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手法整复寰枢关节半脱位的前瞻性随机对照研究及应用
引用本文:王常鸿,高焕民,郭成悦.手法整复寰枢关节半脱位的前瞻性随机对照研究及应用[J].国际中医中药杂志,2009,31(4).
作者姓名:王常鸿  高焕民  郭成悦
作者单位:1. 青岛大学医学院第二附属医院康复科,山东,266042
2. 青岛大学医学院第二附属医院神经内科,山东,266042
3. 青岛大学医学院第二附属医院骨科,山东,266042
摘    要:目的 研究手法整复治疗侧向旋转型寰枢关节半脱位的疗效.方法 经X线片证实的侧向旋转型寰枢 关节半脱位患者128例,随机分为两组各64例,治疗组采用手法定位旋转复位法治疗,对照组采用常规牵引治疗,观察比较两组的临床疗效,并用X片证实.结果 治疗后X片证实齿状突偏移调整情况,两组差异具有统计学意义(P<0.01).椎基底动脉的血流量改善两组差异具有统计学意义(P<0.05).治疗组总有效率95.3%,对照组总有效率78.1%,两组对比差异具有统计学意义(P<0.01):随访1年,治疗组复发6例,对照组复发13例,差异有统计学意义(P<0.05).结论 手法整复治疗寰枢关节半脱位较牵引治疗更能针对病因、整复寰枢椎之间的位置关系,恢复颈椎的力学稳定性,改善患者的椎基底动脉血流量.

关 键 词:寰枢关节半脱位  手法整复  牵引  临床研究  前瞻性随机对照研究

Application and Prospective Randomized Control Study of Manipulative Reduction on Atlanto-axial Subluxation
WANG Chang-hong,GAO Huan-min,GUO Cheng-yue.Application and Prospective Randomized Control Study of Manipulative Reduction on Atlanto-axial Subluxation[J].International Journal of Traditional Chinese Medicine,2009,31(4).
Authors:WANG Chang-hong  GAO Huan-min  GUO Cheng-yue
Abstract:Objective To observe the clinical effect of treating atlanto-axial subluxation by manipulative reduction therapy. Methods 128 patients with atlanto-axial subluxation confirmed by cervical plain X ray were randomized into two groups: 64 in the treatment group treated by manipulative reduction therapy, and 64 in the control group treated by the routine cervical traction. The clinical effect was evaluated by both clinical and X-ray confirmation. Results The X-ray study showed that after treatment the reconstruction of excursion in odontoid process in the treatment group was better than that in the control group significantly (P<0.01). The improvement of vertebra basal artery blood flow in the treatment group was also better than that in the control group significantly (P<0.05). The total effective rate of the treatment group was 95.3%, while the control group was 78.1%. Conclusion The technique of manipulative reduction on atlanto-axial subluxation acts more directly on the cause of the disease than the routine traction, and exerts better results in restoring proper atlanto-axiai joint position and mechanics stability of cervical vertebra.. Thus it is the effective shortcut way with high safety and low cost.
Keywords:Atlantoaxial subluxation  Manipulative therapy  Traction  Prospective randomized control study  Clinical
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