关节松动术结合牵引治疗神经根型颈椎病82例

INTRODUCTION In recent years, joint mobilization combining with traction were used totreat 82 patients with the cervical syndrome, while the control group(64 patients) is done only with traction, and observe the effect of thesetwo groups respectively. As result, the effect of trail group is markedly.     

Cervical traction combined with neural mobilization for patients with cervical radiculopathy: A randomized controlled trial

BackgroundAlthough both neural mobilization (NM) and cervical traction (CT) are widely used interventions in cervical radiculopathy (CR), there is limited clinical data to support their use.ObjectiveTo evaluate the effects of CT, with or without the addition of NM, on pain, function, and disability in patients with CR.DesignA randomized, double-blinded, placebo-controlled clinical trial.Methods66 patients with CR were randomly allocated to: a group (n = 22) received CT combined with NM (CT + NM), a group (n = 22) received CT combined with sham NM (CT + shamNM) and a wait-list control (WLC) group (n = 22). The Neck Disability Index (NDI), the Patient-Specific Functional Scale, the Numeric Pain Rating Scale (NPRS), grip strength and cervical spine mobility were used as outcome measures. A two-way analysis of variance was used to evaluate differences between the three groups at baseline and at 4-week follow-up.ResultsStatistically and clinically significant between-group differences at 4-week follow-up were found between CT + NM and WLC groups in favor of CT + NM group in NDI scores (d = 1.30), NRPS (d = 1.94), and active cervical rotation towards the opposite arm (d = 1.18) and between CT + NM and CT + shamNM groups in favor of CT + NM group in NRPS (d = 1.21). No significant differences were observed between CT + shamNM and WLC groups in all outcome measures. Clinically significant within-group improvements were found only for the CT + NM group.ConclusionAt 4-week follow-up, CT in combination with NM resulted in improved outcomes in pain, function and disability in patients with CR.     

牵引手法治疗椎动脉型颈椎病326例

INTRODUCTION Cervical syndrome of vertebral artery type is in the domain of vertigo intraditional Chinese medicine.     

颈椎牵引加运动疗法治疗神经根型颈椎病疗效观察

目的评价运动疗法对神经根型颈椎病的疗效。方法50例患者随机分为治疗组30例（牵引加运动疗法治疗），对照组20例（单纯颈椎牵引治疗），进行疗效比较。结果治疗组痊愈12例，显效11例，有效8例，无效1例；对照组痊愈6例，显效5例，有效4例，无效无效5例（P〈0．05）。结论牵引与运动疗法联合应用可能取得更佳疗效。     

The effect of cervical traction combined with conventional therapy on grip strength on patients with cervical radiculopathy

OBJECTIVE: To determine if combining intermittent cervical traction with conventional physical therapy methods is more effective than using conventional approaches alone in the improvement of the grip strength and treatment of the patients with unilateral cervical 7 (C7) radiculopathy. DESIGN: Randomized controlled trial (RCT). SETTING: An outpatient physical therapy clinic, University of Social Welfare and Rehabilitation Science, Iran. PATIENTS: A sample of convenience of 30 patients with unilateral C7 radiculopathy participated in this study. Patients were assigned randomly to a control (N = 15, mean age = 46.93 +/- 5.32) and an experimental group (N = 15, mean age = 47.53 +/- 5.6). INTERVENTIONS: Electrotherapy/exercise treatment for control group and combined cervical traction and electrotherapy/exercise for experimental group. Ten physical therapy sessions, three times a week for each group. MAIN OUTCOME MEASURES: Grip strength as an appropriate objective parameter was measured before treatment and after 5 and 10 treatment sessions. RESULTS: Statistical analysis (paired t-test) revealed significant increase in grip strength after 10 treatment sessions in control (p < 0.01) and experimental group (p < 0.01) compared with pretreatment score. In the ANCOVA, controlling for pretest scores, no significant difference was found between the two groups in the after 10 treatment sessions grip score (p = 0.65). However, the change in grip strength after five sessions was significantly greater for the experimental group than for the control group (p = 0.04). CONCLUSIONS: The application of cervical traction combined with electrotherapy and exercise produced an immediate improvement in the hand grip function in patients with cervical radiculopathy.     

