超微针刀颈枕快速松解术结合颈椎微调法治疗青年颈椎曲度异常

目的:观察超微针刀颈枕快速松解术结合颈椎微调法治疗青年颈椎曲度异常患者的临床疗效和安全性。方法:自2016年11月至2018年10月治疗青年颈椎曲度异常88例,因失访而实际获完整临床资料86例,男37例,女49例;年龄20～40(30.55±5.21)岁;病程1～42(14.21±7.38)个月。86例分为两组,44例采用超微针刀颈枕快速松解术结合颈椎微调法治疗(治疗组),42例采用常规针刺结合推拿治疗(对照组)。治疗组1次/周,对照组3次/周,3周为1个疗程。分别于治疗前、治疗3周结束、治疗结束后1个月随访时记录颈痛量表(NPQ)评分(并计算百分率)、颈椎活动度(ROM)评分,治疗前与治疗结束1个月随访时记录颈椎生理曲度D值,并评定治疗结束时和1个月随访时两组临床疗效。治疗期间同时要求患者注意纠正日常不良姿势,睡觉保持低枕位,每日早、晚用高低适中的柱形枕置于颈后,颈椎后伸状态下平睡0.5 h。结果:对照组脱落2例,两组患者均未出现不良反应。与治疗前比较,两组治疗后各个观察时点颈痛评分、颈椎活动度评分、颈椎生理曲度D值均显著改善(均P0.05);组间比较,治疗3周结束及1个月后随访时,治疗组颈痛NPQ评分改善优于对照组,组间比较差异均有统计学意义(均P0.05),治疗前后不同时间点颈痛NPQ评分的差异有统计学意义,即存在时间效应(F=203.63,P=0.000),时间因素和分组因素存在交互效应(F=4.964,P=0.012);两组颈椎活动度的ROM评分组间比较差异均无统计学意义(均P0.05),治疗前后不同时间点颈椎活动度ROM评分的差异有统计学意义,即存在时间效应(F=240.32,P=0.000),但时间因素和分组因素并不存在交互效应(F=0.311,P=0.734)。治疗结束1个月后随访时颈椎生理曲度D值的改善程度治疗组优于对照组,差异有统计学意义(P0.05);治疗结束时治疗组总有效率为90.91%(40/44),高于对照组的80.95%(34/42,P0.05);治疗结束后1个月随访时,治疗组总有效率为84.09%(37/44),对照组有效率为76.19%(32/42,P0.05),两组疗效差异无统计学意义。结论:超微针刀颈枕快速松解术结合颈椎微调法能有效恢复颈椎生理曲度,缓解颈椎疼痛,改善颈椎活动度,安全性较好,是治疗症状型青年颈椎曲度异常患者的有效方法。

Evaluation of therapeutic effects of the ultramicro needle-knife combined with cervical spine fine adjusting on youth cervical curvature abnormality case

Objective: To study the therapeutic effects of the ultramicro needle-knife combine with cervical spine fine adjusting on youth cervical curvature abnormality case.Methods: From November 2016 to October 2018,88 young patients with abnormal curvature of cervical spine were treated. Due to loss of follow-up,86 cases were actually completely including 37 males and 49 females,ranging in age from 20 to 40 years old,with an average of (30.55±5.21) years old,and the course of disease ranged from 1 to 42 months,with a mean of (14.21±7.38) months. All the patients were divided into two groups:treatment group(44 cases) and control group(42 cases). The patients in the treatment group were treated with ultramicro needle-knife and cervical spine fine adjusting,and the patients in the control group were treated with conventional acupuncture and manipulation. The treatments were done 1 time per week in the treatment group while 3 times per week in control group every week,with a duration of 3 weeks for both groups. Before treatment,3 weeks after treatment,and at the end of 1 month follow-up,the score of neck pain questionnaire(NPQ),range of the motion(ROM) in the cervical region and the D values of cervical physiological curvature were recorded. The efficacy at the end of treatment and in the follow-up was evaluated. During the treatment,the patients were also required to correct the bad posture in daily life,to sleep in a low pillow position,and put a moderately columnar pillow behind the neck for 0.5 hours every morning and evening.Results: Two patients in the control group were dropped out after 3 weeks treatment. No adverse reactions were found in the 2 groups during the treatment period. Compared with those before treatment,all scores at all the observation time points were significantly improved between two groups after treatment(all P<0.05). The NPQ scores of cervical symptoms were different significantly between two groups(all P<0.05). The changing range of the the NPQ score of cervical symptoms and cervical spine alignment curve of the treatment group were better than those of the control group(P<0.05).There was statistical difference in NPQ scores between different time points,in the other words,there was time effect(F=203.63,P=0.000). There was interaction between time factor and group factor(F=4.964,P=0.012). There was no statistical difference in the changing range of the ROM score between two groups(all P>0.05). There was statistical difference in ROM scores between different time points,there was time effect(F=240.32),P=0.000). There was no interaction between time factor and group factor(F=0.311,P=0.734). The effective rate of the treatment group and control group were 90.91%(40/44) and 80.95%(34/42) respectively,the treatment group was more effective than the control group (P<0.05). During the follow-up period,the effective rate of the treatment group and the control group were 84.09%(37/44) and 76.19%(32/42) respectively. Obviously,the difference of total effective rate between two groups had no statistical signification(P>0.05) in the follow-up duration.Conclusion: The method of needle-knife combined with cervical spine fine adjusting has a better therapeutic efficiency than conventional acupuncture combined with manipulation in treating youth cervical curvature abnormality patients. Because this novel method can recover the cervical curvature,relieve the neck pain,and improve cervical mobility.