“理筋正骨八步”手法治疗神经根型颈椎病临床观察

目的:观察"理筋正骨八步"手法治疗神经根型颈椎病(cervical spondylotic radiculopathy,CSR)的临床疗效。方法:选取2018年9月至2019年9月本院治疗的CSR患者80例,按照随机数字表法分为试验组和对照组,每组40例。试验组给予"理筋正骨八步"手法治疗,对照组给予推拿手法治疗。所有患者均治疗2个疗程。观察并记录两组患者治疗前后麦基尔疼痛量表-简表中的疼痛强度(present pain intensity,PPI)、视觉模拟评分(visual analogues scale,VAS)和疼痛指数(pain rating index,PRI),正中神经、尺神经肌电图F波传导速度,颈椎功能障碍指数问卷(neck disability index,NDI)评分、症状体征积分。结果:试验组治疗后PPI评分、VAS评分和PRI评分均低于对照组,差异有统计学意义(P<0.05);试验组治疗后正中神经、尺神经肌电图F波传导速度高于对照组,差异有统计学意义(P<0.05);试验组治疗后NDI评分低于对照组,差异有统计学意义(P<0.05);试验组治疗后上肢麻木评分、颈椎活动度评分和上肢肌力评分高于对照组,差异有统计学意义(P<0.05);试验组有效率为95.0%,对照组有效率为77.5%,试验组有效率高于对照组,差异有统计学意义(P<0.05)。结论:"理筋正骨八步"手法治疗神经根型颈椎病,能减轻患者疼痛,改善患者上肢麻木、颈椎活动度和上肢肌力,提高正中神经、尺神经肌电图F波传导速度。

Clinical Observation of Treating Cervical Spondylotic Radiculopathy with Manipulation of "Eight Steps for Regulating Sinew and Setting Bones"

Objective:To observe the clinical curative effect of manipulation of"eight steps for regulating sinew and setting bones"on cervical spondylotic radiculopathy(CSR).Methods:A total of 80 patients with CSR treated in our hospital from September 2018 to September 2019 were selected and randomly divided into the experimental group and the control group,with 40 cases in each group.The experimental group was treated with manipulation of"eight steps for regulating sinew and setting bones",while the control group was treated with massage.All the patients were treated for 2 courses.Then according to McGill Pain Scale-short form,the present pain intensity(PPI),visual analogue scale(VAS)and pain rating index(PRI),median nerve,electromyographic F-wave velocity of ulnar nerve,neck disability index(NDI)score,symptom and sign scores of the two groups before and after the treatment were observed and recorded.Results:After the treatment,the PPI score,VAS score and PRI score of the experimental group were lower than those of the control group,and all the differences were statistically significant(P<0.05).The F-wave conduction velocity of median nerve and ulnar nerve in the experimental group was higher than that in the control group,and all the differences were statistically significant(P<0.05).The NDI score of the experimental group was lower than that of the control group after treatment,and the difference was statistically significant(P<0.05).The scores of upper limb numbness,cervical mobility and upper limb muscle strength in the experimental group were higher than those in the control group,and all the differences were statistically significant(P<0.05).The effective rate of the experimental group was 95.0%,which was higher than that of the control group 77.5%.The difference was statistically significant(P<0.05).Conclusion:In terms of CSR,manipulation of"eight steps for regulating sinew and setting bones"can relieve the pain of patients,improve the numbness of upper limbs,the range of motion of cervical vertebra and the muscle strength of upper limbs,and improve the F-wave conduction velocity of EMG of median nerve and ulnar nerve.