[1]张超,李嘉玮,马增斌,等.刘寿山整颈法治疗慢性非特异性颈痛的随机对照研究[J].中国中医骨伤科杂志,2024,32(10):19-25.[doi:10.20085/j.cnki.issn1005-0205.241004]
　ZHANG Chao,LI Jiawei,MA Zengbin,et al.Randomized Controlled Study of Liu Shoushan Manipulation in Treating of Non-Specific Chronic Neck Pain[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2024,32(10):19-25.[doi:10.20085/j.cnki.issn1005-0205.241004]
点击复制

刘寿山整颈法治疗慢性非特异性颈痛的随机对照研究()
分享到：

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第32卷
期数:
2024年10期
页码:
19-25
栏目:
临床研究
出版日期:
2024-10-15

文章信息/Info

Title:
Randomized Controlled Study of Liu Shoushan Manipulation in Treating of Non-Specific Chronic Neck Pain
文章编号:
1005-0205(2024)10-0019-07
作者:
张超1; 2; 李嘉玮1; 马增斌3; 覃昌龙1; 白春晓1; 翟俊修1; 张帆1; 李忠泽1; 许萌1; 陈江1△
1 北京中医药大学东直门医院(北京,100700)
2北京中医药大学
3北京医院
Author(s):
ZHANG Chao1; 2; LI Jiawei1; MA Zengbin3; QIN Changlong1; BAI Chunxiao1; ZHAI Junxiu1; ZHANG Fan1; LI Zhongze1; XU Meng1; CHEN Jiang1△
1Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China; 2Beijing University of Chinese Medicine,Beijing 100029,China; 3Beijing Hospital,Beijing 100005,China.
关键词:
慢性非特异性颈痛;  刘寿山;  正骨疗法;  剪切波弹性模量成像;  随机对照研究
Keywords:
non-specific chronic neck pain;  Liu Shoushan;  orthopedic therapy;  shear wave elastography;  randomized controlled study
分类号:
R681.5
DOI:
10.20085/j.cnki.issn1005-0205.241004
文献标志码:
A
摘要:
目的:观察刘寿山整颈法治疗慢性非特异性颈痛的疗效及安全性。方法:纳入慢性非特异性颈痛患者40例,随机分为观察组(20例)和对照组(20例); 观察组患者接受刘寿山整颈法治疗,对照组接受牵引治疗; 评估两组患者治疗前后肌肉弹性模量、疼痛程度及颈椎功能障碍程度的差异。结果:治疗后两组患者的剪切波弹性模量(SWE)值均下降,观察组患者左侧胸锁乳突肌(L-SCM)、双侧头夹肌(SPCAP)及双侧上斜方肌(Trapezius)的剪切波弹性模量值显著低于牵引组(P<0.001),两组患者右侧胸锁乳突肌(R-SCM)相比差异无统计学意义(P=0.243); 治疗后两组患者疼痛视觉模拟量表(VAS)评分及颈椎功能障碍指数(NDI)评分均下降,观察组患者VAS评分及NDI评分显著低于对照组,差异有统计学意义(P<0.05)。相关性分析表明VAS评分差异绝对值与上斜方肌、头夹肌剪切波弹性模量差异显著负相关(-1.0<r<-0.5,P<0.001),与左胸锁乳突肌负相关(P=0.002 1),与右胸锁乳突肌相关性无统计学意义(P=0.289 1)。结论:刘寿山整颈法治疗可显著改善慢性非特异性颈痛患者上斜方肌、头夹肌的僵硬度,较好地缓解疼痛程度,改善颈椎功能,且在短期内保持疗效。
Abstract:
Objective:To assess the efficacy and safety of Liu Shoushan manipulation therapy in treating non-specific chronic neck pain(NCNP).Methods:40 patients with NCNP were randomly assigned to either an observation group(20 cases)receiving Liu Shoushan manipulation therapy and a control group(20 cases)receiving traction therapy.The differences of elastic modulus,pain degree and cervical dysfunction of different muscles between the two groups were evaluated before and after treatment.Results:After treatment,the shear wave elastography(SWE)value of the two groups decreased.The observation group demonstrated significantly lower SWE values in the left sternocleidomastoid muscle(L-SCM),trapezius(TRAP)and splenius capitis(SPCAP)compared to the control group(P<0.001),and there was no statistically difference in right sternocleidomastoid muscle(R-SCM)between the two groups(P=0.243).Additionally,visual analogue scale(VAS)and neck disability index(NDI)scores decreased significantly in both groups post-treatment,with the observation group showing greater reductions compared to the control group(P<0.05).Correlation analysis revealed significant negative correlations between VAS score differences and elasticity modulus differences of the trapezius and SPCAP(-1.0<r<-0.5,P<0.001),and negative correlation with the L-SCM(P=0.002 1),while correlations with the R-SCM were not significant statistically(P=0.289 1).Conclusion:Liu Shoushan manipulation therapy can significantly improve the stiffness of the trapezius and SPCAP in patients with chronic non-specific neck pain,effectively alleviate pain,improve cervical spine function,and maintain efficacy in the short-term follow-up.

