仰头摇正法治疗颈源性头痛的临床研究
发布时间：2018-11-01 10:46
【摘要】：目的:探讨龙氏治脊疗法之仰头摇正法治疗颈源性头痛的有效性、安全性及可能作用机制,并与传统手法组进行疗效比较,为临床治疗颈源性头痛提供一种新的思路及途径。方法:将72例符合诊断及纳入标准的颈源性头痛患者随机分为治疗组和对照组,每组各36人。所有患者均给予电针作为基础治疗,治疗组采用龙氏治脊疗法中的仰头摇正法治疗,对照组采用传统手法治疗,治疗时程:每天1次,6次为1疗程,总治疗期2个疗程,每疗程间休息1天。比较治疗前、后两组在简明McGill疼痛量表评分(SF-MPQ)、头痛影响测定-6评分(HIT-6)上的差异,并在治疗结束后进行一次总体疗效评价,利用SPSS21.0统计软件对结果进行分析、处理,探讨仰头摇正法对颈源性头痛患者的有效性、安全性及可能作用机制。结果:1、临床疗效评价方面:总有效率:治疗组86.11%,对照组77.78%,经统计分析,P0.05,还不能表明两组的总有效率有差别。愈显率:治疗组58.33%、对照组19.44%,经统计分析,P0.01,差异具有显著性,表明治疗组的愈显疗效明显高于对照组。2、简明McGill疼痛量表评分方面:在治疗前两组感觉项评分、情感项评分、视觉疼痛评分(VAS)、现有疼痛强度评分(PPI)、McGill疼痛量表总评分分别进行比较,差异无统计学意义(均P0.05),可进行比较;与治疗前相比,治疗后两组的感觉项评分、情感项评分、视觉疼痛评分(VAS)、现有疼痛强度评分(PPI)、McGill疼痛量表总评分差异均有统计学意义(均P0.05),表明两组的治疗均有效;治疗后两组感觉项评分、情感项评分、视觉疼痛评分(VAS)、McGill疼痛量表总评分的差值相比差异均有统计学意义(P0.05),且治疗组各项评分下降更明显,说明治疗组在缓解疼痛方面疗效更显著。治疗后,两组现有疼痛强度评分(PPI)差值比较无显著意义(P0.05),尚不能说明两组在降低PPI评分上有差异。3、头痛影响测定-6(HIT-6)评分方面:在治疗前两组HIT-6评分进行比较,差异无统计学意义(P0.05),可进行比较;在治疗2疗程后,两组的HIT-6评分与分别同治疗前相比较,差异均有统计学意义(P0.05),表明两组的治疗均有效;治疗后两组HIT-6评分差值相比差异有统计学意义(P0.05),且治疗组评分下降更明显,说明治疗组在改善生活质量方面疗效更显著。结论:仰头摇正法为龙氏正骨手法中治疗寰枕及寰枢关节错位最常用的手法,能够有效的纠正上段颈椎椎小关节错位,恢复颈椎生物力学平衡,解除因神经、血管、肌肉等的刺激受压而出现的一系列症状,因此仰头摇正法对颈源性头痛疗效显著。且该疗法操作简单,不良反应少,具有稳、准、轻、巧的特点,值得临床推广应用。
[Abstract]:Objective: to explore the efficacy, safety and possible mechanism of the treatment of cervical headache with the method of raising the head and orthodontic treatment of Longshi chiropractic, and compare the curative effect with that of the traditional manipulation group, so as to provide a new way for clinical treatment of cervical headache. Methods: 72 patients with cervical headache were randomly divided into treatment group and control group with 36 patients in each group. All the patients were given electroacupuncture as the basic treatment, the treatment group was treated with the method of raising the head and shaking the head in the treatment group, and the control group was treated with traditional manipulation. The course of treatment was: once a day, 6 times as a course of treatment, and 2 courses of treatment in the total period of treatment. Take a day off from each course of treatment. Before and after treatment, the difference between the two groups in concise McGill pain scale (SF-MPQ) and headache impact test score (HIT-6) was compared, and the overall curative effect was evaluated after treatment. The results were analyzed and processed by SPSS21.0 software to explore the efficacy, safety and possible mechanism of the method of raising the head in patients with cervical headache. Results: 1, clinical efficacy evaluation: the total effective rate: the treatment group 86.11, the control group 77.78, the statistical analysis, P0.05, still can not show the two groups of the total effective rate difference. The effective rate of callus: 58.33 in the treatment group and 19.4444 in the control group, the difference was significant (P0.01), which indicated that the curative effect of the treatment group was significantly higher than that of the control group. Brief McGill pain scale score: before treatment, the two groups were compared with each other in sensory score, emotion score, visual pain score, (VAS), pain intensity score, (PPI), McGill pain scale total score. The difference was not statistically significant (P0.05), but could be compared. Compared with before treatment, there were significant differences in sensory score, emotion score, visual pain score, (VAS), pain intensity score, (PPI), McGill pain scale total score between the two groups after treatment (P0.05). The results showed that both groups were effective. After treatment, there were significant differences in sensory score, emotion score, visual pain score, total score of (VAS), McGill pain scale between the two groups (P0.05), and the scores of the treatment group decreased more obviously. The treatment group was more effective in relieving pain. After treatment, there was no significant difference in (PPI) difference between the two groups in the pain intensity score (P0.05), which did not indicate that there was a difference between the two groups in reducing the PPI score. Headache impact measurement-6 (HIT-6) score: in the two groups before the treatment of HIT-6 score comparison, the difference was not statistically significant (P0.05), can be compared; After 2 courses of treatment, the HIT-6 scores of the two groups were significantly different from those before treatment (P0.05), which indicated that the two groups were effective. The difference of HIT-6 score between the two groups after treatment was statistically significant (P0.05), and the score of the treatment group decreased more significantly, which indicated that the treatment group was more effective in improving the quality of life. Conclusion: the inversion method is the most commonly used manipulation in the treatment of atlantoaxial and occipital joint dislocation, which can effectively correct the upper cervical vertebrae facet dislocation, restore the biomechanical balance of the cervical vertebrae, and relieve the nerve and blood vessels. Muscle stimulation is a series of symptoms resulting from compression, so the head-shaking orthodontic method is effective in treating cervical headache. The therapy is simple, less adverse, stable, accurate, light and skillful. It is worth popularizing.
