[1]吴烨,郑蒙蒙,李欢△.神经松动术结合牵引治疗神经根型颈椎病的临床观察[J].中国中医骨伤科杂志,2024,32(10):45-49.[doi:10.20085/j.cnki.issn1005-0205.241008]
 WU Ye,ZHENG Mengmeng,LI Huan.Clinical Observation of Neural Mobilization Combined with Traction on the Treatment of Cervical Spondylosis of Nerve Root Type[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2024,32(10):45-49.[doi:10.20085/j.cnki.issn1005-0205.241008]
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神经松动术结合牵引治疗神经根型颈椎病的临床观察()
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《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:
45-49
栏目:
临床研究
出版日期:
2024-10-15

文章信息/Info

Title:
Clinical Observation of Neural Mobilization Combined with Traction on the Treatment of Cervical Spondylosis of Nerve Root Type
文章编号:
1005-0205(2024)10-0045-05
作者:
吴烨1郑蒙蒙2李欢1△
1江南大学附属医院(江苏 无锡,214000)
2无锡市中心康复医院
Author(s):
WU Ye1ZHENG Mengmeng2LI Huan1△
1Affiliated Hospital of Jiangnan University,Wuxi 214000,Jiangsu China; 2Wuxi Central Rehabilitation Hospital,Wuxi 214000,Jiangsu China.
关键词:
神经根型颈椎病 徒手神经松动术 颈肩同步牵引 疼痛程度 颈椎功能障碍
Keywords:
cervical spondylosis of nerve root type unarmed neural mobilization neck and shoulder synchronous traction pain degree cervical spine dysfunction
分类号:
R681.5
DOI:
10.20085/j.cnki.issn1005-0205.241008
文献标志码:
A
摘要:
目的:探讨徒手神经松动术结合颈肩同步牵引对神经根型颈椎病患者的有效性及安全性。方法:选取神经根型颈椎病患者122例,采用随机数字表法随机分为牵引组(61例,仅接受颈肩同步牵引)和联合组(61例,在牵引基础上加徒手神经松动术)。评估两组患者治疗前后的颈椎功能、疼痛程度、炎症指标、生活质量及复发情况。结果:治疗后联合组的右侧屈、右旋转、左侧屈、左旋转角度均高于牵引组,差异有统计学意义(P<0.05); 联合组的血浆黏度、全血低切黏度、全血高切黏度、颈痛量表(NPQ)评分、颈椎功能障碍指数(NDI)评分均低于牵引组,差异有统计学意义(P<0.05)。炎症指标方面,联合组IL-1β、TNF-α、IL-6和PGE2水平均低于牵引组; 联合组世界卫生组织生存质量测定问卷(WHOQOL-BREF)各维度评分高于牵引组(P<0.05)。联合组复发率显著低于牵引组,差异有统计学意义(χ2=3.921,P=0.048)。结论:徒手神经松动术结合颈肩同步牵引可以降低疼痛程度,改善颈椎功能障碍,优化血液流变和炎症指标,从而提高患者的生活质量,治疗安全,适合临床应用。
Abstract:
Objective:This study was to explore unarmed neural mobilization combined with neck and shoulder synchronous traction in patients with cervical spondylosis of nerve root type efficacy and safety.Methods:A total of 122 patients with cervical spondylosis radiculopathy were randomly divided into traction group(61 cases)and combined group(61 cases).Evaluation of two groups of patients before and after treatment of cervical spine function and the degree of pain,inflammation index,the quality of life,and relapse.Results:After treatment,the angles of right flexion,right rotation,left flexion,and left rotation in the combined group were higher than those in the traction group(P<0.05).The plasma viscosity,whole blood low-shear viscosity,whole blood high-shear viscosity,Neck Pain Questionnaire(NPQ)and Neck Disability Index(NDI)scores in the combined group were lower than those in the traction group(P<0.05).Inflammatory indicators,the combined group of IL-1β,TNF-α,IL-6 and PGE2 levels are lower than traction group,combined group WHOQOL-BREF each dimension score higher than traction group(P<0.05).The recurrence rate of the combined group was significantly lower than that of the traction group(χ2=3.921,P=0.048).Conclusion:Manual nerve mobilization combined with neck and shoulder synchronous traction can effectively reduce the degree of pain,improve cervical spine dysfunction,optimize blood rheology and inflammatory indicators,so as to improve the quality of life of patients,treatment safety,suitable for clinical application.

