自重力曲度牵引结合运动疗法治疗颈型颈椎病的临床研究

发布时间：2018-02-15 13:11

本文关键词： 颈型颈椎病自重力曲度牵引颈椎生理曲度值积分肌电值中值频率　出处：《成都中医药大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的：通过随机对照研究,比较自重力曲度牵引结合运动疗法和颌枕带牵引结合运动疗法治疗颈型颈椎病在改善颈椎生理曲度和颈部肌肉功能的差异,来评价自重力曲度牵引结合运动疗法治疗颈型颈椎病的安全性和有效性,为临床治疗本病寻找简便效廉的新方案。方法：将符合纳入标准的86例颈型颈椎病患者按照随机化原则分为试验组(43例)和对照组(43例),试验组采用自重力曲度牵引结合运动疗法,对照组采用颌枕带牵引结合运动疗法；每组共治疗20天,10天为1疗程,每个疗程间休息2天。在治疗开始前、治疗1个疗程后、治疗2个疗程后分别采用简式McGill疼痛问卷(SF-MPQ)评分、颈椎X片生理曲度测量值、积分肌电值(iEMG)和中值频率(MF)等指标,观察两组治疗前后的改变情况。结果：1、临床疗效：两种方法治疗颈型颈椎病均有一定临床疗效,总有效率无显著差别,但在临床治愈率方面自重力曲度牵引结合运动疗法明显优于颌枕带牵引结合运动疗法(P0.05)。2、SF-MPQ评分：组内比较,两组在SF-MPQ评分改善方面均较治疗前有显著性差异(P0.01)；组间比较,两组在治疗1个疗程后疼痛评分差异无统计学意义(P0.05),在治疗2个疗程后,试验组明显优于对照组,差异有统计学意义(P0.01)。3、颈椎X片生理曲度测量值：组内比较,两组在改善颈椎生理曲度方面均较治疗前有改善,差异有统计学意义(P0.01)；组间比较,两组比较有显著性差异(P0.01),试验组改善明显优于对照组。4、iEMG值：组内比较,两组在不同时间点斜方肌和胸锁乳突肌表面肌电iEMG差异有统计学意义(P0.01)；组间比较,治疗1个疗程后,两组斜方肌和胸锁乳突肌表面肌电iEMG差异无统计学意义(P0.05);治疗2个疗程后,两组斜方肌和胸锁乳突肌表面肌电iEMG差异有统计学意义(P0.05),试验组改善优于对照组。5、MF值：组内比较,试验组在不同时间点斜方肌和胸锁乳突肌表面肌电MF差异有统计学意义(P0.01)；对照组在不同时间点斜方肌表面肌电MF差异有统计学意义(P0.05),在治疗1个疗程后与治疗前相比胸锁乳突肌表面肌电MF差异有统计学意义(P0.01),在治疗2个疗程后与治疗1个疗程后相比胸锁乳突肌表面肌电MF差异无统计学意义(P0.05)。组间比较,治疗1个疗程后,两组斜方肌和胸锁乳突肌表面肌电MF差异无统计学意义(P0.05)；治疗2个疗程后,两组斜方肌和胸锁乳突肌表面肌电MF差异有统计学意义(P0.05),试验组改善优于对照组。6、相关性分析：颈型颈椎病患者颈椎生理曲度与SF-MPQ评分相关性分析,pearson相关系数r为-0.683,两者之间有显著的负相关性(P0.01)；与斜方肌和胸锁乳突肌的iEMG相关性分析,pearson相关系数r分别为0.243、0.406,两者之间有正相关性(P0.05)；与斜方肌和胸锁乳突肌的MF相关性分析,pearson相关系数r分别为0.396、0.353,两者之间有显著的正相关性(P0.01)。结论：1、两种方法治疗颈型颈椎病疗效确切,但自重力曲度牵引结合运动疗法的临床治愈率高,特别是在改善颈椎生理曲度和提高颈部肌群iEMG和MF值方面明显优于颌枕带牵引结合运动疗法。2、自重力曲度牵引结合运动疗法治疗颈型颈椎病可能是通过恢复颈椎的曲度序列,改善颈部肌肉功能,增强颈肌肌力,提高颈肌抗疲劳能力来纠正颈椎的内外力学平衡,提高颈椎的稳定性,从而达到治疗的目的。3、自重力曲度牵引结合运动疗法治疗颈型颈椎病是一种安全有效、经济方便的新方法,值得临床应用和推广
[Abstract]:Objective: through randomized controlled study, the difference of self gravity traction combined with exercise therapy and curvature of jaw occipital belt traction combined with exercise therapy for treatment of cervical spondylosis in improving cervical lordosis and neck muscle function, to evaluate the self gravity curve of traction combined with exercise therapy is effective and safe in the treatment of cervical disease, as the new scheme the clinical treatment of this disease is low for effect. Methods: 86 patients met the inclusion criteria of patients with cervical spondylosis were randomly divided into experimental group (43 cases) and control group (43 cases), experimental group using self gravity curvature traction combined with exercise therapy, the control group using jaw occipital belt traction combined with exercise therapy each group were treated for 20 days; 10 days for 1 course, every 2 days rest between treatments in before treatment, after 1 courses of treatment, after 2 courses of treatment McGill pain questionnaire (SF-MPQ) were used to score, cervical X The measurement of physiological curvature sheet value, iEMG (iEMG) and median frequency (MF) and other indicators, observed the changes of the two groups before and after treatment. Results: 1, the clinical curative effect of two methods in the treatment of cervical spondylosis has certain curative effect, the total efficiency was no significant difference, but the clinical cure rate since the curvature of gravity traction combined with exercise therapy was significantly better than the jaw occipital belt traction combined with exercise therapy (P0.05).2, SF-MPQ score: comparison in the group, two groups in SF-MPQ score improved significantly compared with before treatment there was significant difference (P0.01); comparison between groups, two in the treatment group after 1 month treatment pain score no difference statistical significance (P0.05), after 2 courses of treatment, the experimental group was significantly better than the control group, the difference was statistically significant (P0.01.3), cervical X piece of physiological curvature measurements: