)意義[(66.47±5.95)%,(88.28±6.19)%,(91.03±8.90)%,F=142.267,P=0.000]; 短杠桿手法組和長(zhǎng)杠桿手法組治療結(jié)束后的治療成績(jī)?cè)u(píng)分均高于宣教組(P=0.000,P=0.000); 短杠桿手法組和長(zhǎng)杠桿手法組治療結(jié)束后的治療成績(jī)?cè)u(píng)分比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.199)。3組患者治療前后治療成績(jī)?cè)u(píng)分差值比較,差異有統(tǒng)計(jì)學(xué)意義[(9.13±7.79)%,(30.78±8.98)%,(32.93±8.18)%,F=99.672,P=0.000]; 短杠桿手法組和長(zhǎng)杠桿手法組治療前后治療成績(jī)?cè)u(píng)分差值均大于宣教組(P=0.000,P=0.000); 短杠桿手法組和長(zhǎng)杠桿手法組治療前后治療成績(jī)?cè)u(píng)分差值比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.482)。治療前3組患者的SF-36評(píng)分比較,差異無(wú)統(tǒng)計(jì)學(xué)意義[(98.09±7.84)分,(98.02±10.94)分,(99.48±11.78)分,F=0.253,P=0.777]。治療結(jié)束后3組患者的SF-36評(píng)分比較,差異有統(tǒng)計(jì)學(xué)意義[(106.76±6.21)分,(113.30±8.75)分,(118.14±8.26)分,F=21.367,P=0.000]; 短杠桿手法組治療結(jié)束后的SF-36評(píng)分高于宣教組和長(zhǎng)杠桿手法組(P=0.000,P=0.018),長(zhǎng)杠桿手法組治療結(jié)束后的SF-36評(píng)分高于宣教組(P=0.001)。3組患者治療前后SF-36評(píng)分差值比較,差異有統(tǒng)計(jì)學(xué)意義[(8.67±5.69)分,(15.28±7.46)分,(18.66±7.19)分,F=22.151,P=0.000]; 短杠桿手法組和長(zhǎng)杠桿手法組治療前后SF-36評(píng)分差值均大于宣教組(P=0.000,P=0.000); 短杠桿手法組和長(zhǎng)杠桿手法組治療前后SF-36評(píng)分差值比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.073)。短杠桿手法組的療效費(fèi)用比高于長(zhǎng)杠桿手法組[(37.86±7.99)%,(33.21±8.63)%,t=-2.331,P=0.035]。結(jié)論:頸椎特異性短杠桿微調(diào)手法治療神經(jīng)根型頸椎病,療效優(yōu)于單純宣教和長(zhǎng)杠桿手法,療效費(fèi)用比優(yōu)于長(zhǎng)杠桿手法治療。
Abstract:
Objective:To evaluate the applied values of cervical specific short-lever fine-regulation manipulation in the treatment of cervical spondylotic radiculopathy(CSR).Methods:One hundred and twenty patients with CSR were selected out from four hospitals and were randomly divided into education group,long-lever manipulation group and short-lever manipulation group,40 cases in each group.The patients in education group got health education and were guided to correct all kinds of previous bad habits that might induce cervical spondylosis.The patients in long-lever manipulation group were treated with manipulation therapy according to the operation specification of TUINA manipulation of cervical spondylosis which was extracted from TUINA Science.The patients in short-lever manipulation group were treated with cervical specific short-lever fine-regulation manipulation.All patients in the 3 groups were treated for 4 weeks,and the clinical curative effects were evaluated and compared between the 3 groups by using neck disability index(NDI),treatment outcome score of cervical spondylosis and short form 36 health survey questionnaire(SF-36)score respectively,and the effectiveness-cost ratio was calculated according to patients' treatment outcome scores of cervical spondylosis and cost of treatment.Results:There was no statistical difference in NDI between the 3 groups before the treatment(39.80+/-4.31,39.90+/-4.31,39.45+/-4.53%,F=0.122,P=0.885).There was statistical difference in NDI between the 3 groups after the end of the treatment(32.40+/-5.62,11.45+/-6.49,7.75+/-4.94%,F=216.088,P=0.000).The NDI was lower in short-lever manipulation group compared to education group and long-lever manipulation group(P=0.000,P=0.013),and was lower in long-lever manipulation group compared to education group(P=0.000).There was statistical difference between the 3 groups in the differences of NDI between pretreatment and posttreatment(7.40+/-4.18,28.45+/-4.16,31.70+/-3.09%,F=470.802,P=0.000).The difference