参考文献/References:

[1] QIN C L,SUN Y L,JIA Y S,et al.Research progress of non-specific neck pain in traditional Chinese medicine and western medicine[J].Precision Medicine Research,2021,3(1):21-30.
[2] CHILDS J D,CLELAND J A,ELLIOTT J M,et al.Neck pain:clinical practice guidelines linked to the international classification of functioning,disability,and health from the orthopedic section of the American Physical Therapy Association[J].J Orthop Sports Phys Ther,2008,38(9):A1-A34.
[3] HIDALGO B,HALL T,BOSSERT J,et al.The efficacy of manual therapy and exercise for treating non-specific neck pain:a systematic review[J].J Back Musculoskelet Rehabil,2017,30(6):1149-1169.
[4] 魏戌,朱立国,李金学,等.2014年加拿大整脊疗法治疗成人颈痛循证指南解读[J].中国医学前沿杂志(电子版),2014,6(9):157-160.
[5] CHENG Z J,ZHANG S P,GU Y J,et al.Effectiveness of Tuina therapy combined with Yijinjing exercise in the treatment of nonspecific chronic neck pain:a randomized clinical trial[J].JAMA Netw Open,2022,5(12):e2246538.
[6] SAFIRI S,KOLAHI A A,HOY D,et al.Global,regional,and national burden of neck pain in the general population,1990-2017:systematic analysis of the global burden of disease study 2017[J].British Med J(Clinical Research Ed),2020,368:m791.
[7] SHIN D W,SHIN J I,KOYANAGI A,et al.Global,regional,and national neck pain burden in the general population,1990-2019:an analysis of the global burden of disease study 2019[J].Front Neurol,2022,13:955367.
[8] BIER J D,SCHOLTEN-PEETERS W G M,STAAL J B,et al.Clinical practice guideline for physical therapy assessment and treatment in patients with nonspecific neck pain[J].Phys Ther,2018,98(3):162-171.
[9] PARIKH P,SANTAGUIDA P,MACDERMID J,et al.Comparison of CPG's for the diagnosis,prognosis and management of non-specific neck pain:a systematic review[J].BMC Musculoskelet Disord,2019,20(1):81.
[10] CORP N,MANSELL G,STYNES S,et al.Evidence-based treatment recommendations for neck and low back pain across Europe:a systematic review of guidelines[J].Eur J Pain,2021,25(2):275-295.
[11] 黄梅忠,王诗忠.慢性非特异性颈痛的治疗现状[J].中国康复医学杂志,2021,36(9):1190-1194.
[12] 张佳玮,王刚,李飞,等.中医推拿联合功法训练治疗慢性非特异性颈痛的效果[J].中国康复理论与实践,2016,22(4):459-463.
[13] 奚达,孙树椿,马德永.刘寿山正骨经验[M].北京:人民卫生出版社,2006:41-43.
