不同手法及牵引中药组合治疗寰枢节段不稳症疗效观察.docVIP

不同手法及牵引中药组合治疗寰枢节段不稳症疗效观察 　【摘要】 目的 观察不同手法与牵引中药组合治疗寰枢节段不稳症的临床疗效。方法 将126例寰枢节段不稳症患者随机分为2组。治疗组63例采用正骨手法与牵引中药组合治疗方案，对照组63例采用理筋手法与牵引中药组合治疗方案。2组均20日为1个疗程，1个疗程后统计疗效。结果 治疗组和对照组治疗效果优良率分别为87.3%、85.7%，总有效率分别为96.8%、95.2%，2组比较差异均无统计学意义（Pgt;0.05）。结论 正骨手法或理筋手法与牵引中药组合治疗寰枢节段不稳症均有较好临床效果。对于寰枢节段不稳症之寰枢椎解剖移位，不必过于强调正骨复位操作，通过理筋手法配合牵引、中药内服，大部分病例可获得满意纠正。 【关键词】 颈椎节段性不稳；推拿；牵引术 　　【Abstract】 Objective To observe the therapeutic effect of different manoeuvres combined with traction and TCM onatlanto-axial joint unstable syndrome. Methods 126 patients with onatlanto-axial joint unstable syndrome were randomly divided into two groups. 63 patients in treatment group were treated by bone-setting manipulation combined with traction and TCM; 63 patients in control group were treated by manipulation for soothing the injured soft tissues combined with traction and TCM, with a treatment course of one month for both groups. The therapeutic effects were observed after one treatment course. Results The effective rate in treatment group and control group was 87.3% and 85.7% respectively，and the total effective rate was 96.8% and 95.2% respectively. There was no significant difference between two groups(Pgt;0.05). Conclusion Both methods have good therapeutic effects on onatlanto-axial joint unstable syndrome. It is not necessary to be emphasized too much on bone-setting manipulation, the manipulation for soothing the injured soft tissues combined with traction and TCM can also get good efficacy in most cases. 　　【Key words】 Cervical spine segmental unstable; Pulling manipulation; Traction 　　颈椎节段性不稳是指参与颈部功能活动的诸肌群中，某块或某组肌肉由于损害性病变引起肌痉挛，必然会使颈椎及其连结组织失去正常的力学平衡，处于失稳状态。不同收缩功能的颈部肌群发生痉挛后将引起不同颈椎节段的不稳［1］。颈椎寰枢节段不稳是颈椎节段性不稳较常见的一个类型。临床实践表明手法与牵引中药组合治疗本病有较好效果。1995-10—2007-03，笔者对不同手法与牵引中药组合治疗寰枢节段不稳症进行了系统观察，现报告如下。 　　1 资料与方法 　　1.1 一般资料 126例均为本院颈腰痛门诊及住院患者，随机分为2组。治疗组63例，男29例，女34例；年龄13～76岁，平均（39.58±11.72）岁；病程最短1个月，最长15年，平均(22.24±13.38)个月。对照组63例，男28例，女35例；年龄15～75岁，平均(38.82±9.24)岁；病程最短1.5个月，最长13年，平均(20.96±12.65)个月。2组病例主要症状、体征见表1、2。全