体外反搏加牵引治疗椎动脉型颈椎病

目的寻求治疗椎动脉型颈椎病的更有效的方法。方法临床确诊的椎动脉型颈椎病患者90例，男48例，女42例。随机分为三组：反搏组30例，实施单纯体外反搏治疗，用广州产WFB-V型体外反搏装置，气囊压力0．035～0．04MPa，每次治疗50～60min，每日1次，10次为1个疗程；牵引组30例，做单纯牵引治疗，用英国产AKRON-8908型颈椎牵引装置，取坐位，选适当牵引角度，治疗重量取5～15kg，每次治疗15～20min．每日1次，10次为1个疗程；综合组30例，同时应用上述两种方法治疗。结果单纯体外反搏和单纯牵引治疗对椎动脉型颈椎病有一定疗效，体外反搏加牵引综合治疗有显著疗效。反搏组与牵引组比较，差异无统计学意义(P＞0．05)；综合组分别与反搏组、牵引组比较，差异有统计学意义(均P＜0．01)。结论故体外反搏加牵引治疗椎动脉型颈椎病是有效的治疗方法。     

Intermittent cervical traction: a progenitor of lumbar radicular pain.

Twelve patients treated with cervical traction for complaints of cervical radicular pain subsequently developed lumbar radicular discomfort. Intermittent cervical traction therapy had been initiated at 15 pounds and increased to 30 pounds. Lumbar spine roentgenographs in four patients demonstrated a transitional lumbar vertebrae and ten patients had evidence of spinal osteoarthritis with associated degenerative changes. Abnormal electroneuromyographs were found in four patients. In two additional patients with normal electromyographs, the spinal evoked potentials were asymmetrically slowed suggesting chronic lumbar root compromise. The onset of lumbar radiculopathy after intermittent cervical traction suggests that axial tension induced in the spinal cord's dural coverings can be transmitted to lumbar nerve roots. When these structures are tethered by anatomic variants and/or associated degenerative changes, spinal root excursion may be limited, and lumbar pain may be precipitated by traction.     

关节松动技术对脑卒中患者肩-手综合征的影响

目的观察关节松动技术对急性脑卒中患者肩-手综合征的影响。方法伴有肩-手综合征的急性脑卒中患者40例随机分为治疗组、对照组两组,各20例,按常规临床处理的同时,治疗组增加对偏瘫侧上肢行关节松动技术治疗。治疗前及治疗1月后对两组患者进行以下评定：疗效评定、目测类比评分法（VAS）、Fugl—Meyer运动功能指数（FMA）和修订的Barthel指数评定（MBI）。结果治疗后,治疗组患者疗效评定、VAS评分、Fugl—Meyer评分、MBI评分均较对照组差异有统计学意义（P〈0．05）。结论关节松动技术可以显著促进脑卒中患者肩-手综合征的恢复,改善偏瘫上肢运动功能,提高日常生活活动能力。     

卧式颈椎牵引配合按摩及电脑中频治疗椎动脉型颈椎病100例疗效观察

目的观察卧式颈椎牵引配合按摩及电脑中频治疗椎动脉型颈椎病的疗效。方法将100例椎动脉型颈椎病患者随机分组,综合组50例,卧牵组50例,经两个疗程临床观察,进行疗效对比。结果综合组比卧牵组疗效显著,差异有统计学意K（P〈0．025）。结论卧式颈椎牵引配合按摩及电脑中频治疗椎动脉型颈椎病,疗效优于单独卧式颈椎牵引法,提示卧式颈椎牵引配合按摩及电脑中频治疗椎动脉型颈椎病能缩短疗程。     

