林氏正骨推拿治疗青少年颈性眩晕的多中心临床评价研究
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摘要
【目的】评价林氏正骨推拿手法治疗的有效性。【方法】采用前瞻性、多中心、大样本临床对照试验,以颈性眩晕的青少年患者为研究对象,按照简单随机法将180例患者随机分为林氏手法组和常规手法组,每组各90例。林氏手法组给予林氏正骨推拿手法治疗,常规手法组给予常规推拿手法治疗,通过对比两种手法治疗前后患者的眩晕指数评分、风池穴压痛点视觉模拟量表(VAS)评分及影像学表现(椎间隙宽度、棘突位移、生理曲度)的改变,从多方面评价手法治疗的有效性。【结果】(1)治疗后,林氏手法组和常规手法组的总有效率分别为95.56%和85.56%,组间比较(秩和检验)显示林氏手法组的疗效优于常规手法组(P<0.05)。(2)与常规手法组比较,林氏手法组在改善眩晕指数评分、风池穴压痛点VAS评分的效果较好(P<0.05),且在影像学方面纠正椎间隙宽度、棘突位移、生理曲度改变的成功率也较高(P<0.05)。【结论】林氏正骨推拿手法缓解青少年颈性眩晕的症状疗效显著,纠正和改善颈椎影像学错位的成功率高,同时对局部肌肉压痛有一定的缓解作用。
Objective To evaluate the effectiveness of LIN's bone-setting massage manipulations. Methods A prospective,multicenter large-sample controlled trial was carried out in 180 teenagers with cervical vertigo,and the patients were divided into trial group and control group by simple random method,90 cases in each group. The trial group was treated with LIN's bone-setting massage manipulations and the control group was treated with conventional massage manipulations. By observing the vertigo index scores,Visual Analogue Scale(VAS)scores of Fengchi(GB20)tenderness,and vertebral imaging indexes of the width of the intervertebral disc space,the displacement of the spinous process and the change of the physiological curvature,we evaluated the effectiveness of manipulative treatment. Results(1)After treatment,the total effective rate of the trial group was 95.56% and that of the control group was 85.56%, and the results of rank sum test showed that the efficacy of LIN's manipulations was superior to that of the conventional manipulations(P<0.05).(2)Compared with the conventional manipulations, LIN's manipulations had strong effect on improving the vertigo index scores and VAS scores of Fengchi(GB20)tenderness(P<0.05), and had high success rate on correcting the width of the intervertebral disc space,the displacement of the spinous process and the change of the physiological curvature(P < 0.05). Conclusion LIN's bone massage manipulations have significant effects on relieving the symptoms,improving the vertebral imaging indexes,and alleviating local muscle tenderness in teenagers with cervical vertigo.
Objective To evaluate the effectiveness of LIN's bone-setting massage manipulations. Methods A prospective,multicenter large-sample controlled trial was carried out in 180 teenagers with cervical vertigo,and the patients were divided into trial group and control group by simple random method,90 cases in each group. The trial group was treated with LIN's bone-setting massage manipulations and the control group was treated with conventional massage manipulations. By observing the vertigo index scores,Visual Analogue Scale(VAS)scores of Fengchi(GB20)tenderness,and vertebral imaging indexes of the width of the intervertebral disc space,the displacement of the spinous process and the change of the physiological curvature,we evaluated the effectiveness of manipulative treatment. Results(1)After treatment,the total effective rate of the trial group was 95.56% and that of the control group was 85.56%, and the results of rank sum test showed that the efficacy of LIN's manipulations was superior to that of the conventional manipulations(P<0.05).(2)Compared with the conventional manipulations, LIN's manipulations had strong effect on improving the vertigo index scores and VAS scores of Fengchi(GB20)tenderness(P<0.05), and had high success rate on correcting the width of the intervertebral disc space,the displacement of the spinous process and the change of the physiological curvature(P < 0.05). Conclusion LIN's bone massage manipulations have significant effects on relieving the symptoms,improving the vertebral imaging indexes,and alleviating local muscle tenderness in teenagers with cervical vertigo.
引文
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[2]范志勇,李振宝,郭汝松.岭南林氏正骨推拿流派学术渊源、传承脉络及主要学术成就[J].广州中医药大学学报,2016,33(3):440.
[3]中华医学会神经病学分会.眩晕诊治专家共识[J].中华神经科杂志,2010,43(5):369.
[4] Byrne J,Elgohary M,Canas B,et al. ACR-1000 constructability and modularization[C]. International Conference on Nuclear Engineering,2008:907.
[5]王国才.推拿治疗学[M].北京:中国中医药出版社,2007:202.
[6]范志勇,吴山,赖淑华.林氏正骨推拿治疗颈性眩晕所致咔哒声响与即时镇晕疗效的相关性研究[J].新中医,2016,48(1):76.
[7]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:202.
[8]丁原宏.青少年颈性眩晕旋转整骨配合牵引治疗疗效分析[J].当代医学,2009,15(13):69.
[9]戴晓红,张宏伟,陈秋欣,等.头穴丛刺配合颈部中药熏药治疗颈性眩晕临床研究[J].针灸临床杂志,2018,24(4):12.
[10]杜怀斌,董攀,李雪莲.手法为主治疗青少年颈性眩晕90例[J].按摩与导引,2005,11(21):20.
[11]范炳华,王新华,王鹏,等.三部推拿法治疗颈性眩晕120例临床疗效观察[J].浙江中医药大学学报,2011,35(4):581.
[12]曹洁,齐瑞,王辉昊.颈性眩晕病因及发病机制的研究进展[J].河北中医,2016,9(9):1416.