康复结合颈椎操联合颈复康颗粒治疗颈椎病随机平行对照研究
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摘要
[目的]观察康复结合颈椎操联合颈复康颗粒治疗颈椎病疗效。[方法]使用随机平行对照方法,将90例门诊患者按就诊顺序号抽签方法随机分为两组。对照组45例颈复康颗粒,1～2袋/次,2次/d,饭后冲服。治疗组45例中医康复疗法,按压大椎、风池、风府、曲池、外关、合谷,以拇指指肚按压,力度以患者能接受为宜,每次每穴5min,在颈部寻找压痛点(阿是穴)、硬结点、肌肉绷紧处,进行揉按,每次每位置5min;颈椎操,(1)颈部:头向前、后各倾10次,每次停留2s;左、右各转头90°10次,每次停留2s,然后缓慢摇头,左右各10次;(2)肩部:双手置于两侧肩部,手心向下,双臂由后向前旋转20次,再右前向后旋转20次,旋转幅度以患者能耐受为宜;(3)头手相抗:双手交叉贴于颈后,头颈向后用力,双手向前用力,5次;(4)仰头望掌,双手举过头顶,手指交叉,掌心向上,仰头起看向手背,5s。上述动作可每天进行数次;颈复康治疗同对照组。连续治疗15d为1疗程。观测临床表现、VAS评分、颈椎病治疗评分表、不良反应。连续治疗3疗程(45d),判定疗效。[结果]治疗组临床痊愈25例,显效10例,有效7例,无效3例,总有效率93.33%;对照组临床痊愈18例,显效8例,有效8例,无效11例,总有效率75.56%;治疗组疗效优于对照组(P<0.05)。VSA评分、颈椎病治疗成绩评分表两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01)。[结论]康复结合颈椎操联合颈复康颗粒治疗颈椎病,疗效满意,无严重不良反应,值得推广。
[Objective] To observe the therapeutic effect of rehabilitation combined with cervical spondylotomy and cervical rehabilitation on cervical spondylotic disease. [Method] Using the randomized parallel control method, 90 outpatients were randomly divided into two groups according to the order number method. In the control group, 45 cases of cervical fukang granules, 1 to 2 bags/times, 2 times/d, were flushed after meal. In the treatment group, 45 cases of traditional Chinese medicine rehabilitation therapy were pressed on the large vertebrae, wind pools, Fengfu, Quchi, Waiguan, and Hegu. The pressure was pressed with the thumb and the belly. It was appropriate for the patient to accept it. Each point was 5 min. In the neck, look for pressure points(A Shi points), hard points, muscle tendons, and kneading, 5 min per position at a time; Cervical vertebrae, 1 neck: head forward, back 10 times, each stay 2 S; Left and right each turn 90°10 times, each stop2 s, and then slowly shake his head, left and right 10 times; 2 Shoulders: Hands on both sides of the shoulders,palms down, arms rotating 20 times from back to front, and then right to back 20 times. The rotation range is appropriate for patients to tolerate; 3 Head hand resistance: hands crossed behind the neck, head and neck backward force, hands forward force, 5 times; 4 Looking up at the Palm, hands over the top of the head, fingers crossed, palms up, head up to the back of the hand, 5 s. The above actions can be performed several times a day; Cervical rehabilitation treatment in control group. Continuous treatment 15 d is 1 course. Observation clinical manifestation, VAS score, cervical spondylosis treatment score scale, adverse reactions. Consecutive treatment 3 courses(45 d), determine the effect. [Results] In the treatment group, 25 cases were clinically cured, 10 cases were effective, 7 cases were effective, 3 cases were ineffective, and the total effective rate was93.33 %; In the control group, 18 cases were clinically cured, 8 cases were effective, 8 cases were effective, 11 cases were invalid, and the total effective rate was 75.56 %; The curative effect of treatment group was better than that of control group(P<0.05). VSA score and cervical spondylotic treatment score score were improved in both groups(P<0.01), and the treatment group improved better than the control group(P<0.01). [Conclusion]Rehabilitation combined with cervical spondylotomy combined with cervical rehabilitation treatment of cervical spondylotic disease, satisfactory efficacy, no serious adverse reactions, worthy of promotion.