关节松动术配合理疗治疗颞下颌关节紊乱综合征的疗效评估

目的:观察关节松动术手法配合理疗治疗颞下颌关节紊乱综合征(TMD)的疗效。方法:筛选TMDⅡb类患者40例,随机分为关节松动术配合理疗组(A组,n=20)、针灸配合理疗组(B组,n=20)。治疗前及治疗4周后采用疼痛视觉模拟评分(Visual Analogue Scale,VAS)、最大张口度、下颌功能障碍问卷(Mandibular Function Impairment Questionnaire,MFIQ)、MRI评定患者的疼痛程度、最大张口度、下颌功能及盘髁活动度。结果:治疗后,两组疼痛(A组1.10±1.59,B组1.25±1.37)较治疗前差异均具有显著性意义(P0.001),两组组间比较差异无显著性意义(P0.05);A、B组最大张口度(A组36.50±4.68mm,B组26.15±4.49mm)、下颌功能障碍(A组0.50±0.76,B组0.75±0.55)、盘髁活动度(A组6.54±1.22mm,B组4.43±1.36mm)较治疗前差异均具有显著性意义(P0.001),两组组间比较差异有显著性意义(P0.05)。结论:关节松动术配合理疗的治疗方法可有效改善TMDⅡb类患者的关节疼痛。与针灸配合理疗治疗相比较,关节松动术配合理疗对张口受限、下颌功能障碍、盘髁活动度等症状的改善更加明显。     

温针联合关节松动术治疗肩周炎50例临床观察

目的：观察温针联合关节松动术治疗肩周炎的临床疗效。方法采用单盲、随机、对照的临床试验方法将符合纳入标准的100例受试者随机分成治疗组、对照组各50例,治疗组用温针联合关节松动术进行治疗,对照组采用关节松动术进行治疗,两组治疗2个疗程后运用视觉模拟评分法（ VAS）、肩关节被动ROM等评价指标对其临床疗效进行评估。结果治疗组治愈率60％,总有效率98％;对照组治愈率40％,总有效率86％,两组比较差异有统计学意义（ P＜0.05）;两组患者肩关节疼痛、功能活动治疗后均得到显著改善（P＜0.01）,治疗组改善程度明显优于对照组（P＜0.05）;治疗组复发率（3％）低于对照组,差异有统计学意义（ P＜0.05）。结论温针联合关节松动术治疗肩周炎有较好临床疗效,较单纯运用关节松动术治疗具有优势,值得临床推广应用。     

悬吊运动疗法结合推拿改善神经根型颈椎病上肢神经传导的效果北大核心CSCD

目的观察悬吊运动疗法(SET)结合推拿对神经根型颈椎病的疗效。方法2015年8月至2016年12月,本院72例神经根型颈椎病患者随机分为对照组(n=36)和试验组(n=36),分别采用颈椎牵引和SET结合推拿进行治疗,共4周。治疗前后检测正中神经和尺神经F波传导速度、上肢体感诱发电位(SEP)峰潜伏期、上肢电流感觉阈值(CPT),观察治疗显效率。结果治疗后,试验组显效率83.33%,高于对照组的58.33%(Z=2.093,P<0.05)。治疗后两组正中神经和尺神经F波传导速度显著加快(t>12.059,P<0.001),试验组明显快于对照组(t>3.266,P<0.01);两组的臂丛电位(N9)和颈髓电位(N13)的SEP峰潜伏期显著缩短(t>7.061,P<0.001),试验组显著少于对照组(t>8.033,P<0.001);两组CPT分级均显著降低(t>8.895,P<0.001),且试验组低于对照组(t=8.913,P<0.001)。结论SET结合推拿治疗可促进神经根型颈椎病患者神经传导功能修复。     

牵引、中药外敷联合推拿按摩治疗交感型颈椎病的临床观察

目的观察牵引、中药外敷配合推拿按摩治疗交感型颈椎病的临床疗效。方法 120例交感型颈椎病患者给予牵引、中药外敷配合推拿按摩治疗,10 d为1个疗程。1个疗程后评价临床疗效,并对比治疗前后颈椎功能障碍指数量表(NDI)评分的变化。结果治疗1个疗程后,总有效率为90.00%(108/120);治疗前NDI评分为(15.38±2.67)分,1个疗程和3个月后分别为(9.51±2.44)分和(5.82±1.09)分,不同时间点NDI评分比较,差异有统计学意义(P0.01)。结论牵引、中药外敷配合推拿按摩治疗交感型颈椎病临床疗效肯定,安全性高,可迅速改善患者颈椎功能。     

Headache in patients with neck-shoulder-arm pain of cervical radicular origin

In a series of 81 patients with chronic cervicobrachialgia, 54 (67%) reported that they also suffered from recurrent headache. Forty-four (81%) of these patients were classified as having cervical headache, 5 as having migraine, 2 with tension-type headache, and 3 patients were not classifiable according to the diagnostic system of the International Headache Society (IHS). Patients with headache presented significantly higher tenderness scores and pain intensity in the neck-shoulder-arm region than patients without headaches.
Twenty-three (52%) of the 44 patients with cervical headache reported that their headache had improved after treatments directed towards their cervicobrachialgia.
The IHS classification system of cervical headache is discussed.     

