铍针结合旋提手法治疗神经根型颈椎病的疗效评价

发布时间：2018-04-24 17:37

  本文选题：神经根型颈椎 + 铍针　； 参考：《广州中医药大学》2017年硕士论文

【摘要】：目的:神经根型颈椎病为颈椎病分型中的一种,是临床上较常见、较多发、缠绵难愈的颈椎退行性疾病。近些年神经根型颈椎病的发病率呈增长、低龄化趋势,已成为严重危害人们健康妨碍生活的常见疾病之一。本研究探讨铍针结合旋提手法治CSR作用机理及可行性,对比颈椎坐位牵引配合颈托制动治疗方法,观察对神经根型颈椎病患者疼痛及症状体征改善的临床治疗效果,为中医保守治疗方式提供更多的参考和选择。方法:本研究收集于2016年1月-2017年1月在广东省中医院骨科门诊、病房及大学城医院理疗科就诊的神经根型颈椎病患者60例。采用随机分组对照法分为治疗组和对照组各30例。治疗组采用铍针结合旋提手法治疗;对照组采用坐位牵引配合颈托保护治疗。采用VAS疼痛评分和SamPath,PrakashMD神经根型颈椎病症体征评分表及《中医病证诊断疗效标准》评定标准来评定治疗效果,采用SPSS21.0软件对各组评分数据进行统计学分析并得出结论。结果:1.分别比较两组患者年龄、性别、病程长短,通过统计学软件处理数据得出两组基线无明显统计学差异(P0.05)具有可比性。2.VAS、神经根型颈椎病症状体征评分结果:治疗前各组VAS、症状体征评分数据无统计学差异(P0.05),具有可比性;治疗后第1周、第2周得出评分数据均较治疗前有所下降,两组组内评分分别两两对比具有统计学差异(P0.05),说明各组治疗方法均能缓解CSR临床症状;将各组治疗后(第1周、第2周)VAS、症状体征评分以及各组治疗前后评分差值进行组间对比,结果均具有统计学意义(P0.05),进一步说明铍针结合旋提手法组疗效优于牵引配合颈托制动组。3.治疗组30例病例中治愈6例,显效16,有效4例,无效4例;对照组30例病例中治愈4例,显效15例,有效5例,无效6例。两组疗效方面经过统计学计算并无明显统计学差异(P0.05),但治疗组有效率86.7%高于对照组有效率80.0%。结论:1.铍针结合旋提手法治疗神经根型颈椎病疗效确切、稳定,体现了中医骨伤科"筋骨并重"的治疗理念,发挥了中医保守治疗的优势。2.采用铍针配合旋提手法治疗使患者颈肩臂疼痛症状得到明显缓解,生活质量大大提高。本方法操作简便,适合临床推广运用。
[Abstract]:Objective: cervical Spondylotic radiculopathy is one of the cervical spondylopathy types, is a common clinical, more frequent, difficult to recover the cervical spine degenerative disease. In recent years, the incidence of cervical spondylopathy of nerve root type is increasing, and the trend of younger age has become one of the common diseases that seriously endanger people's health and hinder their life. The aim of this study was to investigate the mechanism and feasibility of beryllium needle combined with rotary handle CSR, and to compare the treatment of cervical traction with cervical immobilization, and to observe the effect of clinical treatment on the improvement of pain, symptoms and signs in patients with cervical spondylosis of nerve root type. To provide more reference and choice for conservative treatment of traditional Chinese medicine. Methods: from January 2016 to January 2017, 60 patients with cervical spondylopathy of nerve root type were collected from orthopedic outpatient department, ward of Guangdong traditional Chinese medicine hospital and physiotherapy department of university city hospital. The treatment group and the control group were randomly divided into two groups: 30 cases in the treatment group and 30 cases in the control group. The treatment group was treated by beryllium needle combined with rotary handle, while the control group was treated by sitting traction combined with neck protection. VAS pain score, SamPathan PrakashMD nerve root type cervical spondylopathy score scale and traditional Chinese medicine syndrome diagnosis criteria were used to evaluate the therapeutic effect. SPSS21.0 software was used to statistically analyze the score data of each group and draw a conclusion. The result is 1: 1. Age, sex, duration of disease were compared between the two groups. The statistical software processing data showed that there was no significant statistical difference between the two groups (P0.05). 2.VAS. the scores of symptoms and signs of radicular cervical spondylopathy: before treatment, there was no statistical difference in the scores of symptoms and signs between the two groups (P 0.05), which was comparable. In the first week and the second week after treatment, the score data were all lower than those before treatment, and the scores in the two groups were significantly different (P 0.05), which indicated that the treatment methods in each group could alleviate the clinical symptoms of CSR, and the clinical symptoms of CSR could be alleviated in each group (1 week, 1 week after treatment). In the second week, the scores of symptoms and signs and the difference of scores before and after treatment were compared among the groups. The results showed that the effect of beryllium needle combined with spin-lift manipulation group was better than that of traction combined with neck brake group (P 0.05), and the effect of beryllium needle combined with rotary lifting manipulation group was better than that of traction combined with neck brake group. In the treatment group, 6 cases were cured, 16 cases were effective, 4 cases were effective and 4 cases were ineffective, while in the control group, 4 cases were cured, 15 cases were effective, 5 cases were effective, and 6 cases were ineffective. There was no statistical difference in the curative effect between the two groups, but the effective rate in the treatment group was 86.7% higher than that in the control group (80.05%). Conclusion 1. Beryllium needle combined with rotary handle method is effective and stable in the treatment of cervical spondylopathy of nerve root type, which embodies the treatment idea of "both muscles and bones" in orthopedic and trauma department of traditional Chinese medicine, and exerts the advantage of conservative treatment of traditional Chinese medicine. Beryllium needle combined with rotary handle therapy significantly alleviated the pain of neck, shoulder and arm, and improved the quality of life. The method is simple and suitable for clinical application.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.9
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本文编号：1797610