中医推拿联合功法训练与间歇性颈椎牵引治疗慢性非特异性颈痛随机对照研究

发布时间：2018-07-21 19:45

【摘要】：目的：系统评价慢性非特异性颈痛(NCNP)患者的疼痛与颈椎功能,并分析中医推拿联合功法训练治疗NCNP的疗效。方法：1、临床横断面研究,NCNP患者50例,相匹配的健康对照20例。使用视觉模拟评分(VAS)和颈椎功能障碍指数(NDI)评价NCNP患者的疼痛强度和功能障碍程度。使用颈椎多功能工作站(MCU)测量全体受试者颈椎主动关节活动度(AROM)(前屈、后伸、左侧屈、右侧屈、左旋、右旋)和颈肌最大肌力(前屈、后伸、左侧屈、右侧屈)。2、随机对照研究,纳入NCNP患者102例,随机分为治疗组(n=51)和对照组(n=51)。治疗组中医进行推拿联合功法训练,对照组采用间歇性颈椎牵引,每周5次,治疗2周。分别在干预前、干预后即刻测量VAS、NDI、AROM(前屈、后伸、左侧屈、右侧屈、左旋、右旋)和颈肌最大肌力(前屈、后伸、左侧屈、右侧屈)。干预1个月后随访VAS和NDI。结果：1、NCNP患者VAS值为48(42.42,49.46)mm,NDI评分为12(10,15.25)分:患者AROM和最大颈肌肌力均显著低于健康对照(P0.05)。2、干预后,治疗组和对照组的VAS值、NDI评分均有下降：治疗组在干预后即刻的VAS值(P=0.009)和1个月随访时VAS值(P=0.001)和NDI评分(P=0.008)均显著低于对照组。干预后两组AROM和颈肌最大肌力均显著增加,组间比较无差异。结论：1、NCNP患者中度颈痛,颈肌肌力降低,颈椎活动受限,轻度颈椎功能障碍。2、中医推拿联合功法训练治疗NCNP安全有效,可操作性强,患者接受度高,兼顾颈痛和颈椎功能的改善,疗效优于间歇性颈椎牵引,并有利于疗效维持。
[Abstract]:Objective: to systematically evaluate the pain and cervical function of patients with chronic nonspecific cervical pain (NCNP), and to analyze the effect of combination of traditional Chinese medicine and massage on NCNP. Methods: 1, clinical cross-sectional study, 50 cases of NCNP patients, and 20 matched healthy controls. The visual analog score (VAS) and the cervical spine dysfunction index (NDI) were used to evaluate the NCNP patients. The cervical spine active joint activity (AROM) (anterior flexion, extension, left flexion, right flexion, left rotation, Dextre) and the maximum muscle strength of the neck muscle (anterior flexion, extension, left flexion, right lateral flexion) were measured by the cervical multifunction workstation (MCU) and randomly divided into 102 cases of NCNP patients and randomly divided into treatment group (n =51) and the control group (n=51). The treatment group was trained by combination of massage, and the control group was treated with intermittent cervical traction, 5 times a week for 2 weeks. Before intervention, VAS, NDI, AROM (anterior flexion, left flexion, right flexion, left rotation, right rotation) and the maximum muscle force of the neck muscle (anterior flexion, extension, left flexion, right flexion) were measured. The intervention group was intervened for 1 months. The results of VAS and NDI. were followed up: 1, the VAS of NCNP patients was 48 (42.42,49.46) mm, and the NDI score was 12 (10,15.25). The patients' AROM and maximum neck muscle strength were significantly lower than those of the healthy control (P0.05).2, and the prognosis of the treatment group and the control group decreased. P=0.001) and NDI score (P=0.008) were significantly lower than those in the control group. The maximum muscle strength of the two groups of AROM and neck muscles increased significantly, and there was no difference between the groups. Conclusion: 1, the moderate neck pain, the decrease of cervical muscle strength, the limited activity of cervical vertebra, the mild cervical spine dysfunction,.2, the combination of traditional Chinese medicine and massage therapy for NCNP are effective and effective in the treatment of NCNP, and the maneuverability is strong. Patients with high degree of acceptance, both neck pain and cervical function improvement, the curative effect is better than intermittent cervical traction, and is conducive to the maintenance of efficacy.
【学位授予单位】：中国人民解放军医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R244.1

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