Effect of joint mobilization on serum hyaluronate

Serum hyaluronate was monitored in volunteer patients with rheumatoid arthritis who were mobilized on day 1 at 7 am, but stayed at rest in bed on day 2 until mobilized at 11:30 am. 125I-hyaluronate binding protein assay disclosed a normal morning peak on day 1 but not on day 2. Instead, on day 2 transiently high hyaluronate levels were seen after 11:30 am. This suggests that joint mobilization affects serum hyaluronate. The morning peak may depend on the accumulation of hyaluronate in immobilized joints at night and its mobilization in the morning. High performance liquid chromatography with a size exclusion column used for fraction collection with 125I-hyaluronate binding protein assay showed that the serum hyaluronate in the morning peak is of relatively low molecular weight when compared to synovial fluid hyaluronate. This difference may be due to degradation of synovial fluid hyaluronate before its clearance into the blood stream.     

牵引治疗颈椎间盘突出症疗效与体位变化分析

目的　探讨牵引体位对颈椎间盘突出症的疗效影响。方法回顾分析６年来颈椎间盘突出症６４例,Ａ组行仰卧位颈部牵引,Ｂ组行坐位颈部牵引治疗,对两组疗效进行统计学处理。结果牵引治疗总有效率Ａ组９６．５３％,Ｂ组９１．６７％,Ｐ＜０．０５。结论 牵引治疗颈椎间盘突出症疗效与卧位、坐位的体位变化无显著性差异（Ｐ＜０．０５）。     

负极性静电荷-聚四氟乙烯高分子体膜联合腰椎牵引治疗根性腰痛

背景:负极性静电荷高分子材料、聚四氟乙烯微孔驻极体膜贴于患处表面,可形成高压静电和负静电场,中和患病局部聚集的正电荷.目的:验证负极性静电荷-聚四氟乙烯高分子体膜联合腰椎牵引治疗根性腰痛的临床效果.方法:将120例根性腰痛患者随机分为3组:牵引组、负极性静电荷-聚四氟乙烯高分子体膜组(简称体膜组)和结合组.结合组患者联合上述两种方法治疗.治疗1个月后,通过日本矫形外科学会(JOA)评分评估治疗效果.结果与结论:治疗1个月后3组患者JOA评分为:结合组＞ 牵引组＞ 体膜组,差异均有显著性意义(P ＜ 0.05).结合组患者腰痛改善指数、改善率明显高于与其他两组.提示负极性静电荷-聚四氟乙烯高分子体膜联合腰椎牵引治疗根性腰痛效果好于单纯牵引或负极性静电荷-聚四氟乙烯高分子体膜治疗.     

负极性静电荷-聚四氟乙烯高分子体膜联合腰椎牵引治疗根性腰痛

背景：负极性静电荷高分子材料、聚四氟乙烯微孔驻极体膜贴于患处表面,可形成高压静电和负静电场,中和患病局部聚集的正电荷。目的：验证负极性静电荷-聚四氟乙烯高分子体膜联合腰椎牵引治疗根性腰痛的临床效果。方法：将120例根性腰痛患者随机分为3组：牵引组、负极性静电荷-聚四氟乙烯高分子体膜组（简称体膜组）和结合组。结合组患者联合上述两种方法治疗。治疗1个月后,通过日本矫形外科学会（JOA）评分评估治疗效果。结果与结论：治疗1个月后3组患者JOA评分为：结合组〉牵引组〉体膜组,差异均有显著性意义（P〈0.05）。结合组患者腰痛改善指数、改善率明显高于与其他两组。提示负极性静电荷-聚四氟乙烯高分子体膜联合腰椎牵引治疗根性腰痛效果好于单纯牵引或负极性静电荷-聚四氟乙烯高分子体膜治疗。