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[1]宋永偉,范華雨,樊金輝,等.臥位偏向牽引聯(lián)合中藥薰蒸治療神經(jīng)根型頸椎病的臨床研究[J].中醫(yī)正骨,2023,35(03):31-36.
　SONG Yongwei,FAN Huayu,FAN Jinhui,et al.A clinical study of the treatment of cervical spondylotic radiculopathy by deflected supine traction combined with Chinese herbal steaming[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2023,35(03):31-36.
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臥位偏向牽引聯(lián)合中藥薰蒸治療神經(jīng)根型頸椎病的臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期數(shù):
2023年03期
頁(yè)碼:
31-36
欄目:
臨床研究
出版日期:
2023-03-20

文章信息/Info

Title:
A clinical study of the treatment of cervical spondylotic radiculopathy by deflected supine traction combined with Chinese herbal steaming
作者:
宋永偉; 范華雨; 樊金輝; 曹向陽(yáng); 鮑鐵周; 蔡尚歡; 張杰; 海淵
(河南省洛陽(yáng)正骨醫(yī)院/河南省骨科醫(yī)院,河南 洛陽(yáng) 471002)
Author(s):
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
關(guān)鍵詞:
頸椎病;  神經(jīng)根病;  牽引術(shù);  熏洗療法;  臨床試驗(yàn)
Keywords:
cervical spondylosis;  radiculopathy;  traction;  steaming washing therapy;  clinical trial
摘要:
目的:觀察臥位偏向牽引聯(lián)合中藥薰蒸治療神經(jīng)根型頸椎病的臨床療效。方法:將120例神經(jīng)根型頸椎病患者隨機(jī)分為臥位偏向牽引組、臥位常規(guī)牽引組、坐位牽引組,每組40例。臥位牽引治療包括前屈位牽引8 d、中立位牽引2 d、背伸位牽引4 d; 臥位偏向牽引組在前屈位牽引時(shí)采用臥位偏向牽引,中立位、背伸位牽引時(shí)采用常規(guī)臥位牽引; 臥位常規(guī)牽引組全程采用常規(guī)臥位牽引法牽引; 坐位牽引組采用傳統(tǒng)坐位間歇牽引法。3組患者均采用中藥薰蒸治療。牽引和中藥薰蒸均每日2次,連續(xù)治療14 d。分別于治療前和治療結(jié)束后,采用視覺(jué)模擬量表(visual analogue scale,VAS)評(píng)價(jià)患者頸部疼痛情況,測(cè)量患者頸椎旋轉(zhuǎn)、前屈活動(dòng)度,采用田中靖久神經(jīng)根型頸椎病癥狀量表20分法和頸椎功能障礙指數(shù)(neck disability index,NDI)評(píng)價(jià)臨床療效,采用剪切波彈性成像技術(shù)測(cè)量斜方肌的楊氏模量值。結(jié)果:①頸部疼痛VAS評(píng)分。治療結(jié)束后,3組患者頸部疼痛VAS評(píng)分均小于治療前[(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],臥位偏向牽引組患者頸部疼痛VAS評(píng)分小于臥位常規(guī)牽引組和坐位牽引組(LSD-t=6.040,P=0.000; LSD-t=7.562,P=0.000),臥位常規(guī)牽引組患者頸部疼痛VAS評(píng)分小于坐位牽引組(LSD-t=2.051,P=0.044)。②頸椎旋轉(zhuǎn)活動(dòng)度。治療結(jié)束后,3組患者頸椎旋轉(zhuǎn)活動(dòng)度均大于治療前(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),臥位偏向牽引組患者頸椎旋轉(zhuǎn)活動(dòng)度大于臥位常規(guī)牽引組和坐位牽引組(LSD-t=-3.280,P=0.001; LSD-t=-5.371,P=0.000),臥位常規(guī)牽引組患者頸椎旋轉(zhuǎn)活動(dòng)度大于坐位牽引組(LSD-t=-2.083,P=0.040)。③頸椎前屈活動(dòng)度。治療結(jié)束后,3組患者頸椎前屈活動(dòng)度均大于治療前(28.45°±3.18°,41.57°±2.88°,t=-18.310,P=0.000; 27.70°±3.07°,38.95°±3.38°,t=-16.843,P=0.000; 28.15°±3.30°,35.25°±3.80°,t=-9.692,P=0.000),臥位偏向牽引組患者頸椎前屈活動(dòng)度大于臥位常規(guī)牽引組和坐位牽引組(LSD-t=-3.482,P=0.001; LSD-t=-8.374,P=0.000),臥位常規(guī)牽引組患者頸椎前屈活動(dòng)度大于坐位牽引組(LSD-t=-4.901,P=0.000)。④田中靖久神經(jīng)根型頸椎病癥狀量表20分法評(píng)分。治療結(jié)束后,3組患者田中靖久神經(jīng)根型頸椎病癥狀量表20分法評(píng)分均大于治療前[(7.58±3.87)分,(16.10±2.04)分,t=-14.437,P=0.000;(7.38±3.31)分,(13.25±2.10)分,t=-12.361,P=0.000;(7.25±2.99)分,(12.65±2.70)分,t=-10.696,P=0.000],臥位偏向牽引組患者田中靖久神經(jīng)根型頸椎病癥狀量表20分法評(píng)分大于臥位常規(guī)牽引組和坐位牽引組(LSD-t=-6.172,P=0.001; LSD-t=-6.450,P=0.000),臥位常規(guī)牽引組患者田中靖久神經(jīng)根型頸椎病癥狀量表20分法評(píng)分與坐位牽引組比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(LSD-t=-1.113,P=0.271)。⑤NDI。治療結(jié)束后,3組患者NDI均小于治療前[(49.85±15.29)%,(18.93±12.05)%,t=10.694,P=0.000;(51.73±15.31)%,(29.95±9.08)%,t=10.728,P=0.000;(53.10±12.67)%,(33.85±10.33)%,t=7.190,P=0.000],臥位偏向牽引組患者NDI小于臥位常規(guī)牽引組和坐位牽引組(LSD-t=4.622,P=0.001; LSD-t=5.951,P=0.000),臥位常規(guī)牽引組患者NDI與坐位牽引組比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(LSD-t=1.790,P=0.077)。⑥斜方肌楊氏模量值。治療結(jié)束后,3組患者斜方肌楊氏模量值均小于治療前[(92.67±17.96)%,(62.80±13.35)%,t=14.696,P=0.000;(87.05±12.30)%,(77.03±13.10)%,t=5.959,P=0.000;(87.33±14.48)%,(82.58±15.81)%,t=2.337,P=0.025],臥位偏向牽引組患者斜方肌楊氏模量值小于臥位常規(guī)牽引組和坐位牽引組(LSD-t=4.811,P=0.001; LSD-t=6.044,P=0.000),臥位常規(guī)牽引組患者斜方肌楊氏模量值與坐位牽引組比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(LSD-t=1.711,P=0.091)。結(jié)論:臥位偏向牽引聯(lián)合中藥薰蒸治療神經(jīng)根型頸椎病,能夠緩解頸部疼痛、改善頸部功能和斜方肌僵硬,療效優(yōu)于常規(guī)臥位牽引和坐位牽引聯(lián)合中藥薰蒸。