参考文献/References:

[1] 周新,王越,曹禹,等.双手掌温差与神经根型颈椎病颈椎功能障碍指数相关性研究[J].中国中医骨伤科杂志,2023,31(3):48-54.
[2] ZHOU Y,WANG B,PEI Z,et al.Facet tropism:association between cervical disc degeneration and cervical spondylotic radiculopathy in middle-aged patients[J].Journal of Clinical Neuroscience,2022,99:89-93.
[3] 梁鲁波,左小庭,莫昊风,等.徒手神经松动术结合悬吊训练技术治疗神经根型颈椎病的疗效观察[J].颈腰痛杂志,2021,42(6):881-883.
[4] 尤阳,孔胜建.温针灸联合颈肩同步牵引治疗神经根型颈椎病的临床研究[J].颈腰痛杂志,2022,43(3):461-462.
[5] 中华外科杂志编辑部.颈椎病的分型、诊断及非手术治疗专家共识(2018)[J].中华外科杂志,2018,56(6):401-402.
[6] LEAK A M,COOPER J,DYER S,et al.The Northwick Park neck pain questionnaire,devised to measure neck pain and disability[J].Rheumatology,1994,33(5):469-474.
[7] VERNON H,MIOR S.The neck disability index:a study of reliability and validity[J].Journal of Manipulative and Physiological Therapeutics,1991,14(7):409-415.
[8] TASO M,SOMMERNES J H,BJORLAND S,et al.What is success of treatment? Expected outcome scores in cervical radiculopathy patients were much higher than the previously reported cut-off values for success[J].European Spine Journal,2022,31(10):2761-2768.
[9] 李辉,赵永利,李建国,等.谢兴文主任医师治疗神经根型颈椎病经验总结[J].中国中医骨伤科杂志,2023,31(4):80-81.
[10] LIU T,TIAN S,ZHANG J,et al.Comparison of cervical sagittal parameters among patients with neck pain and patients with cervical spondylotic radiculopathy and cervical spondylotic myelopathy[J].Orthopaedic Surgery,2024,16(2):329-336.
[11] AROOB A,ZAHOOR I A,GHAFFAR M,et al.Comparison of the effectiveness of maitland manipulation of thoracic spine versus grade Ⅰ and Ⅱ maitland mobilization of cervical spine on pain intensity and functional status in patients of cervical radiculopathy:cervical spine on pain intensity and functional status in patients of cervical radiculopathy[J].Pakistan BioMedical Journal,2022,22(3):134-138.
[12] RHAJIBM A N,ISLAM M D W,HOSSAIN M D Z,et al.Evidence based physiotherapy management of a cervical radiculopathy patient by using clinical reasoning process[J].Journal of Spine Research and Surgery,2022,4(2):54-62.
[13] 杨奕,卢姗.神经根型颈椎病患者术后康复的影响因素及路径分析[J].河北医药,2023,45(15):2372-2375.
[14] GHAZANFAR M,AHMAD J,RAFIQ S,et al.Comparative effects of manual cervical traction and natural apophyseal glides on pain and disability among patients with cervical radiculopathy:manual cervical traction and natural apophyseal glides on pain and disability in cervical radiculopathy[J].Pakistan BioMedical Journal,2022,22(2):56-61.
[15] 杨润葆.颈肩牵引联合手法治疗神经根型颈椎病的疗效分析[J].颈腰痛杂志,2019,40(3):419-420.
[16] YUN Y H,LEE B K,YI J H,et al.Effect of nerve mobilization with intermittent cervical segment traction on pain,range of motion,endurance,and disability of cervical radiculopathy[J].Physical Therapy Rehabilitation Science,2020,9(3):149-154.
[17] NUGRAHA M H S,KINANDANA G P.The addition of bilateral neurodynamics in ultrasound therapy and manual traction intervention in cervical radiculopathy[J].Jurnal Keterapian Fisik,2022,7(1):70-79.
[18] 董春力,赵元廷,曹毅,等.芍药甘草汤联合神经松动术治疗腰椎间盘突出症合并坐骨神经痛疗效研究[J].陕西中医,2023,44(9):1245-1247.
[19] TAHIR S,RANA A A,GHAFFAR N,et al.Effect of cervical traction verses strengthening exercises in patients of cervical radiculopathy[J].Pakistan Journal of Medical & Health Sciences,2022,16(4):186-186.
[20] 宋磊,杜仁仁,蔡珍珍,等.肌内效贴联合神经松动术治疗卒中后偏瘫肩痛患者的疗效观察[J].中华物理医学与康复杂志,2022,44(6):527-529.

备注/Memo

备注/Memo:
基金项目:江苏省科研与实践创新计划项目(KYCX21_3107)
通信作者 E-mail:657645071@qq.com
更新日期/Last Update: 2024-10-05