【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】：R244.1
本文编号：2303676
[Abstract]:Objective: to explore the efficacy, safety and possible mechanism of the treatment of cervical headache with the method of raising the head and orthodontic treatment of Longshi chiropractic, and compare the curative effect with that of the traditional manipulation group, so as to provide a new way for clinical treatment of cervical headache. Methods: 72 patients with cervical headache were randomly divided into treatment group and control group with 36 patients in each group. All the patients were given electroacupuncture as the basic treatment, the treatment group was treated with the method of raising the head and shaking the head in the treatment group, and the control group was treated with traditional manipulation. The course of treatment was: once a day, 6 times as a course of treatment, and 2 courses of treatment in the total period of treatment. Take a day off from each course of treatment. Before and after treatment, the difference between the two groups in concise McGill pain scale (SF-MPQ) and headache impact test score (HIT-6) was compared, and the overall curative effect was evaluated after treatment. The results were analyzed and processed by SPSS21.0 software to explore the efficacy, safety and possible mechanism of the method of raising the head in patients with cervical headache. Results: 1, clinical efficacy evaluation: the total effective rate: the treatment group 86.11, the control group 77.78, the statistical analysis, P0.05, still can not show the two groups of the total effective rate difference. The effective rate of callus: 58.33 in the treatment group and 19.4444 in the control group, the difference was significant (P0.01), which indicated that the curative effect of the treatment group was significantly higher than that of the control group. Brief McGill pain scale score: before treatment, the two groups were compared with each other in sensory score, emotion score, visual pain score, (VAS), pain intensity score, (PPI), McGill pain scale total score. The difference was not statistically significant (P0.05), but could be compared. Compared with before treatment, there were significant differences in sensory score, emotion score, visual pain score, (VAS), pain intensity score, (PPI), McGill pain scale total score between the two groups after treatment (P0.05). The results showed that both groups were effective. After treatment, there were significant differences in sensory score, emotion score, visual pain score, total score of (VAS), McGill pain scale between the two groups (P0.05), and the scores of the treatment group decreased more obviously. The treatment group was more effective in relieving pain. After treatment, there was no significant difference in (PPI) difference between the two groups in the pain intensity score (P0.05), which did not indicate that there was a difference between the two groups in reducing the PPI score. Headache impact measurement-6 (HIT-6) score: in the two groups before the treatment of HIT-6 score comparison, the difference was not statistically significant (P0.05), can be compared; After 2 courses of treatment, the HIT-6 scores of the two groups were significantly different from those before treatment (P0.05), which indicated that the two groups were effective. The difference of HIT-6 score between the two groups after treatment was statistically significant (P0.05), and the score of the treatment group decreased more significantly, which indicated that the treatment group was more effective in improving the quality of life. Conclusion: the inversion method is the most commonly used manipulation in the treatment of atlantoaxial and occipital joint dislocation, which can effectively correct the upper cervical vertebrae facet dislocation, restore the biomechanical balance of the cervical vertebrae, and relieve the nerve and blood vessels. Muscle stimulation is a series of symptoms resulting from compression, so the head-shaking orthodontic method is effective in treating cervical headache. The therapy is simple, less adverse, stable, accurate, light and skillful. It is worth popularizing.
【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】：R244.1
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