[1]邓真,元唯安,商海滨,等.定位定向旋扳法治疗寰枢关节骨错缝的长期疗效观察[J].中国中医骨伤科杂志,2025,33(03):24-30.[doi:1005-0205(2025)03-0024-07]
　DENG Zhen,YUAN Weian,SHANG Haibin,et al.Clinical Long-Term Efficacy Observation of Fixed-Point and Direction Rotational Manipulation in the Treatment of Atlantoaxial Joint Subluxation[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2025,33(03):24-30.[doi:1005-0205(2025)03-0024-07]
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定位定向旋扳法治疗寰枢关节骨错缝的长期疗效观察()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第33卷
期数:
2025年03期
页码:
24-30
栏目:
临床研究
出版日期:
2025-03-15

文章信息/Info

Title:
Clinical Long-Term Efficacy Observation of Fixed-Point and Direction Rotational Manipulation in the Treatment of Atlantoaxial Joint Subluxation
文章编号:
10.20085/j.cnki.issn1005-0205.250305
作者:
邓真1; 2;  元唯安2; 3;  商海滨1;  艾有利1;  沈知彼2; 3;  詹红生2; 3△;  李国中1△
1上海市宝山区中西医结合医院/上海中医药大学附属宝山医院(上海,201999)
2詹红生全国名老中医药专家传承工作室
3上海中医药大学附属曙光医院
Author(s):
DENG Zhen1; 2 ;  YUAN Weian2; 3;  SHANG Haibin1;  AI Youli1;  SHEN Zhibi2; 3;  ZHAN Hongsheng2; 3△;  LI Guozhong1△
1Shanghai Baoshan Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 201999,China; 2Zhan Hongsheng National Famous Traditional Chinese Medicine Expert Inheritance Studio,Shanghai 201203,China; 3Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China.
关键词:
定位定向旋扳法;  寰枢关节;  骨错缝;  手法医学
Keywords:
fixed-point and direction rotational manipulation;  atlantoaxial joint;  joint subluxation;  manual medicine
分类号:
R681.5
DOI:
1005-0205(2025)03-0024-07
文献标志码:
A
摘要:
目的:观察采用定位定向旋扳法治疗寰枢关节骨错缝的长期临床疗效。方法:将符合纳入标准的80例患者通过随机数字表法分为观察组和对照组,每组40例。观察组患者采用定位定向旋扳法治疗,对照组患者采用常规旋扳法治疗。两组患者治疗的频率均为每周2次,疗程为4周。在治疗前、治疗第4周及治疗后第8周、第12周、第16周、第20周、第24周随访时,对患者进行颈痛VAS评分、眩晕VSS-C评分、颈椎CT、颈椎活动度评估和测量,在治疗前、治疗后及各随访时间点观察并比较两组患者治疗的临床疗效。结果:治疗4周后,观察组有效率为91.89%,第24周随访时总有效率为81.08%,复发率为8.11%; 对照组治疗4周后有效率为88.89%,第24周随访时总有效率为58.33%,复发率为25.00%; 观察组疗效优于对照组,复发率低于对照组,差异有统计学意义(P<0.05)。治疗后,两组患者的VAS评分均低于治疗前,且观察组VAS评分显著低于对照组,差异有统计学意义(P<0.05); 在各随访时间点,两组患者的VAS评分均低于治疗前,但组间差异无统计学意义(P>0.05)。两组患者的VSS-C评分比较,治疗后均低于治疗前,差异有统计学意义(P<0.05),但组间差异无统计学意义(P>0.05); 在各随访时间点,观察组VSS-C评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后及各随访时间点,观察组患者的寰椎侧块偏离和枢椎棘突偏离得到明显改善,差异有统计学意义(P<0.05); 而对照组患者的影像学检查结果无明显变化,差异无统计学意义(P>0.05)。两组患者的颈椎旋转活动度在治疗后及各随访时间点均优于治疗前,差异有统计学意义(P<0.05); 而且观察组患者颈椎旋转活动度显著大于对照组,差异有统计学意义(P<0.05)。结论:定位定向旋扳法可以明显改善寰枢关节骨错缝患者的疼痛、眩晕临床症状及影像学指征,提高颈椎旋转功能,其疗效优于常规旋扳法,且能为患者带来长期、稳定的临床疗效。
Abstract:
Objective:To observe long-term clinical efficacy of the fixed-point and direction rotational manipulation in treating patients with atlantoaxial joint subluxation.Methods:A total of 80 subjects who met the inclusion criteria were randomly assigned to either the observation group or the control group,40 cases in each group.The observation group underwent treatment using the fixed-point and direction rotational manipulation,while the control group received treatment using the rotational manipulation.Both groups received treatment twice a week for a period of 4 weeks.Prior to treatment,and at four-week intervals thereafter,patients were evaluated and measured using visual analogue scale(VAS),visual analogue scale for cervical spine(VSS-C),cervical