侧头摇正法治疗神经根型颈椎病的临床研究

发布时间：2019-04-21 16:30

【摘要】：目的：通过观察侧头摇正法治疗神经根型颈椎病所取得的效果,再根据其临床疗效,分析并归纳其机理,为临床治疗本病提供一种新的思路,为龙氏正骨手法在临床上的普遍运用树立了根基。方法：60例符合神经根型颈椎病诊断标准的受试者来自于广东省第二中医院针灸康复科五区的住院部患者,严格按照研究方案的规定,将60例受试者随机平均分为治疗组、对照组,单组30人。治疗组采用侧头摇正法,而传统手法施加于对照组。两组均治疗12次,1日1次,周日休息,连续进行两星期,即完成一个疗程,并进行临床观察。在治疗前、后,观察两组的患者的症状、体征及疼痛程度并以神经根型颈椎病JOA量表、VAS量表进行客观评价,并对所获得的数据使用SPSS19.0统计软件分析。结果：1、临床疗效评价方面：总有效率：治疗组96.7%,对照组90.0%,经分析,P0.05,还不能表明两组的总有效率有临床差异。疗效愈显率：治疗组87.5%、对照组75.3%,经统计分析,P0.05,在临床上,具有显著意义,可表明治疗组的愈显疗效比对照组局。2、VAS疼痛程度评分方面：在治疗前两组进行比较,P0.05,两组的疼痛程度具有可比性；在治疗后,两组疼痛评分分别与治疗前相比较,P0.05,差别有显著意义,表明两组的治疗均具有效果,两组治疗后评分比较,P0.05,差别具有显著意义,两组差值评分进行比较,P0.05,表明治疗组的疗效比对照组优。3、JOA神经根型颈椎病的临床症状、体征、整体临床表现评分方面：在治疗前,对两组的JOA整体积分、单项症状、单项体征进行比较评分,经数据分析,结果示：两组在三组评分表格上,均具有可比性(P0.05)。在治疗后,两组在症状评分上进行组内比较,结果示：差别都有显著意义(P0.05),说明在改善临床症状方面,两组都有效果。在体征评分方面,两组治疗前后评分比较,结果示治疗组的前后对比评分结果具有统计学意义(P0.05),而对照组,无统计学意义(P0.05),表明在改善体征上,治疗组具有疗效,但还不能说明两组在临床体征评分上存在差别；在JOA总体评分上,两组进行治疗前后比较,P0.05,两组均有疗效,两组总体评分治疗前后差值变化比较,P0.05,总体上说明在改善神经根型颈椎病的临床症状、体征、整体临床表现评分方面,治疗组比对照组疗效佳。结论：侧头摇正法治疗神经根型颈椎病在改善临床症状、体征及整体临床表现方面具有更明显的疗效,且操作简单,具有稳准、安全、轻巧、准确定位的特点,值得临床进一步推广。
[Abstract]:Objective: to observe the effect of the treatment of cervical spondylosis of nerve root type by shaking the head of the lateral head, analyze and conclude its mechanism according to its clinical curative effect, so as to provide a new way of thinking for the clinical treatment of cervical spondylosis of nerve root type. It lays a foundation for the universal use of Dragon's bone manipulation in clinical practice. Methods: 60 patients with cervical spondylosis of nerve root type were randomly divided into the treatment group and the treatment group according to the research plan strictly according to the stipulation of the research plan, 60 cases of cervical spondylosis came from the inpatient department of the acupuncture and moxibustion rehabilitation department of the second traditional Chinese medicine hospital of Guangdong province. Control group (n = 30). The patients in the treatment group were treated with the lateral head swing correction method, while the traditional manipulation was applied to the control group. The patients in both groups were treated 12 times, 1 day, rest on Sunday for two weeks, that is to say, one course of treatment was completed, and the clinical observation was carried out. Before and after treatment, the symptoms, signs and pain degree of the two groups were observed and evaluated objectively by JOA scale and VAS scale. The data were analyzed by SPSS19.0 software. Results: 1. Clinical efficacy evaluation: the total effective rate: the treatment group 96.7%, the control group 90.0%, the analysis, P0.05, can not show the total effective rate of the two groups have clinical differences. The effective rate was 87.5% in the treatment group and 75.3% in the control group. According to statistical analysis, P 0.05 had significant clinical significance, which could show that the treatment group was more effective than that in the control group. VAS pain score: compared with the two groups before treatment, P0.05, the pain degree of the two groups is comparable; After treatment, the pain scores of the two groups were significantly different from those before treatment (P 0.05), indicating that the treatment of both groups was effective, and there was significant difference between the two groups in the scores after treatment, P 0.05, P 0.05. The difference score between the two groups, P 0.05, showed that the therapeutic effect of the treatment group was better than that of the control group. 3. The clinical symptoms, signs and overall clinical manifestations of cervical spondylosis of JOA nerve root type: before treatment, the JOA integral of the two groups was overall. The results showed that the two groups were comparable on the scoring form of three groups (P0.05). After treatment, the symptom scores of the two groups were compared within the group. The results showed that the difference was significant (P0.05), indicating that the two groups were effective in the improvement of clinical symptoms. In the physical sign score, the two groups before and after treatment score comparison, the results showed that the treatment group before and after the comparison score results were statistically significant (P0.05), but the control group, there was no statistical significance (P0.05), indicating in the improvement of physical signs. The treatment group had curative effect, but it could not explain the difference in clinical sign score between the two groups. In the overall JOA score, the two groups were compared before and after treatment, P0.05, the two groups had curative effect, the difference between the two groups before and after treatment, P0.05, which generally showed that in improving the clinical symptoms and signs of cervical spondylosis of nerve root type, Overall clinical performance score, the treatment group is better than the control group. Conclusion: the treatment of cervical spondylosis with lateral head swing has more obvious curative effect in improving clinical symptoms, signs and overall clinical manifestations, and it has the characteristics of simple operation, stable accuracy, safety, lightness and accurate localization. It is worthy of further promotion in clinical practice.
【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】：2016
【分类号】：R244.1

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