[14] 张颖,贾丽燕,邵建柱,等.中医药临床研究中实施盲法的原则、问题和评价[J].北京中医药,2018,37(12):1159-1162.
[15] 刘博姬,徐辉雄.剪切波弹性成像在肌肉、肌腱、周围神经病变生物力学定量评估中的应用进展[J].肿瘤影像学,2022,31(1):11-15.
[16] 王丽芸,邱逦.超声弹性成像在肌肉硬度评估中的应用进展[J].国际医学放射学杂志,2019,42(1):90-93.
[17] GALINDEZ-IBARBENGOETXEA X,SETUAIN I,RAMÍ-REZ-VELEZ R,et al.Short-term effects of manipulative treatment versus a therapeutic home exercise protocol for chronic cervical pain:a randomized clinical trial[J].J Back Musculoskelet Rehabil,2018,31(1):133-145.
[18] 龙露,王三荣,虞乐华.非特异性颈痛康复治疗进展[J].中国康复医学杂志,2022,37(1):125-130.
[19] 孙悦礼,姚敏,崔学军,等.慢性筋骨病的中医认识与现代理解[J].中医杂志,2014,55(17):1447-1451.
[20] BLANPIED P R,GROSS A R,ELLIOTT J M,et al.Neck pain:revision 2017[J].J Orthop Sports Phys Ther,2017,47(7):A1-A83.
[21] HUANG X,LIN D,LIANG Z,et al.Mechanical parameters and trajectory of two Chinese cervical manipulations compared by a motion capture system[J].Front Bioeng Biotechnol,2021,9:714292.
[22] GRIMES J K,PUENTEDURA E J,CHENG M S,et al.The comparative effects of upper thoracic spine thrust manipulation techniques in individuals with subacromial pain syndrome:a randomized clinical trial[J].J Orthop Sports Phys Ther,2019,49(10):716-724.
[23] SHERMAN K J,CHERKIN D C,HAWKES R J,et al.Randomized trial of therapeutic massage for chronic neck pain[J].Clin J Pain,2009,25(3):233-238.
[24] GOATS G C.Massage-the scientific basis of an ancient art:part 2.Physiological and therapeutic effects[J].Br J Sports Med,1994,28(3):153-156.
[25] WILHELM M,CLELAND J,CARROLL A,et al.The combined effects of manual therapy and exercise on pain and related disability for individuals with nonspecific neck pain:a systematic review with meta-analysis[J].J Man Manip Ther,2023,31(6):393-407.
[26] 徐亦乐,车艳玲,刘洋,等.剪切波弹性成像在肌骨系统疾病诊断上的应用进展[J].影像科学与光化学,2024,42(1):77-82.
[27] 陈柏錱,林铭,邓炜欣,等.基于剪切波超声弹性成像评价不同姿势对胸腰筋膜和斜方肌组织硬度的影响[J].中国康复医学杂志,2021,36(3):283-287.
[28] 刘骏逸,乔雅馨,李涛,等.应用超声剪切波弹性成像技术评价“筋滞骨错”手法对髂胫束综合征治疗效果的研究[J].中国康复医学杂志,2022,37(10):1379-1381.
[29] 方响琴,邓皓月,金可心,等.剪切波弹性成像在肌筋膜疼痛综合征中的临床应用价值[J].临床超声医学杂志,2021,23(7):521-524.
[30] 郭玲,张晨,张丁丁,等.剪切波超声弹性成像技术在颈肩肌筋膜疼痛综合征中的应用[J].中国骨伤,2016,29(2):142-145.

备注/Memo

备注/Memo:
基金项目:国家自然科学基金面上项目(82374492)
北京中医药大学新教师启动基金项目(2023-BUCMXJSY015)
△通信作者 E-mail:cjdzmhp@163.com
更新日期/Last Update: 2024-10-05