本文選題：椎間盤　切入點(diǎn)：神經(jīng)根型頸椎病　出處：《安徽醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的觀察非手術(shù)脊柱減壓治療系統(tǒng)牽引治療神經(jīng)根型頸椎病的臨床療效,并從神經(jīng)電生理學(xué)和分子生物學(xué)角度探討其作用機(jī)制,為臨床治療神經(jīng)根頸椎病提供實(shí)驗(yàn)依據(jù)。方法采用隨機(jī),對(duì)照,單盲的方法,將符合實(shí)驗(yàn)要求的60例患者分為觀察組和對(duì)照組,每組各30例。觀察組在常規(guī)治療基礎(chǔ)上給予非手術(shù)脊柱減壓系統(tǒng)牽引治療,對(duì)照組同樣在常規(guī)治療基礎(chǔ)上給予傳統(tǒng)的頜枕帶坐位頸椎牽引治療;兩組均治療20次,分4周完成。兩組分別在治療前及治療4周后采用疼痛視覺模擬評(píng)分(VAS)觀察其療效,采用肌電圖儀觀察正中神經(jīng)和尺神經(jīng)的F波傳導(dǎo)速度,采用ELISA法檢測(cè)血清中TNF-α、IL-6的水平,治療結(jié)束后評(píng)價(jià)臨床療效。結(jié)果(1)觀察組和對(duì)照組治療前、后VAS評(píng)分比較:治療前兩組VAS評(píng)分差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),治療后兩組評(píng)分均較治療前降低,且觀察組降低的幅度明顯,與對(duì)照組差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)觀察組和對(duì)照組正中神經(jīng)和尺神經(jīng)F波傳導(dǎo)速度值比較:治療前兩組F波傳導(dǎo)速度差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),兩組治療后F波傳導(dǎo)速度均升高,但觀察組升高更明顯,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(3)觀察組和對(duì)照組治療前、后血清TNF-α、IL-6變化水平:兩組患者治療前TNF-α、IL-6差異統(tǒng)計(jì)學(xué)意義(P0.05),與治療前比較,兩組治療后血清TNF-α、IL-6水平均降低,但觀察組降低更明顯,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(4)觀察組治愈17例、顯效9例、有效3例、無(wú)效1例,總顯效率為86.7%;對(duì)照組分別為11、10、5、4例和70.0%;觀察組總顯效率明顯高于對(duì)照組(P0.05)。結(jié)論非手術(shù)脊柱減壓系統(tǒng)牽引治療神經(jīng)根型頸椎病的效果優(yōu)于普通頜枕帶牽引,減輕炎癥反應(yīng),有效阻斷病變神經(jīng)病程發(fā)展,促進(jìn)受損神經(jīng)修復(fù),改善傳導(dǎo)可能是其作用機(jī)制,非手術(shù)脊柱減壓治療系統(tǒng)安全,舒適,無(wú)創(chuàng),故值得在臨床推廣應(yīng)用。
[Abstract]:Objective to observe the clinical effect of non-operative spinal decompression system traction in the treatment of cervical spondylopathy of nerve root type, and to explore its mechanism from the aspects of neurophysiology and molecular biology. Methods 60 patients with cervical spondylosis were divided into observation group and control group. Each group (30 cases) was treated with non-operative spinal decompression system traction on the basis of routine treatment, while the control group was treated with traditional cervical traction treatment of maxillary occipital and sitting position on the basis of routine treatment, both groups were treated for 20 times. The therapeutic effect was observed by visual analogue pain score (VASS) before treatment and 4 weeks after treatment. The F-wave conduction velocity of median nerve and ulnar nerve was observed by electromyography, and the serum TNF- 偽 IL-6 level was detected by ELISA method. Results: before and after treatment, there was no significant difference in VAS score between the two groups before and after treatment. The scores of the two groups were lower than those before treatment, and the extent of the decrease in the observation group was obvious, and there was no significant difference between the two groups before and after treatment. Comparison of F-wave conduction velocities of median nerve and ulnar nerve between the observation group and the control group: there was no significant difference in F wave conduction velocity between the two groups before and after treatment, and the F wave conduction velocity increased after treatment in both groups. But the increase of TNF- 偽 IL-6 was more obvious in the observation group than that in the control group (P 0.05). The level of serum TNF- 偽 IL-6 in the observation group and the control group before and after treatment was significantly higher than that in the control group (P 0.05). The levels of serum TNF- 偽 IL-6 in the two groups were lower than those in the control group before and after treatment (P < 0.05), and the levels of serum TNF- 偽 IL-6 in the two groups were significantly lower than those in the control group before and after treatment (P < 0.05). In the observation group, 17 cases were cured, 9 cases were effective, 3 cases were effective, and 1 case was ineffective. The total effective rate was 86.7 in the control group and 1110 in 4 cases and 70.0 in the control group, respectively, and the total effective rate in the observation group was significantly higher than that in the control group (P 0.05). Conclusion the effect of non-operative spinal decompression system traction on cervical spondylosis of nerve root type is better than that of common maxillary occipital traction, and the inflammatory reaction is alleviated. It may be the mechanism of blocking the development of pathological neuropathy, promoting the repair of injured nerve and improving the conduction. The non-operative spinal decompression treatment system is safe, comfortable and non-invasive, so it is worth popularizing in clinic.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R681.55

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