spine computed tomography(CT),and cervical spine mobility.The clinical efficacy of the subjects in the two groups was observed and compared at the 16th,20th,and 24th week of follow-up,as well as before treatment,after treatment,and at each follow-up node.Results:The effective rate of the observation group was 91.89% after 4 weeks of treatment,and its total effective rate was 81.08% with a recurrence rate of 8.11% at 24 weeks of follow-up,while the effective rate of the control group was 88.89% after 4 weeks of treatment,and its total effective rate was 58.33% with a recurrence rate of 25.00% at 24 weeks of follow-up,and the efficacy of the treatment in the observation group was better than that in the control group(P<0.05),and the recurrence rate was lower than that in the control group(P<0.05).After treatment,the VAS scores of patients in both groups were lower than before treatment,and the VAS scores of the observation group were significantly lower than those of the control group(P<0.05),and the VAS scores of the two groups were lower than those before treatment in each follow-up window,but the difference between the two groups was not statistically significant(P>0.05).After treatment,the VSS-C scores of patients in both groups were lower than those before treatment(P<0.05),but the difference between the two groups was not statistically significant(P<0.05).However,the difference between the groups was not statistically significant(P>0.05),and in the follow-up window,the VSS-C scores of the observation group were significantly lower than those of the control group(P<0.05).After treatment and during the follow-up period,the atlantoaxial lateral block deviation and pivot spinous process deviation of the patients in the observation group were significantly improved(P<0.05),whereas there was no significant change in the imaging of the patients in the control group(P>0.05).After treatment and during the follow-up period,the cervical rotation of the patients in the two groups was significantly reduced(P>0.05).The cervical rotational mobility of patients in both groups was better than that before treatment(P<0.05),but the cervical rotational mobility of patients in the observation group was significantly greater than that of the control group(P<0.05).Conclusion:The fixed-point and direction rotational manipulation can significantly improve the clinical symptoms of pain and dizziness in patients with atlantoaxial joint misalignment,imaging indications,and improve the cervical spine rotational function,and its therapeutic efficacy is better than rotational manipulation,and it can bring long-term and stable clinical efficacy to the patients.

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备注/Memo

备注/Memo:
基金项目:上海市卫生健康委员会临床行业专项面上项目(202240188,201840004)
国家自然科学基金项目(81804114,82374481)
上海市宝山区三江英才青年项目上海市科技创新行动计划启明星扬帆专项(22YF1431900)
上海高水平地方高校创新团队项目(慢性筋骨病损研究与转化)詹红生全国名老中医药专家传承工作室建设项目(国中医药人教函〔2022〕75号)
上海市中医药三年行动计划项目(ZY(2021-2023)-0211)
上海市东方英才计划青年项目(QNWS2024016)
上海中医药大学附属医院“临床研究型骨干人才培养计划”项目(20)
△通信作者 E-mail:zhanhongsheng2010@163.com(詹红生)
15000822918@163.com(李国中)
更新日期/Last Update: 2025-03-10