推拿手法对颈椎病“骨错缝”的治疗作用

目的探讨理筋手法联合颈椎调整手法治疗颈椎病"骨错缝"的作用机制。方法将20例患者随机分为理筋组和理调组各10例,另设正常组10例。理调组采用理筋手法联合颈椎调整手法,理筋组、正常组均采用理筋手法,各组均每周治疗3次,疗程2周。治疗前后采用Philips64排螺旋CT从颅底扫描至T1椎骨水平的长度范围,获得容积数据,重建层厚0.625mm,再采用ITK-SANP软件根据CT数据完成每一节段颈椎骨骼的重建,比较3组治疗前后颈椎C2、C3、C4椎骨三维空间的变化。结果治疗后理调组C2椎骨X轴、Y轴、Z轴均明显大于正常组(P<0.01),X轴、Z轴明显大于理筋组(P<0.05);理筋组治疗后C2椎骨Z轴明显大于正常组(P<0.01)。理调组C3椎骨X轴、Y轴均明显大于正常组(P<0.01),X轴明显大于理筋组(P<0.05);理筋组C3椎骨X轴明显大于正常组(P<0.05)。理调组治疗后C4椎骨X轴、Z轴明显大于正常组及理筋组(P<0.05或P<0.01)。结论理筋手法联合颈椎调整手法可调整颈椎病患者的颈椎三维空间位置,改善颈椎功能,这可能是其治疗颈椎病"骨错缝"的机制之一。

Therapeutic Effect of Tuina Manipulation on Gucuofeng of Cervical Spondylosis

Objective To discuss the effect and mechanism of Tuina manipulation for Gucuofeng (a joint derangement caused by violence or chronic strain and mainly manifested as pain and dysfunction of joints) of cervical spondylosis. Methods Twenty cases were randomized into Lijin (Regulating the tendons and muscles) group and Litiao (regulating the tendons and muscles and cervical vertebrae) group with 10 in each, and a normal group of 10 cases was established. The Litiao group was treated with manipulation on tendons and muscles and cervical vertebrae regulation, while the Lijin group and normal group were treated with manipulation on tendons and muscles. The treatment was given 3 times a week for 2 weeks. Before and after treatment, all patients were examined with Philip 64 spiral CT scanning from the base of skull to the first thoracic vertebra, the volume data was accessed, and the reconstructed thickness was 0.625mm. Then, the ITK-SANP software was used to fulfill the reconstruction of every segment of cervical vertebrae according to the CT data for comparing the changes of three-dimensional space of C2, C3, and C4 of the 3 groups after treatment. Results After treatment, the X, Y, and Z axes of C2 of the Litiao group were all significantly larger than those of the normal group (P<0.01), and the X and Z axes were significantly larger than those of the Lijin group (P<0.05). The Z axis of C2 of the Lijin group was significantly larger than that of the normal group (P<0.01). The X and Y axes of C3 of the Litiao group were both significantly larger than those of the normal group (P<0.01), and the X axis was significantly larger than that of the Lijin group (P<0.05). The X axis of C3 of the Lijin group was significantly larger than that of the normal group (P<0.05). The X and Z axes of C4 of the Litiao group were both significantly larger than those of the normal group and Lijin group (P<0.05 or P<0.01). Conclusion Lijin manipulation plus Litiao manipulation on cervical vertebrae is effective in regulating the three-dimensional space location and improving the functions of cervical vertebrae. This is possibly one of its functional mechanisms for treating Gucuofeng of cervical spondylosis.