[Objective] To observe the therapeutic effect of rehabilitation combined with cervical spondylotomy and cervical rehabilitation on cervical spondylotic disease. [Method] Using the randomized parallel control method, 90 outpatients were randomly divided into two groups according to the order number method. In the control group, 45 cases of cervical fukang granules, 1 to 2 bags/times, 2 times/d, were flushed after meal. In the treatment group, 45 cases of traditional Chinese medicine rehabilitation therapy were pressed on the large vertebrae, wind pools, Fengfu, Quchi, Waiguan, and Hegu. The pressure was pressed with the thumb and the belly. It was appropriate for the patient to accept it. Each point was 5 min. In the neck, look for pressure points(A Shi points), hard points, muscle tendons, and kneading, 5 min per position at a time; Cervical vertebrae, 1 neck: head forward, back 10 times, each stay 2 S; Left and right each turn 90°10 times, each stop2 s, and then slowly shake his head, left and right 10 times; 2 Shoulders: Hands on both sides of the shoulders,palms down, arms rotating 20 times from back to front, and then right to back 20 times. The rotation range is appropriate for patients to tolerate; 3 Head hand resistance: hands crossed behind the neck, head and neck backward force, hands forward force, 5 times; 4 Looking up at the Palm, hands over the top of the head, fingers crossed, palms up, head up to the back of the hand, 5 s. The above actions can be performed several times a day; Cervical rehabilitation treatment in control group. Continuous treatment 15 d is 1 course. Observation clinical manifestation, VAS score, cervical spondylosis treatment score scale, adverse reactions. Consecutive treatment 3 courses(45 d), determine the effect. [Results] In the treatment group, 25 cases were clinically cured, 10 cases were effective, 7 cases were effective, 3 cases were ineffective, and the total effective rate was93.33 %; In the control group, 18 cases were clinically cured, 8 cases were effective, 8 cases were effective, 11 cases were invalid, and the total effective rate was 75.56 %; The curative effect of treatment group was better than that of control group(P<0.05). VSA score and cervical spondylotic treatment score score were improved in both groups(P<0.01), and the treatment group improved better than the control group(P<0.01). [Conclusion]Rehabilitation combined with cervical spondylotomy combined with cervical rehabilitation treatment of cervical spondylotic disease, satisfactory efficacy, no serious adverse reactions, worthy of promotion.
引文
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[14]栾国瑞,陈朝晖,时威,等.简易颈椎操对颈椎活动度和疼痛改善作?用的效果观察[J].中医药临床杂志,2014,26(5):488-489.
[2]中华人民共和国卫生部.涉及人的生物医学研究伦理审查办法(试行)[S].(2007-03-26)[2017-01-01].?http://www.moh.gov.cn/qjjys/s3581/200804/b9f1bfee4ab344ec892e68097296e2a8.shtml.
[3]刘秀芹.X线检查在颈椎病诊断上的意义[J].中国骨伤,2003,16?(10):627-628.
[4]王晓红,何成奇,丁明甫,等.颈椎病治疗成绩评分表[J].华西医学,?2005,20(2):232-233.
[5]国家中医药管理局.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:346-348.
[6]罗晓,刘康,杨维新.某医院2014-2016年颈椎病住院患者流行病学现状分析[J].解放军预防医学杂志,2018,36(1):124-126.
[7]圣磊,朱龙飞.颈椎病年轻化趋势的调查及X线表现[J].中外医学研究,2012,10(3):60-61.
[8]姜淑云,房敏,左亚忠,等.颈部肌群与颈椎病[J].颈腰痛杂志,2006,?27(3):235-238.
[9]王冰,段义萍,张友常,等.颈椎病患病特征的流行病学研究[J].中南大学学报(医学版),2004,29(4):472-474.
[10]计福全,刘书堂.新一代颈复康制剂--颈复康颗粒剂[J].中草药,?2000,31(8):附16-附17.
[11]高学敏.中药学[M].北京:中国中医药出版社,2007.
[12]严广斌.视觉模拟评分法[J].中华关节外科杂志(电子版),2014(2):?34.
[13]国家中医药管理局.经穴部位文献考与解剖[M].北京:中国中医药?出版社,1992.
[14]栾国瑞,陈朝晖,时威,等.简易颈椎操对颈椎活动度和疼痛改善作?用的效果观察[J].中医药临床杂志,2014,26(5):488-489.