定位仰卧拔伸手法治疗椎动脉型颈椎病的疗效观察

目的：根据“骨错逢，筋出槽”评估要素合理运用仰卧拔伸手法治疗椎动脉型颈椎病，并对其进行疗效分析，从而为本病的诊治提供一个新的思路。方法：将60例患者分为治疗组（经评估后在椎骨错缝定位节段运用仰卧拔伸手法）30例，对照组（仰卧拔伸手法）30例。根据《脊柱推拿诊治评估技术规范》中的颈椎评估方法为每一位患者进行评估。治疗以每周4次为1疗程，共3疗程。观察治疗前后患者疗效，并参照相关的椎动脉型颈椎病功能评定量表予以评分。结果：治疗12次后，治疗组的总有效率为96．7％，对照组为93．3％，两组比较差异无统计学意义（P〉0．05）；两组治疗前后症状、体征自身积分差值比较显示治疗组在治疗眩晕和头痛两大椎动脉型颈椎病主要症状方面要优于对照组（P〈0．05）。而其他症状、体征方面如颈肩痛、生活、工作和社会适应能力改善方面两组疗效比较差异无统计学意义（P〉0．05）。结论：经过评估后的手法治疗组对椎动脉型颈椎病的疗效确切。经过评估后的手法治疗组对椎动脉型颈椎病患者最主要的两大症状眩晕与头痛的疗效优于对照组，故根据规范系统的确定病变节段有的放矢进行治疗在短期内能更好的提高手法的疗效，从而使仰卧拔伸手法更加具有针对性。

Clinical Observation and Analysis on Cervical Spondylosis of Vertebral Arteryiopathy treated with Positioning Supine Extension Manipulation

Objective.. To observe the effect of positioning supine extension manipulation in the treatment of cervical spondylosis of vertebral arteryiopathy （CSA）, analyze the clinical efficacy so as to provide a new method for the diagnosis and treatment of this disease. Methods： After being evaluated according to the spinal massage treatment evaluation specification, sixty patients with CSA were randomly divided into treating group （n= 30） and control group （n= 30）. Clinical Effects were evaluated by the functional rating scale of CSA after the three weeks＇ treatment with four times per week. Results.. The total effective rate was 96.7% in the treatment group and 93. 3% in control group. There was no significant difference between the two groups （P〈0.05）. However, the main symptoms of vertigo and headache in the treatment group were improved more obviously than the control group （P〈0.05）. Other symptoms and signs showed no significant difference between the two groups （P〈0.05）. Conclusion.. Positioning supine extension manipulation has obvious effect for CSA, especially in improving the symptoms of vertigo and headache. Therefore, targeted therapy of locking segment can achieve bet- ter results in the short term.