comparison in the group, the two groups in the improvement of cervical lordosis were improved compared with before treatment, the difference was statistically Statistically significant (P0.01); comparison between groups, there were significant differences between two groups (P0.01), the experimental group improved significantly better than the control group.4, iEMG value: comparison in the group, the two groups had statistical significance at different time points of the trapezius muscle and sternocleidomastoid muscle surface electromyography (P0.01); the difference of iEMG between groups comparison, after 1 courses of treatment, the two groups had no statistical significance of trapezius muscle and sternocleidomastoid muscle EMG iEMG difference (P0.05); after 2 courses of treatment, the two groups had statistical significance of trapezius muscle and sternocleidomastoid muscle surface electromyography (P0.05), iEMG difference test group improved better than the control group.5, MF value: comparison in the group, there was statistical significance in experimental group of sternocleidomastoid muscle EMG MF difference at different time points of the trapezius muscle and chest (P0.01); the control group at different time points of trapezius muscle surface electromyography MF difference was statistically significant (P0.05), after 1 course of treatment compared with before treatment of sternocleidomastoid muscle table There are statistically significant differences (P0.01) facial electric MF, there was no statistical significance after 2 courses of treatment and after 1 course of treatment compared to the sternocleidomastoid muscle surface electromyography (P0.05). The difference of MF between the two groups, after 1 courses of treatment, the two groups had no statistical significance of trapezius muscle and sternocleidomastoid muscle EMG MF the difference (P0.05); after 2 courses of treatment, the two groups had statistical significance of trapezius muscle and sternocleidomastoid muscle surface electromyography (P0.05), MF difference test group was better than the control group.6, correlation analysis: analysis of patients with cervical spondylosis cervical lordosis and SF-MPQ score correlation, Pearson correlation coefficient r is -0.683, a a significant negative correlation between them (P0.01); iEMG correlation analysis and trapezius muscle and sternocleidomastoid muscle, Pearson correlation coefficient r was 0.243,0.406, there is a positive correlation between them (P0.05); MF correlation analysis and trapezius muscle and thoracic cleidomastoid process, pea Rson correlation coefficient r was 0.396,0.353, there was a positive correlation between (P0.01). Conclusion: 1. The two method has definite effect on the treatment of cervical spondylosis, but since the curvature of gravity traction combined with exercise therapy clinical cure rate is high, especially with traction in improving cervical lordosis and improve muscle and neck iEMG the value of MF is better than the jaw pillow combined with exercise therapy.2, self gravity traction combined with exercise therapy for treatment of cervical curvature of cervical spondylosis may restore cervical curvature by sequence, improve the neck muscle function, enhance muscle strength, improve the anti fatigue ability of mechanical equilibrium inside and outside the neck to correct the cervical spine, improve the stability of the spine, so as to achieve the treatment the purpose of.3, self gravity traction combined with exercise therapy for treatment of cervical curvature of cervical spondylosis is a safe and effective new method, economical and convenient, is worthy of clinical application and promotion

【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R681.55

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