Abstract:
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=-9.379,P=0.000; 45.95°±9.24° vs 57.58°±7.54°,t=-6.694,P=0.000; 48.22°±9.96° vs 53.72°±9.39°,t=-2.298,P=0.000).The range of motion in cervical rotation in the DST group was greater than those in the CST group and the ST group(LSD-t=-3.280,P=0.001; LSD-t=-5.371,P=0.000).The range of motion in cervical rotation in the CST group was greater than that in the ST group(LSD-t=-2.083,P=0.040).③Range of motion in cervical flexion.After treatment,the ranges of motion in cervical flexion in all groups were greater than those before treatment(28.45°±3.18° vs 41.57°±2.88°,t=-18.310,P=0.000; 27.70°±3.07° vs 38.95°±3.38°,t=-16.843,P=0.000; 28.15°±3.30° vs 35.25°±3.80°,t=-9.692,P=0.000).The range of motion in cervical flexion in the DST group was greater than those in the CST group and the ST group(LSD-t=-3.482,P=0.001; LSD-t=-8.374,P=0.000).The range of motion in cervical flexion in the CST group was greater than that in the ST group(LSD-t=-4.901,P=0.000).④Yasuhisa Tanaka 20 Score Scale score.After treatment,Yasuhisa Tanaka 20 Score Scale scores in all groups were higher than those before treatment(7.58±3.87 vs 16.10±2.04 points,t=-14.437,P=0.000; 7.38±3.31 vs 13.25±2.10 points,t=-12.361,P=0.000; 7.25±2.9 vs 12.65±2.70 points,t=-10.696,P=0.000).The Yasuhisa Tanaka 20 Score Scale score in the DST group was higher than those in the CST group and the ST group(LSD-t=-6.172,P=0.001; LSD-t=-6.450,P=0.000).There was no statistically significant difference in Yasuhisa Tanaka 20 Score Scale score between the CST group and the ST group(LSD-t=-1.113,P=0.271).⑤NDI.After treatment,NDI in all groups was lower than that before treatment(49.85±15.29 vs 18.93±12.05%,t=10.694,P=0.000; 51.73±15.31 vs 29.95±9.08%,t=10.728,P=0.000; 53.10±12.67 vs 33.85±10.33%,t=7.190,P=0.000).The NDI in the DST group was lower than those in the CST group and the ST group(LSD-t=4.622,P=0.001; LSD-t=5.951,P=0.000).There was no statistically significant difference in NDI between the CST group and the ST group(LSD-t=1.790,P=0.077).⑥Young's modulus of trapezius muscle.After treatment,Young's modulus of trapezius muscle in all groups was lower than those before treatment(92.67±17.96 vs 62.80±13.35%,t=14.696,P=0.000; 87.05±12.30 vs 77.03±13.10%,t=5.959,P=0.000; 87.33±14.48 vs 82.58±15.81%,t=2.337,P=0.025).The Young's modulus of trapezius muscle in the DST group was lower than those in the CST group and the ST group(LSD-t=4.811,P=0.001; LSD-t=6.044,P=0.000).There was no statistically significant difference in Young's modulus of trapezius muscle between the CST group and the ST group(LSD-t=1.711,P=0.091).Conclusion:In the treatment of CSR,DST combined with Chinese herbal steaming can relieve cervical pain and improve cervical function and trapezius muscle stiffness,and the efficacy is superior to those of CST and ST combined with Chinese herbal steaming.

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更新日期/Last Update: 1900-01-01