of NDI between pretreatment and posttreatment was larger in short-lever manipulation group compared to education group and long-lever manipulation group(P=0.000,P=0.001),and was larger in long-lever manipulation group compared to education group(P=0.000).There was no statistical difference in the treatment outcome scores between the 3 groups before the treatment(57.33+/-7.07,57.50+/-8.32,58.10+/-6.41%,F=0.124,P=0.884).There was statistical difference in the treatment outcome scores between the 3 groups after the end of the treatment(66.47+/-5.95,88.28+/-6.19,91.03+/-8.90%,F=142.267,P=0.000).The treatment outcome scores were higher in short-lever manipulation group and long-lever manipulation group compared to education group(P=0.000,P=0.000)and there was no statistical difference in the treatment outcome scores between short-lever manipulation group and long-lever manipulation group(P=0.199)after the end of the treatment.There was statistical difference between the 3 groups in the differences of treatment outcome scores between pretreatment and posttreatment(9.13+/-7.79,30.78+/-8.98,32.93+/-8.18%,F=99.672,P=0.000).The differences of treatment outcome scores between pretreatment and posttreatment were larger in short-lever manipulation group and long-lever manipulation group compared to education group(P=0.000,P=0.000).There was no statistical difference between short-lever manipulation group and long-lever manipulation group in the differences of treatment outcome scores between pretreatment and posttreatment(P=0.482).There was no statistical difference in SF-36 scores between the 3 groups before the treatment(98.09+/-7.84,98.02+/-10.94,99.48+/-11.78 points,F=0.253,P=0.777).There was statistical difference in SF-36 scores between the 3 groups after the end of the treatment(106.76+/-6.21,113.30+/-8.75,118.14+/-8.26 points,F=21.367,P=0.000).The SF-36 scores were higher in short-lever manipulation group compared to education group and long-lever manipulation group(P=0.000,P=0.018),and were higher in long-lever manipulation group compared to education group after the end of the treatment(P=0.001).There was statistical difference between the 3 groups in the differences of SF-36 scores between pretreatment and posttreatment(8.67+/-5.69,15.28+/-7.46,18.66+/-7.19 points,F=22.151,P=0.000).The differences of SF-36 scores between pretreatment and posttreatment were larger in short-lever manipulation group and long-lever manipulation group compared to education group(P=0.000,P=0.000).There was no statistical difference between short-lever manipulation group and long-lever manipulation group in the differences of SF-36 scores between pretreatment and posttreatment(P=0.073).The effectiveness-cost ratio was higher in short-lever manipulation group compared to long-lever manipulation group(37.86+/-7.99 vs 33.21+/-8.63%,t=-2.331,P=0.035).Conclusion:The curative effect of cervical specific short-lever fine-regulation manipulation is better than that of health education and that of long-lever manipulation in the treatment of CSR,and it is superior to long-lever manipulation in effectiveness-cost ratio.

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備注/Memo

備注/Memo:
基金項(xiàng)目:上海市進(jìn)一步加快中醫(yī)藥事業(yè)發(fā)展三年行動(dòng)計(jì)劃項(xiàng)目(2014-2016年)(ZY3-LCPT-1-1007) 通訊作者:房敏 E-mail:[email protected]
更新日期/Last Update: 1900-01-01