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目的:评价经络点穴推拿手法联合曲度牵引对交感神经型颈椎病临床疗效及对心率变异分析、去甲肾上腺素浓度的影响。方法:80例交感神经型颈椎病患者随机分为治疗组和对照组,每组各40例。两组均在曲度牵引治疗的基础上给予推拿治疗。其中治疗组应用经络点穴推拿手法治疗,对照组给予常规推拿治疗,1次/d,连续治疗2周。分别于治疗前后采用VAS、NRS、"20分评分法"、NDI、JOA和Borden氏法对两组治疗前后的疼痛、交感神经症状和颈椎功能进行评估。同时,观察两组治疗前后RR间期标准差和尿液去甲肾上腺素浓度的变化,并评估其临床疗效。结果:两组治疗后,治疗组治愈率及总有效率优于对照组(P<0.05)。两组治疗后VAS评分、NRS评分、交感神经症状评分、颈椎生理曲度、NDI评分和尿液中去甲肾上腺素浓度与本组治疗前比较均明显降低,JOA评分和心率变异SDNN值和治疗前相比均明显升高,差异均具有统计学意义(P<0.01),其中两组治疗后组间比较,治疗组均明显优于对照组(P<0.01)。结论:经络点穴推拿手法联合曲度牵引对于交感神经型颈椎病临床疗效明显,值得进一步推广运用。
Abstract:Objective: To evaluate the clinical effect of meridian acupoint massage combined with curvature traction on sympathetic cervical spondylosis its effect on heart rate variability and norepinephrine concentration. Methods: Totally 80 patients with sympathetic cervical spondylosis were divided into the treatment group and control group randomly, with 40 patients in each group. Patients in the two groups were treated with massage on the basis of curvature traction. Among them, the treatment group was treated with meridian acupoint massage, while the control group was treated with routine massage. Each subject was treated once a day for 2 weeks. Before and after treatment, VAS, NRS, "20 score method", NDI, JOA, and Borden's method were used to evaluate the pain, sympathetic symptoms and cervical function of the two groups. At the same time, the changes of RR interval standard deviation and urine noradrenaline concentration were also observed. Finally the clinical efficacy of the two groups were evaluated; Results: The cure rate of the treatment group was 62.50%, while it was 40.00% in the control group, and the effective rate of the treatment group was 95.00%, the total effective rate of the control group was 80.00%, the treatment group was superior to the control group in both cure rate and total effective rate(P<0.05). During post-therapy, VAS score, NRS score, sympathetic symptom score, cervical physiological curvature, NDI score, and noradrenaline concentration in urine in both groups were lower than those of pre-treatment(P<0.01), JOA score and heart rate variability SDNN value were significantly higher(P<0.01), and the treatment group was superior to the control group(P<0.01). Conclusion:Meridian acupoint massage combined with curvature traction has a significant clinical effect on sympathetic cervical spondylosis, which is worth further promotion and application
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基本信息:
DOI:10.13210/j.cnki.jhmu.20200714.002
中图分类号:R246.9
引用信息:
[1]谭曾德,王军,宋仲涛,等.经络点穴推拿联合曲度牵引对交感神经型颈椎病临床疗效的观察[J].海南医学院学报,2020,26(14):1098-1104.DOI:10.13210/j.cnki.jhmu.20200714.002.
基金信息:
国家中医药管理局科研基金; 黑龙江省中医药科研项目(其他)~~
2020-07-14
2020-07-14
2020-07-14