四指推法治疗颈型颈椎病的临床研究

发布时间：2018-05-15 09:34

本文选题：颈型颈椎病 + 推拿　；参考：《南京中医药大学》2016年硕士论文

【摘要】：研究背景及目的：颈型颈椎病是作为颈椎病的早期病变,其临床症状较轻,容易被患者忽视,使得其向较为严重的颈椎病转化,给患者造成诸多不便,严重影响患者学习、工作和生活。推拿具有舒筋通络、理气活血止痛等作用,可以缓解颈型颈椎病患者临床症状。本研究旨在观察四指推法治疗颈型颈椎病的临床疗效,为四指推法治疗颈型颈椎病提供理论依据。研究方法：2015年6月至2016年1月期间从江苏省中医院推拿科门诊招募符合纳入标准的颈型颈椎病患者60例参与本次研究,经解释、阅读后签署知情同意书,通过随机法分组,按受试者首次来诊的先后顺序,用随机数字表法将所观察的病例随机分入两组治疗：即四指推法治疗组(30人)和颈椎牵引对照组(30人)。治疗组取四指推法,对照组去颈椎牵引。两组均1天1次,10次为1个疗程,共1个疗程。在治疗前后对患者进行McGill积分(包括PRI、VAS、PPI)和表面肌电图中位频率值(MF)并采集相关数据,根据评分确定疗效,再根据所得数据进行统计学分析。研究结果：治疗前,两组60例颈型颈椎病患者的一般情况、PRI积分、VAS积分、PPI积分,McGill积分和表面肌电图中位频率值(MF)各项积分比较均无统计学差异(P0.05),具有可比性。治疗结束后,两组积分均下降,与治疗前相比,McGill积分(包括PRI、VAS、PPI)的差异具有显著统计学意义(P0.01),表明两组患者颈肩部疼痛、肌肉僵硬、功能活动都得到缓解。推拿组MF值与治疗前相比具有统计学意义(P0.01),说明推拿可以缓解肌肉疲劳,增加肌肉耐受性,增加局部血液循环,促进组织损伤恢复等作用,然而牵引组治疗后MF积分与治疗前相比不具有统计学意义(P0.05),说明牵引对颈型颈椎病患者肌肉疲劳度方面改善欠佳。治疗后,治疗组与对照组PRI积分、VAS积分、PPI积分、McGill积分和MF值的差异具有统计学意义(P0.05),说明推拿组在缓解颈肩部疼痛、改善功能活动、缓解肌肉疲劳、促进组织修复方面均优于颈椎牵引组。总有效率方面,两组均为100%,说明四指推法与颈椎牵引治疗颈型颈椎病都能起到一定疗效,经过非参数检验,推拿组优于牵引组(P0.05),认为两组疗效比较具有统计学意义,四指推法治疗颈型颈椎病疗效优于颈椎牵引。研究结论：四指推法治疗颈型颈椎病疗效肯定,可以有效缓解颈肩部疼痛,改善颈椎功能活动,增加肌肉抗疲劳作用,且操作简便,易学易用,安全性高,可以作为治疗颈型颈椎病的首选方法或基础治疗方法,值得在临床大力推广并应用。
[Abstract]:Background and objective: cervical spondylosis is an early disease of cervical spondylosis, its clinical symptoms are mild, easy to be ignored by patients, make it to the more serious cervical spondylosis, cause more inconvenience to patients, seriously affect the patients' learning. Work and life Massage can relieve the clinical symptoms of cervical spondylosis. The purpose of this study was to observe the clinical effect of four-finger push therapy on cervical spondylosis and to provide theoretical basis for four-finger push in treating cervical spondylosis. Methods: from June 2015 to January 2016, 60 patients with cervical spondylosis were recruited from the Department of Massage of Jiangsu Provincial Hospital of traditional Chinese Medicine to participate in the study. According to the order of the first visit, the observed cases were randomly divided into two groups: the four-finger push treatment group (30 patients) and the cervical vertebra traction control group (30 patients). The treatment group was treated with four fingers and the control group with cervical vertebrae traction. The two groups were given 10 times a day for a course of treatment. Before and after treatment, the patients were treated with McGill score (including pri VASA PPI) and the median frequency of surface electromyography (EMG), and the relevant data were collected, the curative effect was determined according to the score, and then the statistical analysis was carried out according to the obtained data. Results: before treatment, there was no statistical difference between the two groups in the general situation of 60 patients with cervical spondylopathy and the PPI score, McGill integral and the median frequency value of surface electromyography (MFV). After treatment, the scores of both groups decreased, and the difference of McGill score (including PRI VAS-PPI) between the two groups was statistically significant (P 0.01), indicating that the neck and shoulder pain, muscle stiffness and functional activity of the two groups were relieved. The MF value of massage group was statistically significant compared with that before treatment, indicating that massage can relieve muscle fatigue, increase muscle tolerance, increase local blood circulation and promote tissue injury recovery, etc. However, the MF score after treatment in traction group was not statistically significant compared with that before treatment, indicating that the improvement of muscle fatigue in cervical spondylosis patients was not good. After treatment, the difference of PRI integral, PRI integral, PPI integral and MF between the treatment group and the control group was statistically significant (P 0.05), which indicated that the massage group could relieve the pain of neck and shoulder, improve the functional activity and relieve muscle fatigue. All of them were superior to the cervical traction group in promoting tissue repair. The total effective rate was 100 in both groups, indicating that both four-finger push and cervical traction could play a certain role in the treatment of cervical spondylosis. After non-parametric test, the massage group was superior to the traction group (P 0.05), and the comparison between the two groups was statistically significant. The effect of four-finger push therapy on cervical spondylosis is better than that on cervical traction. Conclusion: the treatment of cervical spondylosis with four fingers is effective, which can relieve the pain of neck and shoulder, improve the function of cervical vertebrae, increase the anti-fatigue effect of muscle, and is easy to operate, easy to learn and use, and high safety. It can be used as the first choice or basic treatment for cervical spondylosis, and it is worth popularizing and applying in clinic.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R244.1

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