仰卧位拔伸整复手法治疗神经根型颈椎病的随机、对照、多中心临床研究

目的:评价仰卧位拔伸整复手法治疗神经根型颈椎病的有效性和安全性。方法:以颌枕吊带牵引为平行对照,选择符合神经根型颈椎病诊断标准的受试者,采用分层随机方法将其分配至治疗组或对照组,分别接受仰卧位拔伸整复手法或颌枕吊带牵引治疗。采用积分法比较两组总体疗效和主要症状体征的差异,以P<0.05作为差异具有统计学意义;并对疗效与年龄、病程、病情和中医证型的相关性进行分析。结果:共计纳入病例273例,剔除2例,进入统计学分析者271例。基线比较,两组各项指标的差异均无统计学意义。疗效统计结果,治疗组和对照组的愈显率分别为70.2%和67.5%、总有效率分别为94.2%和94.0%;两种治疗方法对于缓解颈项痛、上肢痛、头痛、上肢麻木、上肢无力、头晕等症状和颈部活动不利、颈项压痛、叩击试验、压颈试验、牵拉试验阳性具有显著疗效;同时,还可明显提高患者工作能力和生活能力。手法治疗效果与年龄、病程、病情和中医证型无显著相关性。远期疗效分析,半年内症状与体征有轻度复发者86例,其中,治疗组31例占20%,对照组55例占47%,两组之间的差异具有统计学意义,未见中、重度复发者。安全性分析结果,治疗组有10例出现轻度不良反应,对照组有12例出现轻度不良反应。两组均未见骨折、脱位、晕厥等其他不良反应。结论:仰卧位拔伸整复手法治疗神经根型颈椎病是安全、有效的,手法治疗的远期疗效和受试者依从性优于牵引。

Pulling-manipulation in dorsal position for the treatment of cervicalspondylotic radiculopathy:A randomized,multi-center controlled trial

Objective:To evaluate the clinical effect and safety of pulling-manipulation treating cervicalspondylotic radiculopathy in dorsal position.Methods:Patients with cervicalspondylotic radiculopathy were randomly allocated to manipulation group and control group.The control group was treated with traction.Cure rate,effective power and scores of present symptoms and physical sign were statisticsed,adverse events were recorded.Results:Two hundreds and seventy-one patients who were 25 to 68 years old were enrolled.The base-line characteristics of the patients in the treatment and control group were similar.Cure rate in manipulation group was 70.2 percent,vs.67.5 percent in control group and the total effective power was 94.2 percent vs.94 percent.Two methods could relieve the symptoms of cervicodynia,brachialgia,headache,epipodite,acroanesthesia weak and dizziness,also could improve the work capacity and viability.And the effects of manipulation were independent of ages,course of disease,pathogenetic condition and traditional Chinese medicine's type of syndrome on patients.Prostecdtive efficacy,31 patients in manipulation group were palindromia and 55 did in control group.Four cases feel aching pain aggravate and 6 cases had ecchymosis on neck and nape after first treatment in manipulation group,the control group had 12 cases with ecchymosis on lower mandible,other adverse effects were not observed.Conclusion:Pulling-manipulation in dorsal position is safety and effective to patient with cervicalspondylotic radiculopathy.The effect of manipulation is better than traction.