本文選題：神經(jīng)根型頸椎 + 鈹針�。� 參考：《廣州中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:神經(jīng)根型頸椎病為頸椎病分型中的一種,是臨床上較常見(jiàn)、較多發(fā)、纏綿難愈的頸椎退行性疾病。近些年神經(jīng)根型頸椎病的發(fā)病率呈增長(zhǎng)、低齡化趨勢(shì),已成為嚴(yán)重危害人們健康妨礙生活的常見(jiàn)疾病之一。本研究探討鈹針結(jié)合旋提手法治CSR作用機(jī)理及可行性,對(duì)比頸椎坐位牽引配合頸托制動(dòng)治療方法,觀察對(duì)神經(jīng)根型頸椎病患者疼痛及癥狀體征改善的臨床治療效果,為中醫(yī)保守治療方式提供更多的參考和選擇。方法:本研究收集于2016年1月-2017年1月在廣東省中醫(yī)院骨科門診、病房及大學(xué)城醫(yī)院理療科就診的神經(jīng)根型頸椎病患者60例。采用隨機(jī)分組對(duì)照法分為治療組和對(duì)照組各30例。治療組采用鈹針結(jié)合旋提手法治療;對(duì)照組采用坐位牽引配合頸托保護(hù)治療。采用VAS疼痛評(píng)分和SamPath,PrakashMD神經(jīng)根型頸椎病癥體征評(píng)分表及《中醫(yī)病證診斷療效標(biāo)準(zhǔn)》評(píng)定標(biāo)準(zhǔn)來(lái)評(píng)定治療效果,采用SPSS21.0軟件對(duì)各組評(píng)分?jǐn)?shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析并得出結(jié)論。結(jié)果:1.分別比較兩組患者年齡、性別、病程長(zhǎng)短,通過(guò)統(tǒng)計(jì)學(xué)軟件處理數(shù)據(jù)得出兩組基線無(wú)明顯統(tǒng)計(jì)學(xué)差異(P0.05)具有可比性。2.VAS、神經(jīng)根型頸椎病癥狀體征評(píng)分結(jié)果:治療前各組VAS、癥狀體征評(píng)分?jǐn)?shù)據(jù)無(wú)統(tǒng)計(jì)學(xué)差異(P0.05),具有可比性;治療后第1周、第2周得出評(píng)分?jǐn)?shù)據(jù)均較治療前有所下降,兩組組內(nèi)評(píng)分分別兩兩對(duì)比具有統(tǒng)計(jì)學(xué)差異(P0.05),說(shuō)明各組治療方法均能緩解CSR臨床癥狀;將各組治療后(第1周、第2周)VAS、癥狀體征評(píng)分以及各組治療前后評(píng)分差值進(jìn)行組間對(duì)比,結(jié)果均具有統(tǒng)計(jì)學(xué)意義(P0.05),進(jìn)一步說(shuō)明鈹針結(jié)合旋提手法組療效優(yōu)于牽引配合頸托制動(dòng)組。3.治療組30例病例中治愈6例,顯效16,有效4例,無(wú)效4例;對(duì)照組30例病例中治愈4例,顯效15例,有效5例,無(wú)效6例。兩組療效方面經(jīng)過(guò)統(tǒng)計(jì)學(xué)計(jì)算并無(wú)明顯統(tǒng)計(jì)學(xué)差異(P0.05),但治療組有效率86.7%高于對(duì)照組有效率80.0%。結(jié)論:1.鈹針結(jié)合旋提手法治療神經(jīng)根型頸椎病療效確切、穩(wěn)定,體現(xiàn)了中醫(yī)骨傷科"筋骨并重"的治療理念,發(fā)揮了中醫(yī)保守治療的優(yōu)勢(shì)。2.采用鈹針配合旋提手法治療使患者頸肩臂疼痛癥狀得到明顯緩解,生活質(zhì)量大大提高。本方法操作簡(jiǎn)便,適合臨床推廣運(yùn)用。
[Abstract]:Objective: cervical Spondylotic radiculopathy is one of the cervical spondylopathy types, is a common clinical, more frequent, difficult to recover the cervical spine degenerative disease. In recent years, the incidence of cervical spondylopathy of nerve root type is increasing, and the trend of younger age has become one of the common diseases that seriously endanger people's health and hinder their life. The aim of this study was to investigate the mechanism and feasibility of beryllium needle combined with rotary handle CSR, and to compare the treatment of cervical traction with cervical immobilization, and to observe the effect of clinical treatment on the improvement of pain, symptoms and signs in patients with cervical spondylosis of nerve root type. To provide more reference and choice for conservative treatment of traditional Chinese medicine. Methods: from January 2016 to January 2017, 60 patients with cervical spondylopathy of nerve root type were collected from orthopedic outpatient department, ward of Guangdong traditional Chinese medicine hospital and physiotherapy department of university city hospital. The treatment group and the control group were randomly divided into two groups: 30 cases in the treatment group and 30 cases in the control group. The treatment group was treated by beryllium needle combined with rotary handle, while the control group was treated by sitting traction combined with neck protection. VAS pain score, SamPathan PrakashMD nerve root type cervical spondylopathy score scale and traditional Chinese medicine syndrome diagnosis criteria were used to evaluate the therapeutic effect. SPSS21.0 software was used to statistically analyze the score data of each group and draw a conclusion. The result is 1: 1. Age, sex, duration of disease were compared between the two groups. The statistical software processing data showed that there was no significant statistical difference between the two groups (P0.05). 2.VAS. the scores of symptoms and signs of radicular cervical spondylopathy: before treatment, there was no statistical difference in the scores of symptoms and signs between the two groups (P 0.05), which was comparable. In the first week and the second week after treatment, the score data were all lower than those before treatment, and the scores in the two groups were significantly different (P 0.05), which indicated that the treatment methods in each group could alleviate the clinical symptoms of CSR, and the clinical symptoms of CSR could be alleviated in each group (1 week, 1 week after treatment). In the second week, the scores of symptoms and signs and the difference of scores before and after treatment were compared among the groups. The results showed that the effect of beryllium needle combined with spin-lift manipulation group was better than that of traction combined with neck brake group (P 0.05), and the effect of beryllium needle combined with rotary lifting manipulation group was better than that of traction combined with neck brake group. In the treatment group, 6 cases were cured, 16 cases were effective, 4 cases were effective and 4 cases were ineffective, while in the control group, 4 cases were cured, 15 cases were effective, 5 cases were effective, and 6 cases were ineffective. There was no statistical difference in the curative effect between the two groups, but the effective rate in the treatment group was 86.7% higher than that in the control group (80.05%). Conclusion 1. Beryllium needle combined with rotary handle method is effective and stable in the treatment of cervical spondylopathy of nerve root type, which embodies the treatment idea of "both muscles and bones" in orthopedic and trauma department of traditional Chinese medicine, and exerts the advantage of conservative treatment of traditional Chinese medicine. Beryllium needle combined with rotary handle therapy significantly alleviated the pain of neck, shoulder and arm, and improved the quality of life. The method is simple and suitable for clinical application.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R246.9
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本文編號(hào)：1797610