颈部拔伸微调扳法治疗神经根型颈椎病的临床疗效观察

目的：观察颈部拔伸微调扳法治疗神经根型颈椎病的临床疗效。方法：选取符合纳入标准的63例神经根型颈椎病患者，依据随机数字表随机分为治疗组31例和对照组32例，治疗期间两组各脱落1例，对照组终止治疗1例，最终各纳入30例。对照组患者颈部仅采用传统推拿手法联合颈部牵引治疗，治疗组患者在传统推拿手法基础上以颈部拔伸微调扳法治疗，两组均治疗14 d。比较两组患者治疗前后颈椎病临床评价量表（CASCS）、疼痛视觉模拟（VAS）评分及血清炎性因子IL-6、IL-8水平的变化情况，并比较临床疗效。结果：治疗后，两组患者VAS评分，CASCS评分均较治疗前明显改善（P <0.05），血清IL-6、IL-8水平均较治疗前明显下降（P <0.05），且治疗组以上指标改善情况明显优于对照组（P <0.05）。治疗组临床有效率93.33%(28/30)，显著高于对照组86.67%(26/30)(P <0.05)。结论：颈部拔伸微调扳法在神经根型颈椎病患者的治疗中具有较好的疗效，较传统中医颈部推拿手法联合牵引法能更快缓解患者症状，减轻炎症反应。

Clinical Observation on the Treatment of Cervical Spondylotic Radiculopathy with Neck Extension and Fine Adjustment and Pulling Method

Objective: To observe the clinical effect of the manipulation method of neck extension and fine adjustment and pulling in the treatment of cervical spondylotic radiculopathy. Methods: Sixty-three patients with cervical spondylotic radiculopathy who met the inclusion criteria were selected, and were randomly divided into a treatment group(n=31) and a control group(n=32) based on a random number table. During the treatment period, 1 patient in each group dropped out, and 1 patient terminated in the control group, and therefore, 30 patients in each group completed the study. The patients in the control group were only treated with traditional massage combined with neck traction, while the patients in the treatment group were treated with neck pulling and fine adjustment and pulling in addition to the treatment used in the control group, and both groups were treated for 14 days. The clinical assessment scale for cervical spondylosis(CASCS), visual analogue scale(VAS) of pain, changes of serum inflammatory factors IL-6 and IL-8 were recorded before and after the treatment. Results: VAS and CASCS scores in both groups improved after the treatment(P <0. 05), the levels of serum IL-6 and IL-8 were significantly reduced(P < 0. 05), and the improvement of the above indicators in the treatment group was more significant than that in the control group(P < 0. 05).The clinical effective rate of the treatment group was 93. 33%(28/30), which was significantly higher than that of the control group(86. 67%, 26/30; P < 0. 05). Conclusion: Neck extension and fine adjustment and pulling method has good therapeutic effect in the treatment of cervical spondylotic radiculopathy patients.Compared to traditional Chinese medicine neck massage, this massage can faster alleviate patient symptoms and reduce inflammatory reactions.